嗜酸性粒细胞性食管炎:病理生理学、诊断和治疗的最新概念

D. García-Compeán, A.R. Jiménez-Rodríguez, C.E. González-Martínez
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摘要

嗜酸性粒细胞性食管炎(EoE)是一种慢性、免疫介导的疾病,其特征是嗜酸性粒细胞浸润到食管粘膜。它是成人中最常见的吞咽困难和食物嵌塞的原因。由于其病理生理与变应性鼻炎、哮喘、特应性皮炎相似,被认为是变态反应的食道表现。它在美国、欧洲和澳大利亚更为常见。过去三十年来,这些国家的发病率和流行率显著增加,以至于有些人认为这是一种流行病。这种疾病在墨西哥和拉丁美洲很少被诊断出来,在我们这个世界区域,关于这种疾病的信息很少。解释这种低发病率的确切因素尚不清楚。另一方面,近年来,世界其他地区对EoE的研究也非常活跃。其病理生理学已被更好地理解和内镜和临床程序已完善作出诊断。此外,还引进了治疗该病的新药和现有药物的特殊配方。更简单、更有效的饮食治疗策略也得到了评估。目前工作的目的是审查全球和墨西哥的EoE现状,强调影响我国低发病率的可能因素(环境和技术)。此外,我们亦回顾了近年来在不同方面的研究进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Eosinophilic esophagitis: Current concepts of pathophysiology, diagnosis, and treatment
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease characterized by the infiltration of eosinophils into the esophageal mucosa. It is the most frequent cause of dysphagia and food impaction in adults. Due to its similar pathophysiology to allergic rhinitis, asthma, and atopic dermatitis, it has been considered the esophageal manifestation of allergy. It is more frequently seen in the United States, Europe, and Australia. Incidence and prevalence have increased significantly in those countries over the past three decades, to such a degree that some consider it an epidemic. The disease is infrequently diagnosed in Mexico and Latin America, and so little information on this disease is produced in our region of the world. The precise factors explaining this low incidence are unknown.
On the other hand, there has been intense research on EoE in other parts of the world in recent years. Its pathophysiology has been better understood and endoscopic and clinical procedures have been refined for making the diagnosis. In addition, new drugs and special formulations of existing ones have been introduced for treating the disease. Simpler and more effective dietary treatment strategies have also been evaluated.
The aim of the present work was to review the current status of EoE globally and in Mexico, emphasizing the probable factors (environmental and technical) that intervene in the low incidence recorded in our country. In addition, we conducted a review of the advances in research on the different aspects of EoE carried out in recent years.
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