Potential for improving therapy and defining new research targets in eosinophilic oesophagitis based on understanding of immunopathogenesis.

摘要: OBJECTIVES: This review considers the potential for therapeutic advances in management of eosinophilic oesophagitis (EoE) based on recently increased understanding pathophysiology disorder. METHODS: is a publications characterising mucosal changes and leucocyte recruitment patterns human experimental EoE. RESULTS: EoE, although diagnosed by epithelial infiltration eosinophils, actually transmural inflammation which eosinophil occurs via deeper layers. Penetration eosinophils into epithelium variable, explaining need multiple biopsies to diagnose what may be clearly visible Fibrosis neuromuscular dysfunction both occur within subepithelial tissues. Recent murine studies have identified that T-cell underpins antigen-specific oesophageal recruitment. Involvement innate immunity also suggested role invariant natural killer T cells CONCLUSIONS: Looking beyond present options with view future studies, we identify as candidates "upstream therapy" if antigen specificity or homing markers are determined. Evidence aeroallergen sensitisation suggests possibility lymphocyte priming nasal-associated lymphoid tissue Waldeyer ring, topical therapy. We consider acquired target acute symptomatic deterioration bolus obstruction. assess possible similarities stratagems chronic asthma, recognising at same time anatomic oesophagus difficulty delivering effective medication tissues this location compared airway.