Letter: dietary therapy in eosinophilic oesophagitis – do not test, just eliminate and reintroduce the most common food triggers

Molina–Infante, Javier; Lucendo, Alfredo J.

doi:10.1111/apt.13742

Cited by 5 publications

(8 citation statements)

References 10 publications

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“…22 The effectiveness of a milk elimination diet should be evaluated in well-designed, rigorous, multicenter studies in children and adults. In line with previous studies on SFGED, [12][13][14][15][16][17] we obtained similar results in children and adults with every evaluated dietary intervention.…”

Section: Discussionsupporting

confidence: 92%

“…In the present study a TFGED achieved 43% efficacy and obtained similar results to those previously reported [13][14][15][16][17][18] when patients were stepped up to an FFGED (60%) or SFGED (79%). This step-up strategy, starting with a TFGED, exhibits a relevant number of advantages over beginning with highly restrictive diets (top-down dietary strategies).…”

Section: Discussionsupporting

confidence: 91%

“…As such, a step-up combination of TFGED and FFGED is capable of detecting the vast majority of those potential SFGED responders who had just 1 or 2 food triggers after 6 food challenges, followed by 6 endoscopies. 17 Undoubtedly, these patients with 1 or 2 food triggers are the best candidates for maintenance dietary therapy through long-term avoidance of these few food triggers.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, egg has been reported as the third most common food trigger for EoE, with gluten as the second most common food trigger. 17 Milk, gluten-containing grains, and eggs are staple foods worldwide. In contrast, legumes seem to be common food triggers only in Spanish studies (including the present study), 14,15,18 with a minor role reported in studies conducted in the United States 12,13 and Australia.…”

Section: Discussionmentioning

confidence: 99%

“…It is of note that up to three quarters of responders to an SFGED have been found to have just 1 or 2 food triggers after individual food reintroduction. 17 The most common causative foods identified after a response to an SFGED were cow's milk, wheat, egg, and, to a lesser extent, soy/legumes. In light of these data, a 4-food-group elimination diet (FFGED) was developed.…”

mentioning

confidence: 99%

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Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: The 2-4-6 study

Molina–Infante

Arias

Alcedo

et al. 2018

Journal of Allergy and Clinical Immunology

232

101

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: The 2-4-6 study

Molina–Infante

Arias

Alcedo

et al. 2018

Journal of Allergy and Clinical Immunology

232

101

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Is eosinophilic esophagitis an equivalent of pollen allergic asthma? Analysis of biopsies and therapy guided by component resolved diagnosis

Armentia

Martín-Armentia

Blanca

et al. 2018

Allergologia et Immunopathologia

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Diagnosis, management and therapeutic options for eosinophilic esophagitis

Caminati,

Senna,

Maule

et al. 2024

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review Eosinophilic esophagitis is a chronic and commonly evolving condition leading to relevant and potentially irreversible burden in terms of tissue damage and related functional impairment, thus significantly impacting on quality of life. The aim of the present review is to summarize the recent advances in terms of diagnostic work-up and pharmacological and nonpharmacological management of the disease, under the broader perspective of type 2 inflammation. Recent findings Two major novelties have prompted an innovative approach to EoE. In terms of diagnosis, it has been proposed to dissect the disease heterogeneity in three endotypes, independent from tissue eosinophil number: EoEe1, characterized by normal appearing oesophagus; EoEe2, associated with type 2 inflammation and steroid-refractoriness; EoEe3, whose features include adult onset, a more fibro-stenotic aspect and loss of epithelial gene expression. Concerning treatment, two recently licensed drugs for EoE, oro-dispersible budesonide and dupilumab represent the first treatment options specifically developed for EoE and addressing EoE-related peculiar pathobiological features. Summary In the era of precision medicine, managing EoE according to a phenotype-driven approach might be helpful in defining the best treatment options in the different disease forms or stages. In addition, exploring the coexistence or the previous occurrence of other type 2 conditions may suggest the opportunity to specifically target type 2 inflammation through biologic therapy. The complex EoE pathobiology combining inflammatory and functional features, both at organ and systemic level, requires a multidimensional approach relying on the strict integration of gastroenterologists and allergist-immunologists.

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Letter: dietary therapy in eosinophilic oesophagitis – do not test, just eliminate and reintroduce the most common food triggers

Cited by 5 publications

References 10 publications

Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: The 2-4-6 study

Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: The 2-4-6 study

Is eosinophilic esophagitis an equivalent of pollen allergic asthma? Analysis of biopsies and therapy guided by component resolved diagnosis

Diagnosis, management and therapeutic options for eosinophilic esophagitis

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