Persistent Basal Cell Hyperplasia Is Associated With Clinical and Endoscopic Findings in Patients With Histologically Inactive Eosinophilic Esophagitis

CD73+ Epithelial Progenitor Cells That Contribute to Homeostasis and Renewal Are Depleted in Eosinophilic Esophagitis

“… 2 Histologically, the most conspicuous finding in EoE, in addition to the eosinophilic infiltrate, is basal cell hyperplasia (BCH). 3 , 4 BCH is induced by injury or inflammation and involves an expansion of basal cells (>20% of epithelial height) with limited formation of intercellular bridges, a hallmark of squamous cell differentiation. The EoE transcriptome suggests stalled differentiation of the esophageal epithelium, leading to epithelial barrier defects and ongoing antigen exposure.…”

Advancing patient care through the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR)

“…The development of novel model systems, including organoids and ex vivo functional human mucosal platforms, will hopefully lead to novel ways to study EGIDs. 17…”

EoE disease monitoring

“…Symptomatology and endoscopic findings were found to be more common in those patients with persistent basal cell hyperplasia seen on pathology. 7 Similarly, the presence of dilated intercellular spaces (DIS) has also shown clinical relevance, with a decrease in DIS in patients on therapy. 27 These studies highlight the importance of histologic evaluation that goes beyond eosinophils alone in clinical decision making, and may help guide the clinician when there are fewer than 15 eosinophils per high-powered field but ongoing symptoms.…”

“…3 The current theory is that eosinophilic inflammation in the esophagus over time leads to fibrosis and narrowing of the esophagus, thus, it is hypothesized that many, though likely not all, older patients with increased duration of disease have more sequelae of fibrostenosis. 4 Although EoE is a lifelong disease, 5 therapy has been shown to reduce side effects, improve symptomatic burden, and decrease necessity of esophageal dilation, 6,7 highlighting the importance of understanding disease activity even in the asymptomatic patient. 8e10 To perform this histologic investigation to determine disease activity in EoE, an endoscopy is required to obtain a biopsy of the esophageal mucosa.…”