Review of eosinophilic oesophagitis in children and young people

Ahmed, Mansoor; Mansoor, Nyaish; Mansoor, Tihami

doi:10.1007/s00431-021-04174-0

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…The cut-off point of 15 eosinophils by CGA has recently shown a sensitivity of 100% and a specificity of 96% in the diagnosis of EoE. 23 However, this threshold can be arbitrary, since the size of an AGC varies between microscope manufacturers and must always be evaluated within the clinical context, especially in those cases with counts compatible with EoE obtained from samples of asymptomatic patients. 17 Once the diagnosis is established, symptoms and the presence or absence of eosinophilic inflammation in the mucosa of the esophagus in response to therapeutic inter-ventions should be monitored.…”

Section: Diagnosismentioning

confidence: 99%

“…Viscous, orodispersible or aerosol formulas are encapsulated within them; but viscose is recommended because of a clinical trial that compared the efficacy of 1mg budesonide administered twice as a viscous solution and achieved up to 64% histological remission compared to 27% aerosol. 23 However, suppression of the pituitary-adrenal axis has been documented in small series of pediatric patients when given prolonged treatment with topical corticosteroids. 25 A reduction in plasma cortisol levels has also been documented (without adrenal insufficiency or impact on growth), so monitoring in the pediatric population is recommended.…”

Section: Topical Corticosteroidsmentioning

confidence: 99%

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The role of dupilumab in diverse allergic pathologies

Zerecero-Morcksharpea,

Reyes Altamirano,

García Vences

2023

psrua

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Allergic responses represent a significant health problem due to the ineffectiveness of current treatments, as they attempt to decrease the immune response triggered but are unable to create immune memory that reduces the intensity of such response, so the intensity of the response will always be the same as the first time. An allergic response is characterized by the exacerbated and prolonged release of immunoglobulin E (IgE) that triggers innate immune responses due to the activation of T lymphocytes towards a Th2 phenotype, responsible for the release of interleukins 3 and 4 (IL-3 and IL-4), and the activation of B lymphocytes towards IgE-producing plasma cells. Currently, monoclonal antibodies (mAbs) are used as treatment for various allergic pathologies as they can be used to inhibit the signaling pathways of various interleukins, inactivating the differentiation of T lymphocytes, B lymphocytes, and the production of IgE. One of the most versatile mAbs in the treatment of various allergic responses is Dupilumab, which is designed to inhibit the signaling chain of IL-3 and IL-4, more specifically, it binds to the α receptor of IL-4 and the cytokine-induced receptor complex IL-13. Dupilumab inhibits IL-4 and IL-13 through receptor 1, stopping the release of IgE and proinflammatory cytokines. This treatment can be used to control the inflammatory response caused by allergens. On the other hand, the use of Dupilumab is not patented as the treatment of choice for allergic pathologies. Therefore, in this review, we compile the results of clinical studies of Dupilumab and other mAbs in atopic dermatitis (AD), eosinophilic esophagitis (EoE), chronic rhinosinusitis with nasal polyps (CRSwNP), and asthma, with the aim of determining which of the mAbs has provided better results.

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Section: Diagnosismentioning

confidence: 99%

Section: Topical Corticosteroidsmentioning

confidence: 99%

The role of dupilumab in diverse allergic pathologies

Zerecero-Morcksharpea,

Reyes Altamirano,

García Vences

2023

psrua

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“…Treatment options encompass elimination diets, proton-pump inhibitors (PPIs), swallowed topical corticosteroids (TCSs), and, if clinically relevant strictures persist despite initial therapies, esophageal dilation. 11 – 16 While broad consensus exists on these initial therapies, some patients do not respond adequately to current treatments. Therefore, there is a need for effective therapies targeting the underlying inflammatory processes to induce and sustain disease remission.…”

Section: Introductionmentioning

confidence: 99%

Eosinophilic esophagitis in adults and adolescents: epidemiology, diagnostic challenges, and management strategies for a type 2 inflammatory disease

Savarino,

Barbara,

Bilò

et al. 2024

Therap Adv Gastroenterol

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Background: Eosinophilic esophagitis (EoE) is recognized as a chronic type 2 inflammatory disease characterized by the eosinophilic infiltration of the esophageal tissue, posing a significant disease burden and highlighting the necessity for novel management strategies to address unmet clinical needs. Objectives: To critically evaluate the existing literature on the epidemiology and management of EoE, identify evidence gaps, and assess the efficacy of current and emerging treatment modalities. Design: An extensive literature review was conducted, focusing on the epidemiological trends, diagnostic challenges, and therapeutic interventions for EoE. This was complemented by a survey among physicians and consultations with a scientific expert panel, including a patient’s association (ESEO Italia), to enrich the study findings. Data sources and methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, scrutinizing epidemiological studies and management research to compile comprehensive insights into the disease’s landscape. The physician survey and expert panel discussions aimed to bridge identified evidence gaps. Results: The review included 59 epidemiological and 51 management studies, uncovering variable incidence and prevalence rates of EoE globally, with an estimated diagnosed prevalence of 41 per 100,000 in Italy. Diagnostic challenges were identified, including nonspecific symptoms and the lack of definitive biomarkers, which complicate the use of endoscopy. Treatment options such as elimination diets, proton-pump inhibitors, and swallowed corticosteroids were found to have varying success rates, while Dupilumab, an emerging therapy targeting interleukin (IL)-4 and IL-13, shows promise. Conclusion: Despite advancements in understanding and managing EoE, significant unmet clinical needs remain, particularly in biomarker identification, therapy personalization, and cost-effectiveness evaluation. A comprehensive, multidimensional approach to patient management is required, emphasizing the importance of early symptom recognition, accurate diagnosis, and tailored treatment strategies. Dupilumab offers potential as a novel treatment, underscoring the need for future research to explore the economic and social dimensions of EoE care pathways.

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Review of eosinophilic oesophagitis in children and young people

Cited by 2 publications

References 26 publications

The role of dupilumab in diverse allergic pathologies

The role of dupilumab in diverse allergic pathologies

Eosinophilic esophagitis in adults and adolescents: epidemiology, diagnostic challenges, and management strategies for a type 2 inflammatory disease

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