Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eosinophilic esophagitis (EE) is a chronic inflammatory, immunoallergic disease of the esophagus that represents the most common eosinophilic gut disease. Understanding and diagnosis regarding this condition have greatly increased in recent years, particularly in Europe and North America, in parallel with other allergic disorders. It consists of dense esophageal infiltration with eosinophils in the absence of gastro-esophageal reflux (GER). It involves individuals at all ages, and is particularly common in males during childhood and up to the 5th decade of life. It manifests with chronic, intermittent esophageal symptoms that predominantly include dysphagia, food impaction episodes, and GER-attributable complaints that do not respond to antisecretory therapy. Endoscopically, EE is a polymorphous disease that presents with various changes in esophageal caliber, and subtle changes in mucosal appearance, which lead to biopsy collection as a key procedure for diagnosis. Management must be multidisciplinary, including gastroenterologists, pathologists, allergologists, and also nutrition specialists in pediatric cases. Regarding therapy, dietary food restrictions are especially useful in the management of pediatric EE, but effectiveness is lower in the adult, maybe because of a greater involvement of air allergens. Drug use is standard, particularly involving topical steroids, which may revert manifestations and histological lesions, even though recurrence following discontinuation is common.
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PMID:Eosinophilic esophagitis -- clinical manifestations, diagnosis, and treatment. 1933 33

Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory disease of undetermined pathophysiology that results in dense mucosal eosinophilia and esophageal dysfunction. In childhood, vague symptoms associated with GERD and feeding difficulties are the first manifestations of EoE. Adults typically present with dysphagia and food impaction. No pathognomonic features have been identified for EoE and, therefore, its diagnosis must be made on both clinical and histological grounds. Effective treatments rely on steroids and dietary exclusions.
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PMID:Eosinophilic esophagitis: the newest esophageal inflammatory disease. 1940 67

Eosinophilic esophagitis (EE) and gastroesophageal reflux disease (GERD) have similar clinical presentations. The immunoregulatory mechanisms involved in both diseases are not clearly defined. We studied cellular inflammation in pediatric patients with EE and GERD compared to normal controls (NC). Pathology records were reviewed of 10 EE, 8 GERD, and 10 NC children who were seen at Texas Children's Hospital in the past 3 yr. FOXP3, CD4, CD8, CD25, eotaxin-3, and IL-5 immunohistochemical stains were performed on formalin-fixed, paraffin-embedded esophageal tissue sections and assessed by a blinded observer. The numbers of FOXP3(+), CD25(+), and CD8(+) cells were significantly increased in both EE and GERD compared with NC. No significant differences in the numbers of FOXP3(+), CD4(+), CD8(+), and CD25(+) cells were detected between the patients with EE and GERD. Eotaxin-3(+) was found in mature epithelial cells and IL-5 was detected in esophageal intravascular space in all 3 groups. Eosinophil degranulation and microabscesses were significantly increased in EE compared to GERD. IL-5 was detected in vessels of the affected esophageal area and eotaxin-3 is produced locally by mature epithelial cells. Increased numbers of esophageal FOXP3(+) regulatory T cells, and CD8(+) T cells in both EE and GERD suggest that a negative feedback mechanism may regulate the inflammatory response.
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PMID:Increased esophageal regulatory T cells and eosinophil characteristics in children with eosinophilic esophagitis and gastroesophageal reflux disease. 1942 94

Eosinophilic esophagitis (EoE) is an increasingly recognized disease characterized by esophageal symptoms accompanied by increased esophageal mucosal eosinophilia. The reasons for the increasing prevalence and understanding of the pathogenesis of EoE are areas of active investigation. Food and environmental allergy, host immunologic predisposition, and interactions with gastroesophageal reflux disease have emerged as important aspects of the disease. The optimal management of EoE is controversial and evolving. Therapeutic options include medical therapy with acid suppression, corticosteroids, and biologic agents. Elimination diets and endoscopic esophageal dilation have shown effectiveness. Management strategies for individual patients range from clinical observation to multimodal therapy, depending on the clinical presentation.
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PMID:Eosinophilic esophagitis: pathophysiology and optimal management. 1946 16

Eosinophilic esophagitis is a recently recognized but expanding disorder characterized by antigen-driven eosinophil accumulation in the esophagus. Symptoms frequently mimic those of gastroesophageal reflux disease, but the diseases are distinct in their histopathology, gene expression signature, response to therapy, hereditary risk, and association with allergies. The pathogenesis of eosinophilic esophagitis involves environmental and genetic factors, particularly food antigens and expression level of the eosinophil chemoattractant eotaxin-3, respectively. Analyses of gene expression signatures and animal models have indicated the importance of adaptive T-cell immunity that involves interleukin-5 and interleukin-13-induced esophageal epithelial cell responses. Symptoms, dysregulation of esophageal gene expression, and pathology are largely reversible following reduced exposure to specific food antigens as well as anti-inflammatory therapy, but chronic treatment is necessary to prevent relapse. Therefore, eosinophilic esophagitis is a disease with unique features that include chronic esophagitis, atopy, immune sensitization to oral antigens, reversibility, and familial association.
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PMID:Biology and treatment of eosinophilic esophagitis. 1959 9

Eosinophilic esophagitis (EE) is an inflammatory condition characterized by intense eosinophilic infiltration of the esophagus. EE is frequently misdiagnosed as gastroesophageal reflux disease. Here, we present a child with EE and a characteristic endoscopic finding, "ringed esophagus". An 11-year-old Saudi boy presented with dysphagia for 1 year. He had experienced an intermittent sensation of solid food sticking in his chest, which was relieved by drinking liquids. A barium swallow excluded anatomical causes of dysphagia, but revealed multiple-ringed esophagus. Endoscopy showed a furrowing and trachealizing appearance of the entire esophagus. Hisologically, extensive eosinophilic infiltration was a feature in biopsies obtained from the esophagus. The child responded well to a 2-month course of inhaled fluticasone. Symptoms recurred 3 months after discontinuation of therapy, which necessitated resumption of inhaled fluticasone. The endoscopic appearance of multiple esophageal rings should raise suspicion of EE and be confirmed by esophageal biopsies.
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PMID:Esophageal trachealization: a feature of eosinophilic esophagitis. 1963 82

Eosinophilic esophagitis is a clinicopathological disease characterized by GERD-like symptoms, food impaction and dysphagia that occur with the histological finding of dense esophageal eosinophilia. Endoscopic features include linear furrows, white exudate and longitudinal shearing. Current concepts regarding the pathophysiology relate to a food allergen-induced overexpression of eosinophil-related cytokines including Il-5, IL-13 and eotaxin-3. Effective treatments include topical and systemic corticosteroids and dietary restrictions.
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PMID:Eosinophilic esophagitis. 2020 8

Eosinophilic esophagitis is an under-recognized inflammatory disorder of the esophagus. It has been frequently diagnosed in pediatric patients; however, over the last few years, there has been an increase in the number of cases recognized in adults as well. Despite this fact, eosinophilic esophagitis (EE) is often a delayed diagnosis in the primary care setting due to the overlapping symptoms it shares with other esophageal and gastrointestinal disorders such as gastroesophageal reflux disease and gastroenteritis, as well as a lack of awareness among physicians who see adult patients. We performed an exhaustive search of the literature, which revealed over 400 articles on EE; however, most were reported in gastroenterology or autoimmune specialty journals. We report a case of eosinophilic esophagitis in a 39-year-old man who presented with persistent epigastric abdominal pain and who was diagnosed via endoscopy and biopsy.
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PMID:The Case of the Infection that Wasn't ! 2030 Apr 4

Eosinophilic esophagitis (EoE) is a chronic clinicopathological entity characterized by large numbers of intraepithelial eosinophils infiltrating the esophageal mucosa, which is not caused by gastroesophageal reflux. This disease has become widely recognized over the past few years and new methods have been developed to reveal its underlying pathophysiological mechanisms. Owing to the high prevalence of food and/or airborne allergen sensitization in EoE patients, the allergic nature of the disease had to be defined, which has certain factors in common with other IgE-dependent entities, such as bronchial asthma or allergic rhinitis. Of these, some cytokines and chemokines previously studied in asthma have also been implicated in molecular mechanisms causing eosinophil-rich esophageal inflammation. However, the role played by IgE in relation to the esophageal eosinophilic infiltrate must be clarified, together with the possible function of mast cells in the inflammatory infiltrate and its activation stimuli. A putative role has also been recently suggested for gastroesophageal reflux in the origin of EoE that should be profoundly analyzed, together with the role of specific genes implicated in other digestive inflammatory disorders. This article reviews recent advances in the immunopathogenesis of EoE, which should also consider other pathways to activate the esophageal mucosal immune system.
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PMID:An update on the immunopathogenesis of eosinophilic esophagitis. 2035 Feb 61

Eosinophilic esophagitis (EoE) has emerged as an important cause of dysphagia and food impactions in young adults. Previously considered a rare condition, an increasing number of cases of EoE have been attributable to a rising incidence and a growing awareness of the condition. Typical endoscopic features include concentric mucosal rings, linear furrowing, white exudates, and a narrow caliber esophagus. Current consensus guidelines define EoE by 1) the presence of characteristic symptoms, especially dysphagia and food impactions in adults, 2) >or= 15 eosinophils per high power field in esophageal tissue, and 3) exclusion of other disorders with similar presentations (eg, gastroesophageal reflux disease). Current knowledge about the pathophysiology implicates food allergens, aeroallergens, and genetic factors. The main treatment options for EoE are proton pump inhibitors, dietary manipulation, and topical or oral glucocorticoids. Endoscopic dilation may be performed in patients who do not respond to medical therapy. This review highlights recent insights into the diagnosis and management of EoE in young adults.
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PMID:Approach to dysphagia in the young patient in the era of eosinophilic esophagitis. 2043 68


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