Eosinophilic
oesophagitis
(EoE)
is
a
chronic,
immune/antigen-mediated
condition
characterised
by
eosinophil-dominated
inflammation
of
the
oesophagus,
leading
to
dysphagia
and
oesophageal
dysfunction
[1].
Despite
advancements
in
diagnosis
treatment,
EoE
management
remains
challenging
due
its
chronicity
high
relapse
rates
after
treatment
discontinuation
[2].
Recent
innovations,
including
novel
drug
delivery
systems
biologic
therapies,
offer
new
avenues
for
improving
patient
outcomes.
The
Phase
II
randomised
clinical
trial
(RCT)
ESO-101,
mucoadhesive
system
mometasone
furoate,
represents
pivotal
step
towards
precision
medicine
[3].
This
approach
allows
localised
mucosa,
minimising
systemic
side
effects.
study
demonstrated
significant
histologic
endoscopic
improvements
with
ESO-101.
Peak
eosinophil
counts
decreased
49.1
per
high-power
field
on
ESO-101
compared
6.6
increase
placebo
(p
=
0.0318).
Additionally,
appearance
as
defined
Esophagitis
Endoscopic
Reference
Score
(EREFS)
improved,
median
decrease
from
7
4
group,
while
group
showed
no
change
0.001).
However,
relief
odynophagia
was
comparable
both
groups,
underscoring
complex
nature
and,
probably,
difficulties
assessing
outcome
according
current
methods
[4].
discordance
between
histological
outcomes
observed
aligns
findings
other
RCTs
investigating
lirentelimab,
benralizumab,
mepolizumab
reslizumab,
where
positive
reached
despite
symptom
persistence.
these
complexities,
regulatory
authorities
continue
mandate
reduction
co-primary
endpoint
registration
trials
[5].
Moreover,
discrepancies
highlight
that
perception
influenced
not
only
eosinophilic
but
also
structural
remodelling,
adaptive
behaviours
psychological
factors,
such
hypervigilance
anxiety
[6,
7].
prior
dilation
procedures
can
affect
trajectories
during
therapy,
introducing
variability
[8].
Furthermore,
eosinophils
are
key
diagnostic
therapeutic
markers,
they
part
larger
inflammatory
cascade
includes
Th2
cells,
mast
cytokines
mediators
could
contribute
These
observations
importance
addressing
physiological
aspects
disease.
expanding
landscape
proton
pump
inhibitors,
elimination
diets,
topical
corticosteroids
like
dupilumab,
offering
diverse
pathways
remission
[9,
10].
several
questions
remain.
Should
goal
always
be
complete
remission,
or
partial
acceptable
if
it
results
durable
control?
How
support
effectively
integrated
into
disease
management?
Advances
biomarkers,
motility
assessments
imaging
technologies
promise
refine
goals
enable
more
personalised
care
strategies.
exemplifies
progress
being
made
emphasising
need
deeper
understanding
pathophysiology.
Variability
responses
highlights
approaches,
supported
collaboration
among
researchers,
clinicians
patients
within
multidisciplinary
framework.
Moving
forward,
must
extend
beyond
controlling
restoring
quality
life
individuals
through
combination
medical
innovation
patient-centred
care.
Luisa
Bertin:
conceptualization,
writing
–
review
editing,
original
draft.
Edoardo
Vincenzo
Savarino:
supervision,
article
linked
Lucendo
et
al
paper.
To
view
this
article,
visit
https://doi.org/10.1111/apt.18443.
Data
sharing
applicable
data
were
created
analyzed
study.
ABSTRACT
Background
Exposure
to
Helicobacter
pylori
(
H.
)
has
been
associated
with
a
decreased
risk
of
eosinophilic
oesophagitis
(EoE).
Aim
The
aim
this
study
is
determine
the
association
between
infection
and
EoE
in
updated
meta‐analysis.
Methods
We
searched
MEDLINE,
Scopus
ISI
Web
Science,
through
November
2024.
included
studies
reporting
status
patients
without
or
oesophageal
eosinophilia
(EE).
used
random‐effects
model
pool
estimates.
Results
analysed
19
including
1.704.821
subjects.
was
46%
lower
EoE/EE
(OR:
0.54,
95%
CI
0.43
0.67).
Comparable
findings
were
observed
when
subgrouping
by
location
design.
There
nonsignificant
decrease
odds
for
paediatric
exposed
(OR
0.57,
0.26
1.24),
using
serology
diagnose
0.41,
0.16
1.04).
found
compared
overall
that
diagnosed
only
gastric
biopsy
0.43,
0.25
0.74)
those
published
after
2019
0.44,
0.28
0.68).
Conclusions
significantly
EoE/EE.
As
stronger
protective
effect
more
recent
studies,
epidemiology
may
evolve
deserve
be
further
monitored.
Expert Review of Clinical Immunology,
Journal Year:
2025,
Volume and Issue:
unknown
Published: Jan. 2, 2025
Atopic/allergic
diseases
impose
a
growing
burden
on
public
health,
affecting
millions
of
patients
worldwide.
The
main
objective
this
study
was
to
develop
national
expert
consensus
relevant
clinical
questions
related
type
2
inflammation.
Diagnostics,
Journal Year:
2025,
Volume and Issue:
15(3), P. 240 - 240
Published: Jan. 21, 2025
Eosinophilic
esophagitis
(EoE)
is
a
chronic,
immune-mediated
inflammatory
condition
of
the
esophagus
characterized
by
eosinophilic
infiltration,
and
hallmark
symptoms
esophageal
dysfunction
such
as
dysphagia
food
impaction.
Over
past
three
decades,
EoE
has
been
recognized
distinct
clinical
entity,
distinguished
from
gastroesophageal
reflux
disease
(GERD)
through
advancements
in
diagnostic
techniques,
particularly
endoscopy
with
biopsy.
The
rising
global
prevalence
reflects
enhanced
awareness,
evolving
criteria,
environmental
along
lifestyle
changes.
etiology
multifactorial,
involving
genetic
predispositions,
immune
dysregulation,
gut
microbiome,
triggers,
including
dietary
allergens
aeroallergens.
Key
mechanisms
include
type
2
helper
T-cell
(Th2)-driven
response,
epithelial
barrier
dysfunction,
variants
CAPN14
TSLP.
Chronic
inflammation
leads
to
tissue
remodeling,
fibrosis,
narrowing,
contributing
progression
complications.
Management
strategies
have
evolved
elimination,
proton
pump
inhibitors,
topical
corticosteroids,
biologics,
endoscopic
interventions
for
fibrostenotic
Emerging
therapies
targeting
cytokines
interleukin
(IL)-4,
IL-5,
IL-13,
alongside
novel
tools
like
string
test
Cytosponge,
offer
promising
avenues
improved
control
non-invasive
monitoring.
Long-term
surveillance
combining
histological
evaluations
biomarkers
critical
optimizing
outcomes
preventing
Future
research
should
address
gaps
understanding
role
refine
therapeutic
approaches,
develop
personalized
improve
management
patient
quality
life.
Frontiers in Medicine,
Journal Year:
2025,
Volume and Issue:
11
Published: Jan. 21, 2025
Dupilumab
is
a
monoclonal
antibody
targeting
interleukin-4
and
interleukin-13,
approved
for
the
treatment
of
multiple
T2
diseases
more
recently
Eosinophilic
Esophagitis
(EoE).
EoE
chronic
inflammatory
disease,
believed
to
be
member
“atopic
march”,
due
similarities
with
other
atopic
diseases,
ranging
from
epidemiology
genetics
pathophysiology.
Although
often
co-existing
in
same
patient,
these
are
still
treated
as
separated
entities
by
different
specialists,
resulting
polypharmacy
use
steroids.
Thus,
shared-decision
approach
multidisciplinary
team
composed
specialists
might
improve
clinical
management
outcomes.
Yet,
prospective
data
on
effectiveness
dupilumab
single
agent
lacking,
since
only
few
case
reports
small
studies
have
been
published
so
far
reporting
outcomes
patients
affected
diseases.
The
purpose
this
review
illustrate
rationale
evidence
supporting
possibility
using
therapeutic
those
addition
EoE.
Cureus,
Journal Year:
2025,
Volume and Issue:
unknown
Published: Feb. 10, 2025
Esophageal
symptoms,
including
dysphagia,
heartburn,
and
non-cardiac
chest
pain,
are
prevalent
concerns
in
gastroenterology.
This
review
examines
the
roles
of
advanced
diagnostic
modalities
such
as
high-resolution
manometry
(HRM),
pH-impedance
monitoring,
EndoFLIP
understanding
esophageal
physiology
pathology.
Here,
we
discuss
clinical
presentations
common
symptoms
explore
how
structural
abnormalities
like
strictures
motility
disorders,
achalasia
spasms,
assessed
using
these
tools.
The
utility
endoscopy
visualizing
mucosal
changes
is
highlighted
alongside
emerging
technologies
artificial
intelligence
enhancing
detection
capabilities.
Complementary
techniques,
barium
esophagrams
reflux
provide
additional
functional
anatomical
insights,
crucial
for
comprehensive
patient
evaluation.
integration
approaches
fosters
a
deeper
guiding
effective
management
strategies
improving
outcomes.
aimed
to
highlight
importance
adopting
multimodal
approach
modern
gastroenterological
practice.
Russian Journal of Allergy,
Journal Year:
2025,
Volume and Issue:
unknown
Published: March 6, 2025
Aim:
to
systemize
existing
data
on
the
treatment
strategies
for
patients
with
eosinophilic
esophagitis.
Eosinophilic
esophagitis
is
a
T2-
disease
characterized
by
infiltration
of
esophageal
mucosa,
subepithelial
and
submucosal
fibrosis,
progressive
dysphagia.
Early
diagnosis
appropriate
can
prevent
development
strictures
other
complications.
The
includes
use
elimination
diets,
pharmacological
therapy,
endoscopic
dilation
or
bougienage
strictures.
most
effective
drugs
achieving
clinical
histological
remission
in
are
proton
pump
inhibitors,
topical
glucocorticosteroids,
biological
agents
represented
monoclonal
antibodies.
Over
time,
advantages
systemic
antibody
therapies
(anti-IL4/IL-13)
over
inhibitors
glucocorticosteroids
have
become
evident,
particularly
terms
their
impact
mucosal
inflammation
remodeling
wall.
Currently,
only
approved
anti-interleukin
drug
dupilumab,
which
has
demonstrated
high
efficacy
safety
trials
children
aged
1
year
older,
as
well
adults.
Endoscopic
performed
who
stenosis
(with
an
diameter
13
mm)
following
course
pharmacotherapy.
To
this
day,
numerous
questions
remain
regarding
maintenance
its
duration,
predictors
progression.
With
emergence
new
biologic
esophagitis,
accessibility,
long-term
efficacy,
critically
important
considerations.
ImmunoTargets and Therapy,
Journal Year:
2024,
Volume and Issue:
Volume 13, P. 367 - 383
Published: July 1, 2024
Eosinophilic
esophagitis
(EoE)
is
a
chronic
type
2
inflammation-mediated
disease
characterized
by
an
eosinophil-predominant
inflammation
of
the
esophagus
and
symptoms
esophageal
dysfunction.
Relevant
treatment
outcomes
in
setting
EoE
include
improvement
histology,
symptoms,
endoscopy
findings,
quality
life
(QoL),
psychological
burden
disease.
Established
validated
tools
for
assessment
questionnaires
on
dysphagia
QoL
(ie,
DSQ,
EEsAI,
EoE-IQ).
More
recently,
symptom-specific
anxiety
hypervigilance,
assessed
using
hypervigilance
scale
(EHAS),
have
emerged
as
contributors
to
burden,
confirming
importance
aspects
patients.
The
endoscopic
reference
score
(EREFS)
only
can
quantify
mucosal
burden.
However,
panometry
functional
lumen
imaging
probe
(FLIP)
high-resolution
manometry
(HRM)
shown
potential
optimize
fibrostenotic
features
EoE,
providing
novel
insights
into
pathophysiology
symptoms.
There
growing
number
licenced
off-label
therapeutic
options
with
various
randomized
controlled
trials
demonstrating
efficacy
proton
pump
inhibitors,
topical
steroids,
food
elimination
diets,
biological
drugs,
dilatation.
standardized
optimal
management
strategies
are
currently
lacking.
In
this
review,
we
provide
overview
established
including
patient
reported
outcomes,
FLIP
panometry,
HRM,
endoscopy,
histology
outcome
measures
improve
addition,
summarize
available
based
most
recent
evidence.
