The Nurse Practitioner, Год журнала: 2024, Номер 49(4), С. 8 - 8
Опубликована: Март 26, 2024
The American Journal of Gastroenterology, Год журнала: 2025, Номер 120(1), С. 31 - 59
Опубликована: Янв. 1, 2025
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus. It diagnosed in setting symptoms esophageal dysfunction and an eosinophilic predominant infiltrate The condition rapidly increasing incidence prevalence commonly encountered gastroenterology allergy practices, emergency departments, primary care settings. Over past decade, there have been paradigm shifts diagnosis management, increases knowledge about EoE risk factors, natural history, pathogenesis, development validated outcome metrics. This updated American College Gastroenterology Clinical Guideline uses Grading Recommendations, Assessment, Development, Evaluation methodology to make recommendations across domains diagnosis, treatment, monitoring assessment response, pediatric-specific considerations. Proton pump inhibitors, topical steroids, empiric diet elimination, biologic, dilation are all recommended treatments; feeding therapy used adjunctively children with food aversion or dysfunction. Monitoring clinical, endoscopic, histologic assessments assess for treatment response follow patients over time maintenance therapy. When evaluating following EoE, consideration should be given assessing controlling both inflammatory fibrostenotic aspects disease.
Язык: Английский
Процитировано
7
International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(2), С. 927 - 927
Опубликована: Янв. 11, 2024
Eosinophilic esophagitis (EoE) is a chronic, progressive, type 2 inflammatory disease with increasing global prevalence. An eosinophil-predominant inflammation that permeates the epithelium and deeper esophageal layers characterizes disease. Several cytokines, mainly derived from T-helper (Th2) cells epithelial cells, are involved in perpetuating responses by surface permeability promoting tissue remodeling characterized epithelial–mesenchymal transition (EMT) collagen deposition. This leads to strictures narrow caliber esophagi, which proportional patient’s age untreated length. Pathophysiological mechanisms leading EoE have been described recent years, transforming growth factor beta (TGF)-beta fibrotic phenomena EoE. However, evidence on dependence of these TGF-beta scarce contradictory. review provides state-of-the art knowledge intimate fibrosis its clinical consequences.
Язык: Английский
Процитировано
7
International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(3), С. 1702 - 1702
Опубликована: Янв. 30, 2024
Eosinophilic esophagitis (EoE) is a multifaceted disease characterized by wide heterogeneity of clinical manifestations, endoscopic and histopathologic patterns, responsiveness to therapy. From the perspective an effective approach patient, different inflammatory mechanisms involved in pathogenesis EoE biologics, particular monoclonal antibodies (mAbs), targeting these pathways are needed. Currently, most relevant dupilumab, which interferes with both interleukin (IL)-4 IL-13 binding IL-4 receptor α, only mAb approved European Medicine Agency US Food Drug Administration for treatment EoE. Other mAbs investigated include mepolizumab, reslizumab, benralizumab (interfering IL-5 axis), cendakimab dectrekumab (anti-IL-13s), tezepelumab (anti-TSLP), lirentelimab (anti-SIGLEG-8), many others. Despite undeniable economic impact biologic therapies, near future, there will be room further reflection about opportunity prescribe agents, not as last-line therapy selected cases such patients comorbidities involving common pathways. Although recent findings very encouraging, road permanent success still long, studies needed determine long-term effects discover new potential targets.
Язык: Английский
Процитировано
7
Immunological Reviews, Год журнала: 2024, Номер 326(1), С. 35 - 47
Опубликована: Июль 25, 2024
Food allergies occur due to a lack of tolerance the proteins found in foods. While IgE- and non-IgE-mediated food have different clinical manifestations, epidemiology, pathophysiology, management, they share dysregulated T cell responses. Recent studies shed light on contributions subsets development persistence allergic diseases. This review discusses role cells both considers potential future investigations this context.
Язык: Английский
Процитировано
4
Педиатрическая фармакология, Год журнала: 2025, Номер 21(6), С. 520 - 533
Опубликована: Янв. 9, 2025
Dupilumab is a genetically engineered immunobiological drug that has been increasingly used in recent years to treat bronchial asthma (BA), atopic dermatitis (AD) and eosinophilic esophagitis (EE) children. The aim of the study analyze current literature data on use dupilumab treatment BA, AD EE Despite short history pediatric population, its usage shown promising results many conditions whose pathogenesis T2 inflammation, primarily EE. It demonstrated efficacy patients with various clinical manifestations characterized by moderate severe course or refractory treatment, led an improvement quality life patients. With expansion dupilumab, there more evidence usefulness other T-cell-mediated diseases.
Язык: Английский
Процитировано
0
Revista de Gastroenterología de México, Год журнала: 2025, Номер unknown
Опубликована: Янв. 1, 2025
Процитировано
0
Frontiers in Medicine, Год журнала: 2025, Номер 11
Опубликована: Янв. 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.
Язык: Английский
Процитировано
0
Cellular and Molecular Gastroenterology and Hepatology, Год журнала: 2025, Номер unknown, С. 101464 - 101464
Опубликована: Янв. 1, 2025
Язык: Английский
Процитировано
0
Life, Год журнала: 2025, Номер 15(2), С. 307 - 307
Опубликована: Фев. 17, 2025
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder of the esophagus with rising prevalence. Dupilumab (DUPI), monoclonal antibody that targets interleukin-4 receptor α, has shown promise as treatment option. We conducted systematic review and network meta-analysis randomized controlled trials searching PubMed/Medline database, Cochrane Database Systematic Reviews, Central Register Controlled Trials (CENTRAL), medRxiv preprint server up to 31 July 2024, assessing DUPI's efficacy optimal dosing in EoE. Finally, three randomized-controlled comprising 470 participants, including 102 children under 12 years age, were included qualitative synthesis. Both high-exposure (HE-DUPI, 300 mg weekly) low-exposure (LE-DUPI, biweekly) regimens achieved significant histologic remission relative placebo (OR = 26.88, 95% CI 11.98-60.29 for LE-DUPI; OR 29.15, 13.68-62.12 HE-DUPI). Although overall adverse events comparable between groups, HE-DUPI was associated notable increase serious events. These findings suggest DUPI effective promoting EoE, LE-DUPI emerging preferred option balancing safety. This study highlights safety profiles different pediatric groups. Further studies are warranted explore long-term outcomes identify patient subgroups may derive greatest benefit from therapy.
Язык: Английский
Процитировано
0
Journal of Clinical Gastroenterology, Год журнала: 2025, Номер unknown
Опубликована: Фев. 17, 2025
Background: Dupilumab is the only FDA-approved medication for eosinophilic esophagitis (EoE). Clinical trials have shown its effectiveness in alleviating symptoms and decreasing inflammation associated with EoE. However, real-world data on efficacy still limited. Methods: We searched multiple databases articles reporting outcomes of dupilumab treatment EoE conducted a meta-analysis. Results: Five retrospective studies including 209 subjects (mean age: 22.12±12.01 y 61.24% males) were analyzed. The pooled outcome symptom improvement was 89.2% [95% Cl: 68.0%-97.0%; I 2 =58%]. Peak eosinophil count improved markedly postdupilumab [pre: 47.13 (95% 45.5-48.67; =98%) vs. post: 6.44 0.72-13.60; eos/hpf, P <0.001]. There significant reduction Endoscopic Reference Score (EREFS) 4.10 1.74-6.43; =95%) 0.77 0.14-1.7; =95%), mean duration follow-up 5.66±1.14 months. most common adverse event reported pain due to injection, which controlled local anesthetics. Conclusion: Our study shows that scenario, administration induces histologic endoscopic remission symptomatic improvement. Hence, can be considered option EoE, especially resistant cases. Future should evaluate long-term preventing esophageal fibrosis/stricture side effect profile. Furthermore, cost-effectiveness analysis warranted help establish role as potential first-line strategy.
Язык: Английский
Процитировано
0