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Novel targets in EoE: one step forward?
  1. Alex Straumann1,
  2. Thomas Greuter2
  1. 1Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
  2. 2Department of Gastroenterology and Hepatology, Lausanne University Hospital, Lausanne, Switzerland
  1. Correspondence to Dr Alex Straumann, Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich CH-8091, Switzerland; alex.straumann{at}hin.ch

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Eosinophilic oesophagitis (EoE) is a chronic inflammatory condition of the oesophagus, with a rapidly increasing prevalence and incidence.1 When EoE first appeared on the medical landscape—introduced by two independent, but coincident case series almost three decades ago—it was considered a rare disease.2 3 Today, EoE represents the most frequent cause of solid food dysphagia, with incidence and prevalence rates comparable with those of Crohn’s disease, at least in the Western hemisphere.4

Immunological studies revealed a T helper 2 (Th2)-type inflammatory (allergic) response in EoE.5 High efficiency of allergen-free diets, amino acid-based formula in particular,6 further supported the concept of EoE being a food allergy. Of note, EoE is a late-phase allergic reaction, mainly involving T cells,7 rather than an IgE-mediated response, as IgE plays at best a subsidiary role in its pathogenesis. IgE-based allergic tests have therefore shown disappointing correlation with trigger food identification. How allergens in EoE result in the aforementioned Th2-type inflammatory response still is only partially known.

The hypothesis of epithelial barrier dysfunction has recently gained attraction. In …

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Footnotes

  • Contributors Both authors contributed equally.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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