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Letter
Toning down the role of eosinophils in eosinophilic oesophagitis
  1. Carlo Maria Rossi1,2,
  2. Marco Vincenzo Lenti1,2,
  3. Antonio Di Sabatino1,2
  1. 1 Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
  2. 2 Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy
  1. Correspondence to Professor Antonio Di Sabatino, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; a.disabatino{at}smatteo.pv.it

https://doi.org/10.1136/gutjnl-2023-329864

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    Eosinophilic oesophagitis (EoE) is an immune-mediated disease of uncertain aetiology. The diagnosis of EoE relies on the epithelial infiltration of eosinophils (peak eosinophil count of ≥15 per high-power field (HPF)) and on the presence of symptoms. Consequently, a combined clinical–histological endpoint has been devised to assess response to treatments in clinical trials. Recent guidelines drafted by the British Society of Gastroenterology have confirmed the pivotal role of swallowed topical steroid and, for the first time, explicitly considered the use of biological therapy in case of a coexisting severe allergic condition.1 These guidelines have appraised the results of pivotal trials leading to the approval of orodispersible budesonide and dupilumab, a monoclonal antibody targeting interleukin (IL)-14 and IL-13, since they both met the aforementioned coprimary endpoint.2 3 Additionally, dupilumab also proved to enhance distensibility of …

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    Footnotes

    • Contributors CMR and MVL wrote the manuscript; ADS revised the manuscript for important intellectiual content.

    • 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 Not commissioned; internally peer reviewed.