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Food and aeroallergens in eosinophilic esophagitis: role of the allergist in patient management

Aceves, Seema S.

Current Opinion in Gastroenterology: July 2014 - Volume 30 - Issue 4 - p 391–395
doi: 10.1097/MOG.0000000000000088
ESOPHAGUS: Edited by Stuart J. Spechler
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Purpose of review Eosinophilic esophagitis is a clinicopathologic disease of increasing worldwide prevalence that is triggered by food antigens. The concurrent management of all of the atopic diseases affecting a single individual is likely to be important for successful long-term eosinophilic esophagitis management. This review covers the role of the allergist in eosinophilic esophagitis with a focus on the literature from the past 2 years.

Recent findings Studies in the past 2 years document that testing for immediate and delayed allergic hypersensitivity to foods can be of utility in building elimination diets in children, but that this may not be the case in adults. In addition, it has been shown that a number of cells and interleukins involved in Th2 inflammation such as invariant natural killer T cells, basophils, and interleukin-9 are important in eosinophilic esophagitis pathogenesis. Finally, the role of foods in generating esophageal remodeling has been shown using murine models.

Summary Recent studies support the role of the allergist in eosinophilic esophagitis management, especially for food allergen testing, interpretation, and the management of food allergies concurrent atopic diatheses. In addition, allergists have made significant research contributions in our understanding of eosinophilic esophagitis.

Division of Allergy and Immunology, Department of Pediatrics and Medicine, University of California, San Diego, La Jolla, California, USA

Correspondence to Seema S. Aceves, MD, PhD, Division of Allergy and Immunology, Department of Pediatrics and Medicine, University of California, San Diego, 9500 Gilman Drive, MC-0760, La Jolla, CA 92093-0760, USA. Tel: +1 858 534 2983; e-mail: saceves@ucsd.edu

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins