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Eosinophilic disorders of the gastro-intestinal tract: an update

机译：胃肠道嗜酸性疾病：最新进展

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摘要

Eosinophilic diseases of the gastrointestinal tract, including eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE), are rare chronic pathologies of the digestive system, with an immuno-mediated pathogenesis. Recent data suggest that, together with the “classic” IgE-response to allergens, also a delayed hypersensitivity mechanism could be involved in the development of eosinophilic disorders. EoE and EGE were studied only in the latest decades and as a consequence accurate data are not yet available, concerning not only pathogenesis, but also epidemiology, treatment and outcomes. The diagnosis of EoE is centered on endoscopic findings but the certainty is obtained by histological examination from biopsy samples, that has a sensitivity of 100% when based on five samples. The currently available treatments include topical corticosteroids, specific diets and endoscopic treatment. Concerning EGE, three subtypes (mucosal, muscular, and serosal) were identified. The diagnosis is based, as for EoE, on endoscopic and histological assessment, and the treatment includes pharmacological and dietetic approaches. Further studies are warranted in order to better define the etiology and pathogenesis of eosinophilic diseases of the gastrointestinal tract, and thus to develop more appropriate and specific therapies.
机译：胃肠道嗜酸性疾病，包括嗜酸性食管炎（EoE）和嗜酸性胃肠炎（EGE），是消化系统罕见的慢性病，​​具有免疫介导的发病机制。最新数据表明，与对过敏原的“经典” IgE反应一起，迟发型超敏反应机制也可能与嗜酸性粒细胞疾病的发展有关。 EoE和EGE仅在最近的几十年中得到了研究，因此尚无准确的数据，不仅涉及发病机理，还涉及流行病学，治疗和预后。 EoE的诊断以内窥镜检查结果为中心，但可通过组织学检查从活检样本中获得确定性，当基于五个样本时，其敏感性为100％。当前可用的治疗包括局部糖皮质激素，特定饮食和内窥镜治疗。关于EGE，鉴定了三种亚型（粘膜，肌肉和浆膜）。就EoE而言，诊断基于内窥镜和组织学评估，并且治疗包括药理学和饮食学方法。为了更好地确定胃肠道嗜酸性粒细胞疾病的病因和发病机制，有必要进行进一步的研究，从而开发出更合适和更具体的疗法。

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