PDF(Pubmed)
Abstract：
Eosinophilic esophagitis (EoE) is an antigen-mediated chronic inflammatory disease of the esophagus, the prevalence of which has steadily increased in recent years. The pathogenesis of EoE is not yet well-defined; however, recent studies have demonstrated that the esophageal microbiota is an essential regulator of physiological and pathological processes of EoE. Currently, research on EoE and microbiota is an emerging field of study that is receiving increasing attention. Here, we review existing EoE-related esophageal microbiota studies to explore the potential mechanisms underlying esophageal microbiota-mediated EoE. The esophageal microbiome is altered in patients with EoE. Although α diversity is usually not significantly different, an increase in Haemophilus and a decrease in Firmicutes were observed in EoE patients. The role of microbiota in initiating and perpetuating inflammation is not fully understood. Current evidence suggests that the penetration of microbiota leads to the activation of epithelial cells as well as innate and adaptive immune cells, with the subsequent release of cytokines, leading to immune responses and inflammation. The involvement of toll-like receptors in EoE also supports the potential role of the microbiota in the progression of this disease. While EoE-induced inflammation can also lead to alterations in the local microbiome. Moreover, dietary modifications, proton pump inhibitors, and corticosteroids can modulate the esophageal microbiota; however, definitive conclusions about the alterations of microbes after treatment cannot be drawn. These findings provide promising avenues for future studies.
摘要：
嗜酸细胞性食管炎(EoE)是一种抗原介导的慢性食道炎症性疾病,近年来患病率稳步上升。EoE的发病机制尚未明确；然而，最近的研究表明，食管微生物是EoE生理和病理过程的重要调节因子。目前,EoE和微生物群的研究是一个新兴的研究领域，受到越来越多的关注。这里,我们回顾了现有的EoE相关食管菌群研究,以探索食管菌群介导的EoE潜在机制.EoE患者的食管微生物组发生改变。虽然α多样性通常没有显著差异，在EoE患者中观察到嗜血杆菌增加和Firmicutes减少.微生物群在引发和延续炎症中的作用尚未完全了解。目前的证据表明，微生物群的渗透导致上皮细胞以及先天和适应性免疫细胞的激活，随着细胞因子的释放，导致免疫反应和炎症。Toll样受体在EoE中的参与也支持微生物群在该疾病进展中的潜在作用。而EoE诱导的炎症也可导致局部微生物组的改变。此外，饮食调整，质子泵抑制剂,和皮质类固醇可以调节食道微生物群;然而，无法得出治疗后微生物变化的确切结论。这些发现为未来的研究提供了有希望的途径。
