Abstract:
Eosinophilic gastrointestinal diseases (EGIDs) are a group of diseases characterized by selective eosinophil infiltration of the gastrointestinal (GI) tract in the absence of other causes of eosinophilia. These diseases are generally driven by type 2 inflammation, often in response to food allergen exposure. Among all EGIDs, the clinical presentation often includes a history of atopic disease with a variety of GI symptoms. EGIDs are traditionally separated into eosinophilic esophagitis (EoE) and non-EoE EGIDs. EoE is relatively better understood and now associated with clinical guidelines and 2 US Food and Drug Administration-approved treatments, whereas non-EoE EGIDs are rarer and less well-understood diseases without US Food and Drug Administration-approved treatments. Non-EoE EGIDs are further subclassified by the area of the GI tract that is involved; they comprise eosinophilic gastritis, eosinophilic enteritis (including eosinophilic duodenitis), and eosinophilic colitis. As with other GI disorders, the disease presentations and mechanisms differ depending on the involved segment of the GI tract; however, the differences between EoE and non-EoE EGIDs extend beyond which GI tract segment is involved. The aim of this article is to summarize the commonalities and differences between the clinical presentations and disease mechanisms for EoE and non-EoE EGIDs.
摘要:
嗜酸性粒细胞胃肠道疾病(EGID)是一组疾病,其特征是在没有其他嗜酸性粒细胞增多原因的情况下胃肠道的选择性嗜酸性粒细胞浸润。这些疾病通常是由2型炎症引起的,通常是对食物过敏原暴露的反应。在所有EGID中常见的是临床表现,其特征在于具有多种胃肠道症状的特应性疾病史。EGID传统上分为嗜酸性食管炎(EoE)和非EoEEGID。EoE相对更好地理解,现在与临床指南和FDA批准的治疗相关,而在没有FDA批准的治疗方法的情况下,非EoEEGID是罕见且较少理解的疾病。非EoEEGIDs进一步根据所涉及的胃肠道区域进行细分,包括嗜酸性粒细胞性胃炎(EoG),嗜酸性粒细胞性肠炎(EoN,包括嗜酸性十二指肠炎(EoD)),和嗜酸性粒细胞性结肠炎(EoC)。和其他胃肠道疾病一样,疾病的表现和机制因胃肠道的受累部位而异;然而,EoE和非EoEEGID之间的差异超出了涉及胃肠道段的范围。本文的目的是总结EoE和非EoEEGID的临床表现和疾病机制之间的共性和差异。