Abstract:
Eosinophilic esophagitis (EoE) is an increasingly prevalent immune-mediated disease that leads to chronic changes in the oesophagus. These changes can include strictures, narrowing, and stenosis, mediated by an interleukin (IL)-13 pathway, which leads to remodelling and fibrosis through increasing migration of fibroblasts and subepithelial fibrosis via collagen deposition 1. IL-13 downregulates TSPAN12, a gene whose expression regulates fibrosis and causes changes in barrier function and higher rates of fibrostenosis in EoE. Dupilumab, a biologic therapy aimed at blocking IL-13, has been shown to improve EoE-related inflammation and fibrosis in clinical trials. We report here four unique patients with documented oesophageal stenosis with inability to pass a paediatric endoscope due to structuring disease, requiring dilation, who had resolution of their oesophageal narrowing following dupilumab therapy.
摘要:
嗜酸性粒细胞性食管炎(EoE)是一种日益流行的免疫介导疾病,可导致食道慢性变化。这些变化可能包括狭窄,缩小,狭窄,由白细胞介素(IL)-13途径介导,通过增加成纤维细胞的迁移和通过胶原蛋白沉积导致上皮下纤维化1。IL-13下调TSPAN12,其表达调节纤维化并导致屏障功能变化和EoE中纤维狭窄率较高的基因。Dupilumab,一项旨在阻断IL-13的生物疗法在临床试验中已被证明可改善EoE相关的炎症和纤维化.我们在这里报告了四名因结构性疾病而无法通过儿科内窥镜的食管狭窄患者。需要扩张,在dupilumab治疗后,他们的食管狭窄得到了解决。