Eosinophilic Esophagitis: immunological perspectives and therapeutic strategies

Authors

DOI:

https://doi.org/10.56294/saludcyt20251080

Keywords:

Eosinophilic esophagitis, dietary modifications, pharmacological, Chronic inflammation

Abstract

Introduction: Eosinophilic esophagitis is a chronic disease characterized by the accumulation of eosinophils in the esophageal wall, causing inflammation and damage to the esophageal mucosa, which can affect swallowing ability. Despite being an idiopathic disease, it is believed that several factors may trigger the overproduction of eosinophils. Diagnosis is made through endoscopy, where the esophageal mucosa is examined, and a biopsy is taken to detect the presence of eosinophils in the esophageal tissue. Treatment is multidisciplinary, including dietary modifications (such as restricting foods that trigger the inflammatory response) and pharmacological therapy. In severe cases, esophageal dilations may also be considered to relieve esophageal narrowing.
Methods: Data were collected from articles indexed in Scopus, PubMed, Scielo, and Elsevier, considering bibliographies in English and Spanish from 2017 to 2024. For this investigation, 72 articles were used as references.
Results: After analyzing the selected articles, important aspects of eosinophilic esophagitis were identified. Various studies concluded that the prevalence of this pathology has increased in recent years, with a higher incidence of cases in Western countries, suggesting a possible link to environmental and dietary factors. This disease affects both children and adults, with a higher frequency in men.
Conclusions: The analysis of the bibliographic sources used in the research reveals that, despite being discovered just over 30 years ago, eosinophilic esophagitis remains an idiopathic disease, affecting a diverse population regardless of age. Studies show that the exact reasons why certain individuals are more susceptible than others have not been determined, suggesting a complex interaction between genetic, immunological, and environmental factors.

References

Biedermann L, Straumann A, Greuter T, Schreiner P. Eosinophilic esophagitis-established facts and new horizons. Semin Immunopathol. 2021 Jun;43(3);319-335. doi: 10.1007/s00281-021-00855 DOI: https://doi.org/10.1007/s00281-021-00855-y

Sawada, A., Imai, T., Ihara, Y., Tanaka, F., Hirano, I., & Fujiwara, Y. Epidemiology and Risk Factors of Eosinophilic Esophagitis in Japan: A Population-Based Study. Clinical Gastroenterology and Hepatology. 2024 Oct; 22(10);2023-2032.e6. doi: 10.1016/j.cgh.2024.04.035 DOI: https://doi.org/10.1016/j.cgh.2024.04.035

Chang J, & Jensen E. Epidemiologic and Clinical Clues to the Etiology of Eosinophilic Esophagitis. Immunology and Allergy Clinics. 2024 Jan, 44(2);145–155. doi:10.1016/j.iac.2023.12.003 DOI: https://doi.org/10.1016/j.iac.2023.12.003

Licari A, Votto M, Scudeller L, De Silvestri A, Rebuffi C, Cianferoni A, et al. Epidemiology of Nonesophageal Eosinophilic Gastrointestinal Diseases in Symptomatic Patients: A Systematic Review and Meta-Analysis. J. Allergy Clin. Immunol. Pract. 2020 Jun; 8(6);1994–2003.e2. DOI: https://doi.org/10.1016/j.jaip.2020.01.060

Licari A, Votto M, D’Auria E, Castagnoli R, Caimmi S, Marseglia G. Eosinophilic Gastrointestinal Diseases in Children: A Practical Review. Curr. Pediatr. Rev. 2020 May;16(2);106–114. doi: 10.2174/1573396315666191022154432 DOI: https://doi.org/10.2174/157339631566619102215443

Camargo N, Santiago J, Varela, L., Maestre R, Rodríguez M. Esofagitis eosinofílica. Medicina Interna de México. 2021 Aug;37(6);1094-1098. doi: 10.24245/mim.v37i6.3862 DOI: https://doi.org/10.24245/mim.v37i6.3862

Rank M, Sharaf R, Furuta G, Aceves S, Greenhawt M, Spergel J, et al. Technical Review on the Management of Eosinophilic Esophagitis: A Report from the AGA Institute and the Joint Task Force on Allergy-Immunology Practice Parameters. Gastroenterology. 2020 May; 158(6);1789–1810.e15. doi: 10.1053/j.gastro.2020.02.039 DOI: https://doi.org/10.1053/j.gastro.2020.02.039

Gratacós A, Gómez E, Eosinophilic Esophagitis Due to Aeroallergens: A Systematic Review and Update. J. Investig. Allergol. Clin. Immunol. 2022 Aug; 32(6);438-450. doi: 10.18176/jiaci.0853 DOI: https://doi.org/10.18176/jiaci.0853

Shomali, W.; Gotlib, J. World Health Organization-defined eosinophilic disorders: 2022 update on diagnosis, risk stratification, and management. Am. J. Hematol. 2022 Jan; 97(1);129-148. doi: 10.1002/ajh.26352. DOI: https://doi.org/10.1002/ajh.26352

Gonsalves NP, Aceves SS. Diagnosis and treatment of eosinophilic esophagitis. J Allergy Clin Immunol. 2020Jan;145(1);1-7. doi: 10.1016/j.jaci.2019.11.011

Thomsen G, Christoffersen M, Lindegaard H, Davidsen J, Hartmeyer G, Assingy K, et al. Front Oncol. 2023 May; 18:13:1193730. doi: 10.3389/fonc.2023.1193730 DOI: https://doi.org/10.3389/fonc.2023.1193730

Ansotegui I, Melioli G, Canonica G, Caraballo L, Villa E, Ebisawa M, et al. IgE Allergy Diagnostics and Other Relevant Tests in Allergy, sa World Allergy Organization Position Paper. World Allergy Organ. J. 2020 Feb 25;13(2);100080. doi: 10.1016/j.waojou.2019.100080 DOI: https://doi.org/10.1016/j.waojou.2019.100080

Sung K, Kyu C. Samter’s Triad: State of the Art. Clin. Exp. Otorhinolaryngol. 2018 Jun; 11(2);71–80. doi: 10.21053/ceo.2017.01606 DOI: https://doi.org/10.21053/ceo.2017.01606

Laky K, Kinard J, Min J, Moore I, Lack J, Fischer E, et al. Epithelial-intrinsic defects in TGFβR signaling drive local allergic inflammation manifesting as eosinophilic esophagitis. Sci Immunol. 2023 Jan; 8(79);eabp9940. doi: 10.1126/sciimmunol.abp9940 DOI: https://doi.org/10.1126/sciimmunol.abp9940

Weiss E, Ko C, Leung T, Micheletti R, Mostaghimi A, Ramachandran S, et al. Neutrophilic dermatoses: a clinical update. Curr Dermatol Rep. 2022 Mar;11(2);89-102. doi: 10.1007/s13671-022-00366-y. DOI: https://doi.org/10.1007/s13671-022-00355-8

Lopes J & Sicherer S. Food allergy: epidemiology, pathogenesis, diagnosis, prevention, and treatment. Current Opinion in Immunology. 2020 Oct; 66; 57-64. doi: 10.1016/j.coi.2020.03.014 DOI: https://doi.org/10.1016/j.coi.2020.03.014

Li K, Ruan G, Liu S, Xu T, Guan K, Li J, Li J. Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment. Chinese Medical Journal. 2023 Apr; 136(8);899-909. doi: 10.1097/CM9.0000000000002511 DOI: https://doi.org/10.1097/CM9.0000000000002511

Kennedy K, Muir A, Ruffner M. Pathophysiology of Eosinophilic Esophagitis. Immunology and Allergy Clinics. 2024 May; 44(2); 119-128. DOI: https://doi.org/10.1016/j.iac.2023.12.001

Fritscher A, Pflaum A, Mösinger M, Ruchay Z, Röcken C, Milla P, et al. Many Patients With Irritable Bowel Syndrome Have Atypical Food Allergies Not Associated With Immunoglobulin E. Gastroenterology. 2019 Jul;157(1);109-118.e5. doi: 10.1053/j.gastro.2019.03.046 DOI: https://doi.org/10.1053/j.gastro.2019.03.046

O’Shea K; Aceves S, Dellon E, Gupta S, Spergel J, Furuta G, Rothenberg, M. Pathophysiology of Eosinophilic. Esophagitis. Gastroenterology. 2018 Jan; 154(2),333–345. doi: 10.1053/j.gastro.2017.06.065 DOI: https://doi.org/10.1053/j.gastro.2017.06.065

Votto M, Marseglia G, De Filippo M, Brambilla I, Caimmi S, Licari A. Early life risk factors in pediatric EoE: could we prevent this modern disease?. Frontiers in Pediatrics. 2020 May; 8: 263. doi: 10.3389/fped.2020.00263 DOI: https://doi.org/10.3389/fped.2020.00263

Votto, M., De Filippo, M., Castagnoli, R., Delle Cave, F., Giffoni, F., Santi, V., ... & Licari, A. (2021). Non-invasive biomarkers of eosinophilic esophagitis. Acta Bio Medica: Atenei Parmensis, 92(Suppl 7).

Rochman Y, Kotliar M, Ben-Baruch N, Barski A, Wen T, Rothenberg ME. TSLP shapes the pathogenic responses of memory CD4+ T cells in eosinophilic esophagitis. Sci Signal. 2023 Sep;16(802) doi: 10.1126/scisignal.adg6360. DOI: https://doi.org/10.1126/scisignal.adg6360

Stanbery A, Smita S, Von Moltke J, Wojno E, Ziegler S. TSLP, IL-33, and IL-25: not just for allergy and helminth infection. J Allergy Clin Immunol. 2022 Nov;150(6);1302-1313. doi: 10.1016/j.jaci.2022.07.003. DOI: https://doi.org/10.1016/j.jaci.2022.07.003

Manresa M, Chiang A, Kurten R, Dohil R, Brickner H, Dohil L, Aceves S. Increased production of LIGHT by T cells in eosinophilic esophagitis promotes differentiation of esophageal fibroblasts toward an inflammatory phenotype. Gastroenterology. 2020 Nov;159(5);1778-1792.e5. doi: 10.1053/j.gastro.2020.07.035 DOI: https://doi.org/10.1053/j.gastro.2020.07.035

Chua Z, Fletcher A. The LIGHT switch: mechanisms of fibroblast pathology in eosinophilic esophagitis. Mucosal Immunol. 2022 Feb;15(2);195-197. doi: 10.1038/s41385-022-00486-y DOI: https://doi.org/10.1038/s41385-022-00486-y

Schoepfer A, Simko A, Bussmann C, Safroneeva E, Zwahlen M, Greuter T, et al. Eosinophilic esophagitis: relationship of subepithelial eosinophilic inflammation with epithelial histology, endoscopy, blood eosinophils, and symptoms. Am J Gastroenterol. 2018 Mar;113(3);348-357. doi: 10.1038/ajg.2018.6. DOI: https://doi.org/10.1038/ajg.2017.493

Muñoz D, Chapa A, Bahna S. Eosinophilic esophagitis clinical manifestations and differential diagnosis. Clin Rev Allergy Immunol. 2018 Aug;55(6):1-12. doi: 10.1007/s12016-017-8663-y. DOI: https://doi.org/10.1007/s12016-017-8663-y

De Matteis, A., Pagliaro, G., Corleto, V. D., Pacchiarotti, C., Di Giulio, E., Villa, M. P., ... & Di Nardo, G. (2020). Eosinophilic esophagitis in children: clinical findings and diagnostic approach. Current Pediatric Reviews, 16(3), 206-214. DOI: https://doi.org/10.2174/1573396315666191004110549

Izquierdo E, Rodriguez J, Delgado M, Gomez C, Barber D, Escribese M. Epithelial barrier: Protector and Trigger of Allergic disorders. J Investig Allergol Clin Immunol. 2022; 32(2); 81-96. doi: 10.18176/jiaci.0779 DOI: https://doi.org/10.18176/jiaci.0779

Barni S, Arasi S, Mastrorilli C, Pecoraro L, Giovannini M, Mori F, et al. Pediatric eosinophilic esophagitis: a review for the clinician. Ital J Pediatr. 2021 Nov;47(1);1-14. doi:10.1186/s13052-021-01178-2 DOI: https://doi.org/10.1186/s13052-021-01178-2

Hirano I, Furuta G. Approaches and challenges to management of pediatric and adult patients with eosinophilic esophagitis. Gastroenterology. 2020 Mar;158(4);840-845. doi: 10.1053/j.gastro.2019.09.052 DOI: https://doi.org/10.1053/j.gastro.2019.09.052

Safroneeva E, Balsiger L, Hafner D, Kuehni E. Adults with eosinophilic oesophagitis identify symptoms and quality of life as the most important outcomes. Aliment Pharmacol Ther. 2018 Nov;48(10);1082-1090. doi: 10.1111/apt.15000. DOI: https://doi.org/10.1111/apt.15000

Lieberman J. Minimally symptomatic patients with eosinophilic esophagitis should still be actively treated—con. Ann Allergy Asthma Immunol. 2019 Jun;122(6);574-575. doi: 10.1016/j.anai.2018.11.020. DOI: https://doi.org/10.1016/j.anai.2018.11.020

Nakamura R, Omori T, Suda K, Wada N. Endoscopic findings of laryngopharyngeal and esophageal involvement in autoimmune bullous disease. Dig Endosc. 2017 May;29(7):765–72. doi: 10.1111/den.12893. DOI: https://doi.org/10.1111/den.12893

Rothenberg M, Hottinger S, Gonsalves N, Furuta G, Collins M, Talley N, et al. Impressions and aspirations from the FDA GREAT VI Workshop on eosinophilic gastrointestinal disorders beyond eosinophilic esophagitis and perspectives for progress in the field. J Allergy Clin Immunol. 2022 Mar;149(3);844-853. doi: 10.1016/j.jaci.2021.12.768. DOI: https://doi.org/10.1016/j.jaci.2021.12.768

Molina J, Arias Á, Alcedo J, García R. Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: the 2-4-6 study. J Allergy Clin Immunol. 2017 Oct;141(4);1365-1372. doi: 10.1016/j.jaci.2017.08.038. DOI: https://doi.org/10.1016/j.jaci.2017.08.038

Wang R, Hirano I, Doerfler B, Zalewski A, Gonsalves N, Taft T. Assessing adherence and barriers to long-term elimination diet therapy in adults with eosinophilic esophagitis. Dig Dis Sci. 2018 Apr;63(7);1756-1762. doi: 10.1007/s10620-018-5045-0. DOI: https://doi.org/10.1007/s10620-018-5045-0

Doerfler B, Lam A, Gonsalves N. Dietary management of eosinophilic esophagitis. Gastroenterol Hepatol (N Y). 2023 Nov;19(11):680-690.

Munoz-Persy M, Lucendo A. Treatment of eosinophilic esophagitis in the pediatric patient: an evidence-based approach. Eur J Pediatr. 2018 May;177(5);649-663. doi: 10.1007/s00431-018-3129-7. DOI: https://doi.org/10.1007/s00431-018-3129-7

Visaggi P, Baiano F, Savarino E. Food elimination diets in eosinophilic esophagitis: Practical tips in current management and future directions. Best Pract Res Clin Gastroenterol. 2023 Feb-Mar;62-63:101825. doi: 10.1016/j.bpg.2023.101825. DOI: https://doi.org/10.1016/j.bpg.2023.101825

Visaggi P, Savarino E, Sciume G, Chio T, Bronzini F, Tolone S, et al. Eosinophilic esophagitis: clinical, endoscopic, histologic and therapeutic differences and similarities between children and adults. Therapeutic Advances in Gastroenterology. 2021 Jun;14. doi:10.1177/1756284820980860 DOI: https://doi.org/10.1177/1756284820980860

Kliewer K, Gonsalves N. Dellon, Katzka D, Abonia J, Aceves S, et al. One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial. 2023 May;8(5); 408-421. doi: 10.1016/S2468-1253(23)00012-2 DOI: https://doi.org/10.1016/S2468-1253(23)00012-2

Ma C, Bram D, Jairath V, Nguyen T, Parker C, Aceves S, et al. Heterogeneity in Clinical, Endoscopic, and Histologic Outcome Measures and Placebo Response Rates in Clinical Trials of Eosinophilic Esophagitis: A Systematic Review. Clinical Gastroenterology and Hepatology. 2018 Nov; 16(11);1714-1729.e3. doi: 10.1016/j.cgh.2018.06.005. DOI: https://doi.org/10.1016/j.cgh.2018.06.005

Wechsler J, Schwartz S, Arva N, Kim K, Chen L, Makhija M, et al. A single-food milk elimination diet is effective for treatment of eosinophilic esophagitis in children. Clin Gastroenterol Hepatol. 2022 Aug;20(8);1748-1756. doi: 10.1016/j.cgh.2022.01.003 DOI: https://doi.org/10.1016/j.cgh.2021.03.049

Kanagaratham C, El Ansari Y, Sallis B, Hollister B, Lewis O, Minnicozzi S, et al. Omeprazole inhibits IgE-mediated mast cell activation and allergic inflammation induced by ingested allergen in mice. J Allergy Clin Immunol. 2020 Oct;146(4);884-893.e5. doi: 10.1016/j.jaci.2020.02.032. DOI: https://doi.org/10.1016/j.jaci.2020.02.032

Wechsler J, Hirano I. Biological therapies for eosinophilic gastrointestinal diseases. J Allergy Clin Immunol. 2018 Jul;142(1);24-31.e2. doi: 10.1016/j.jaci.2018.05.018. DOI: https://doi.org/10.1016/j.jaci.2018.05.018

Shoda T, Wen T, Aceves S, Abonia P, Atkins A, Bonis P, et al. Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: a cross-sectional study. Lancet Gastroenterol Hepatol. 2018 May;3(6);477-488. doi: 10.1016/S2468-1253(18)30096-7. DOI: https://doi.org/10.1016/S2468-1253(18)30096-7

Lima J, Thomas CD, Barbarino J, Desta Z, Van S, Rouby N, et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2C19 and proton pump inhibitor dosing. Clin Pharmacol Ther. 2021 Jun;109(6);1417-1423. doi: 10.1002/cpt.2015. DOI: https://doi.org/10.1002/cpt.2015

Massironi S, Mulinacci G, Gallo C, Elvevi A, Danese S, Invernizzi P, et al. Mechanistic insights into eosinophilic esophagitis: therapies targeting pathophysiological mechanisms. Cells. 2023 Oct;12(20):2473. doi: 10.3390/cells12202473. DOI: https://doi.org/10.3390/cells12202473

Molina F, Ugalde L, Arias L, Armenteros E, Relaño C, Casabona S, et al. Proton pump inhibitor effect on esophageal protein signature of eosinophilic esophagitis, prediction, and evaluation of treatment response. Allergy. 2023 Nov. doi: 10.1111/all.14979. DOI: https://doi.org/10.1111/all.14979

Yoon H, Youn Y, Park J, Park H. Reversibility of endoscopic features after treatment for eosinophilic esophagitis. Yonsei Med J. 2021 Jun;62(6);487-493. doi: 10.3349/ymj.2021.62.6.487. DOI: https://doi.org/10.3349/ymj.2021.62.6.487

Strossman N, Donovan K, Trovato A, Manem N, Nudelman N, Tadros M, et al. Exploring treatment options for eosinophilic esophagitis. Gastroenterol Insights. 2022 Jul;13(3);228-237. doi: 10.3390/gastroent13030023. DOI: https://doi.org/10.3390/gastroent13030023

Fernandez N, Raja S, Scarpignato C, Lynch K, Ahuja N, Horsley J. Eosinophilic esophagitis: updates on key unanswered questions. Ann N Y Acad Sci. 2020 Dec;1481(1);30-42. doi: 10.1111/nyas.14421 DOI: https://doi.org/10.1111/nyas.14421

Syverson E, Hait E. Update on emerging pharmacologic therapies for patients with eosinophilic esophagitis. Gastroenterol Hepatol. 2022 Apr;18(4);207-212.

Lucendo AJ. Drug treatment strategies for eosinophilic esophagitis in adults. Expert Opinion on Pharmacotherapy. 2022 FeB;23(7):827-840. doi: 10.1080/14656566.2022.206007 DOI: https://doi.org/10.1080/14656566.2022.2060077

Hirano I, Collins M, Katzka D, Mukkada V, Falk G, Morey R, et al. Budesonide oral suspension improves outcomes in patients with eosinophilic esophagitis: results from a phase 3 trial. Clin Gastroenterol Hepatol. 2021 Apr;20(3):525-534. doi: 10.1016/j.cgh.2021.04.022. DOI: https://doi.org/10.1016/j.cgh.2021.04.022

Dellon E, Collins M, Katzka D, Mukkada V, Falk D, Morey D. Long-term treatment of eosinophilic esophagitis with budesonide oral suspension. Clin Gastroenterol Hepatol. 2022 Jul; 20(7);1488-1498.e1. doi: 10.1016/j.cgh.2021.06.020. DOI: https://doi.org/10.1016/j.cgh.2021.06.020

Ketchem C, Reed C, Stefanadis Z, Dellon S. Treatment with compounded fluticasone suspension improves the clinical, endoscopic, and histologic features of eosinophilic esophagitis. Dis Esophagus. 2021 Jul;34(7). doi: 10.1093/dote/doaa120. DOI: https://doi.org/10.1093/dote/doaa120

Chen X, Li X. Budesonide oral suspension improves outcomes in patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2022 May;20(5);1188-1189. DOI: https://doi.org/10.1016/j.cgh.2021.05.028

Nennstiel S, Schlag C. Treatment of eosinophlic esophagitis with swallowed topical corticosteroids. World J Gastroenterol. 2020 Sep;26(36);5395-5407. doi: 10.3748/wjg.v26.i36.5395 DOI: https://doi.org/10.3748/wjg.v26.i36.5395

Hirano I, Safroneeva E, Roumet M, Comer G, Eagle G, Schoepfer A, et al. Randomised clinical trial: the safety and tolerability of fluticasone propionate orally disintegrating tablets versus placebo for eosinophilic oesophagitis. Aliment Pharmacol Ther. 2020 Apr;51(8);750-759. doi: 10.1111/apt.15703. DOI: https://doi.org/10.1111/apt.15670

Nistel M, Furuta G, Pan Z, Hsu S. Impact of dose reduction of topical steroids to manage adrenal insufficiency in pediatric eosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2023 Jun;76(6);786-792. doi: 10.1097/MPG.0000000000003588. DOI: https://doi.org/10.1097/MPG.0000000000003647

Rosen I, Mahamed A, Garah J, Magen R, Shaoul R. The management and course of eosinophilic esophagitis in Israeli children. Acta Paediatr. 2021 May;110(5);1653-1657. doi: 10.1111/apa.15746. DOI: https://doi.org/10.1111/apa.15746

Kochis S, Cooke D, Dantzer J, Wood R, Keet C. Low detection of adrenal suppression secondary to swallowed steroids for eosinophilic esophagitis in a quality improvement project. J Allergy Clin Immunol Pract. 2020 Dic;8(10);3647-3649. doi: 10.1016/j.jaip.2020.06.050. DOI: https://doi.org/10.1016/j.jaip.2020.06.050

Gonsalves N, Aceves S. Diagnosis and treatment of eosinophilic esophagitis. J Allergy Clin Immunol. 2020 Jan;145(1);1-7. doi: 10.1016/j.jaci.2019.11.011. DOI: https://doi.org/10.1016/j.jaci.2019.11.011

Główczewski A, Krogulska A. Formulations of topical steroids in eosinophilic esophagitis—current treatment and emerging possibilities. J Clin Med. 2022 Mar;11(5);1454. doi: 10.3390/jcm11051454. DOI: https://doi.org/10.3390/jcm11051454

Chawla K, Alabbas B, Sheth D, Papademetriou M. As easy as EoE: a novel and effective multidisciplinary approach to care of patients with eosinophilic esophagitis in the age of biologics. Dig Dis Sci. 2020 Aug; 65(8):2196-2202. doi: 10.1007/s10620-020-06366-4. DOI: https://doi.org/10.1007/s10620-020-06366-4

Lam A, Ma C, Lee J, Bredenoord A. Eosinophilic esophagitis: new molecules, better life?. Curr Opin Pharmacol. 2022 Apr; 63:102183. doi: 10.1016/j.coph.2022.102183. DOI: https://doi.org/10.1016/j.coph.2022.102183

Cafone J, Ruffner M, Spergel J. The role of eosinophils in immunotherapy. Curr Allergy Asthma Rep. 2020 Jan; 7;20(1):1. doi: 10.1007/s11882-020-0895-x. DOI: https://doi.org/10.1007/s11882-020-0895-x

Ridolo E, Barone A, Ottoni M, Peveri S, Montagni M, Nicoletta F. The new therapeutic frontiers in the treatment of eosinophilic esophagitis: biological drugs. Int J Mol Sci. 2024 Jan;25(3):1702. doi: 10.3390/ijms25031702. DOI: https://doi.org/10.3390/ijms25031702

Dellon E, Rothenberg M, Collins M, Hirano I, Chehade M, Bredenoord A, et al. Dupilumab in adults and adolescents with eosinophilic esophagitis. N Engl J Med. 2022 Dec;387(25):2317-2330. doi: 10.1056/NEJMoa2205982. DOI: https://doi.org/10.1056/NEJMoa2205982

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2025-01-01

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Fajardo Lucero PA, Espinosa Feijoó KL, Loor Cedeño KL, Ortiz Ramírez IA, Chica Huayamabe GV, Jarrín Wong TL, et al. Eosinophilic Esophagitis: immunological perspectives and therapeutic strategies. Salud, Ciencia y Tecnología [Internet]. 2025 Jan. 1 [cited 2025 Nov. 28];5:1080. Available from: https://sct.ageditor.ar/index.php/sct/article/view/1080