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1.
Front Immunol ; 15: 1405084, 2024.
Article in English | MEDLINE | ID: mdl-38835771

ABSTRACT

Introduction: Cynaroside exhibits various biological properties, including anti-inflammatory, antiviral, antitumor, and cardioprotective effects. However, its involvement in methotrexate (MTX)-induced intestinal inflammation remains inadequately understood. Thus, we investigated the impact of cynaroside on MTX-induced intestinal inflammation and its potential mechanisms. Methods: To assess the protective potential of cynaroside against intestinal inflammation, Sprague-Dawley rats were subjected to a regimen of 7 mg/kg MTX for 3 days, followed by treatment with cynaroside at varying doses (10, 20, or 40 mg/kg). Histopathological evaluations were conducted alongside measurements of inflammatory mediators to elucidate the involvement of the NLRP3 inflammasome in alleviating intestinal inflammation. Results: Administration of 7 mg/kg MTX resulted in decreased daily food intake, increased weight loss, and elevated disease activity index in rats. Conversely, treatment with cynaroside at 20 or 40 mg/kg ameliorated the reductions in body weight and daily food intake and suppressed the MTX-induced elevation in the disease activity index. Notably, cynaroside administration at 20 or 40 mg/kg attenuated inflammatory cell infiltration, augmented goblet cell numbers and lowered serum levels of tumor necrosis factor-α, interleukin (IL)-1ß, and IL-18, as well as the CD68-positive cell rate in the intestines of MTX-induced rats. Furthermore, cynaroside downregulated the expression levels of NLRP3, cleaved caspase 1, and cleaved IL-1ß in MTX-induced rats. Discussion: Collectively, our findings indicated that cymaroside alleviates intestinal inflammatory injury by inhibiting the activation of NLRP3 inflammasome in MTX-induced rats.


Subject(s)
Enteritis , Inflammasomes , Methotrexate , NLR Family, Pyrin Domain-Containing 3 Protein , Rats, Sprague-Dawley , Animals , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , Inflammasomes/metabolism , Rats , Male , Enteritis/chemically induced , Enteritis/drug therapy , Anti-Inflammatory Agents/pharmacology , Anti-Inflammatory Agents/therapeutic use , Cytokines/metabolism , Glucosides/pharmacology , Glucosides/therapeutic use , Disease Models, Animal
2.
BMC Microbiol ; 24(1): 157, 2024 May 06.
Article in English | MEDLINE | ID: mdl-38710998

ABSTRACT

BACKGROUND: Clostridium perfringens, a common environmental bacterium, is responsible for a variety of serious illnesses including food poisoning, digestive disorders, and soft tissue infections. Mastitis in lactating cattle and sudden death losses in baby calves are major problems for producers raising calves on dairy farms. The pathogenicity of this bacterium is largely mediated by its production of various toxins. RESULTS: The study revealed that Among the examined lactating animals with a history of mastitis, diarrheal baby calves, and acute sudden death cases in calves, C. perfringens was isolated in 23.5% (93/395) of the total tested samples. Eighteen isolates were obtained from mastitic milk, 59 from rectal swabs, and 16 from the intestinal contents of dead calves. Most of the recovered C. perfringens isolates (95.6%) were identified as type A by molecular toxinotyping, except for four isolates from sudden death cases (type C). Notably, C. perfringens was recovered in 100% of sudden death cases compared with 32.9% of rectal swabs and 9% of milk samples. This study analyzed the phylogeny of C. perfringens using the plc region and identified the plc region in five Egyptian bovine isolates (milk and fecal origins). Importantly, this finding expands the known data on C. perfringens phospholipase C beyond reference strains in GenBank from various animal and environmental sources. CONCLUSION: Phylogenetic analyses of nucleotide sequence data differentiated between strains of different origins. The plc sequences of Egyptian C. perfringens strains acquired in the present study differed from those reported globally and constituted a distinct genetic ancestor.


Subject(s)
Clostridium Infections , Clostridium perfringens , Enteritis , Genetic Variation , Mastitis, Bovine , Milk , Phylogeny , Animals , Clostridium perfringens/genetics , Clostridium perfringens/isolation & purification , Clostridium perfringens/classification , Clostridium perfringens/pathogenicity , Cattle , Egypt , Female , Clostridium Infections/microbiology , Clostridium Infections/veterinary , Milk/microbiology , Enteritis/microbiology , Enteritis/veterinary , Mastitis, Bovine/microbiology , Cattle Diseases/microbiology , Feces/microbiology , Type C Phospholipases/genetics , Dairying , Farms , Bacterial Toxins/genetics
3.
Food Funct ; 15(10): 5641-5654, 2024 May 20.
Article in English | MEDLINE | ID: mdl-38726659

ABSTRACT

Exposure to food allergens elicits fast changes in the intestinal microenvironment, which guides the development of allergic reactions. Investigating the key information about these changes may help in better understanding food allergies. In this research, we explored the relationship between a food allergy and extracellular adenosine triphosphate (ATP), a danger molecule that has been proved to regulate the onset of allergic asthma and dermatitis but has not been studied in food allergies, by developing a unique animal model through allergen-containing diet feeding. After consuming an allergen-containing diet for 7 days, the allergic mice exhibited severe enteritis with elevated luminal ATP levels. The dysregulated luminal ATP worsened food-induced enteritis by enhancing Th17 cell responses and increasing mucosal neutrophil accumulation. In vitro experiments demonstrated that ATP intervention facilitated Th17 cell differentiation and neutrophil activation. In addition, the diet-induced allergy showed noticeable gut dysbiosis, characterized by decreased microbial diversity and increased diet-specific microbiota signatures. As the first, we show that food-induced enteritis is associated with an elevated concentration of luminal ATP. The dysregulated extracellular ATP exacerbated the enteritis of mice to a food challenge by manipulating intestinal Th17 cells and neutrophils.


Subject(s)
Adenosine Triphosphate , Food Hypersensitivity , Neutrophil Activation , Neutrophils , Th17 Cells , Animals , Adenosine Triphosphate/metabolism , Mice , Food Hypersensitivity/immunology , Th17 Cells/immunology , Neutrophils/immunology , Neutrophils/metabolism , Disease Models, Animal , Female , Gastrointestinal Microbiome , Mice, Inbred C57BL , Allergens/immunology , Enteritis/immunology , Mice, Inbred BALB C , Humans
4.
Fish Shellfish Immunol ; 149: 109618, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38729251

ABSTRACT

An eight-week feeding trial was designed to assess which component of commensal Bacillus siamensis LF4 can mitigate SBM-induced enteritis and microbiota dysbiosis in spotted seabass (Lateolabrax maculatus) based on TLRs-MAPKs/NF-кB signaling pathways. Fish continuously fed low SBM (containing 16 % SBM) and high SBM (containing 40 % SBM) diets were used as positive (FM group) and negative (SBM group) control, respectively. After feeding high SBM diet for 28 days, fish were supplemented with B. siamensis LF4-derived whole cell wall (CW), cell wall protein (CWP), lipoteichoic acid (LTA) or peptidoglycan (PGN) until 56 days. The results showed that a high inclusion of SBM in the diet caused enteritis, characterized with significantly (P < 0.05) decreased muscular thickness, villus height, villus width, atrophied and loosely arranged microvillus. Moreover, high SBM inclusion induced an up-regulation of pro-inflammatory cytokines and a down-regulation of occludin, E-cadherin, anti-inflammatory cytokines, apoptosis related genes and antimicrobial peptides. However, dietary supplementation with CW, LTA, and PGN of B. siamensis LF4 could effectively alleviate enteritis caused by a high level of dietary SBM. Additionally, CWP and PGN administration increased beneficial Cetobacterium and decreased pathogenic Plesiomonas and Brevinema, while dietary LTA decreased Plesiomonas and Brevinema, suggesting that CWP, LTA and PGN positively modulated intestinal microbiota in spotted seabass. Furthermore, CW, LTA, and PGN application significantly stimulated TLR2, TLR5 and MyD88 expressions, and inhibited the downstream p38 and NF-κB signaling. Taken together, these results suggest that LTA and PGN from B. siamensis LF4 could alleviate soybean meal-induced enteritis and microbiota dysbiosis in L. maculatus, and p38 MAPK/NF-κB pathways might be involved in those processes.


Subject(s)
Animal Feed , Bacillus , Diet , Dysbiosis , Enteritis , Fish Diseases , Gastrointestinal Microbiome , Glycine max , Lipopolysaccharides , Peptidoglycan , Teichoic Acids , Animals , Fish Diseases/immunology , Animal Feed/analysis , Enteritis/veterinary , Enteritis/immunology , Enteritis/microbiology , Dysbiosis/veterinary , Dysbiosis/immunology , Bacillus/physiology , Bacillus/chemistry , Gastrointestinal Microbiome/drug effects , Diet/veterinary , Glycine max/chemistry , Lipopolysaccharides/pharmacology , Teichoic Acids/pharmacology , Peptidoglycan/pharmacology , Peptidoglycan/administration & dosage , Bass/immunology , Probiotics/pharmacology , Probiotics/administration & dosage , Dietary Supplements/analysis , Random Allocation
5.
World J Gastroenterol ; 30(19): 2603-2611, 2024 May 21.
Article in English | MEDLINE | ID: mdl-38817661

ABSTRACT

BACKGROUND: The gut microbiota is strongly associated with radiation-induced gut damage. This study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation enteritis. CASE SUMMARY: A 64-year-old female with cervical cancer developed abdominal pain, diarrhea, and blood in the stool 1 year after radiotherapy. An electronic colonoscopy was performed to diagnose chronic radiation enteritis. Two courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were performed. The patient experienced short- and long-term relief from symptoms without adverse effects. Whole 16S rRNA sequencing revealed significant differences in the intestinal flora's composition between patient and healthy donors. Pathogenic bacteria, such as Escherichia fergusonii and Romboutsia timonensis, were more in the patient. Beneficial bacteria such as Faecalibacterium prausnitzii, Fusicatenibacter saccharivorans, Ruminococcus bromii, and Bifidobacterium longum were more in the healthy donors. Intestinal microbiota transplantation resulted in a significant change in the patient's intestinal flora composition. The composition converged with the donor's flora, with an increase in core beneficial intestinal bacteria, such as Eubacterium rectale, and a decrease in pathogenic bacteria. Changes in the intestinal flora corresponded with the patients' alleviating clinical symptoms. CONCLUSION: Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal flora. This study provides a new approach for treating patients with chronic radiation enteritis.


Subject(s)
Enteritis , Fecal Microbiota Transplantation , Gastrointestinal Microbiome , Radiation Injuries , Uterine Cervical Neoplasms , Humans , Female , Middle Aged , Enteritis/microbiology , Enteritis/diagnosis , Enteritis/etiology , Enteritis/therapy , Radiation Injuries/diagnosis , Radiation Injuries/microbiology , Radiation Injuries/etiology , Radiation Injuries/surgery , Gastrointestinal Microbiome/radiation effects , Fecal Microbiota Transplantation/methods , Uterine Cervical Neoplasms/radiotherapy , RNA, Ribosomal, 16S/genetics , Treatment Outcome , Chronic Disease , Colonoscopy , Intestines/microbiology , Intestines/radiation effects , Feces/microbiology , Radiotherapy/adverse effects
6.
World J Gastroenterol ; 30(10): 1377-1392, 2024 Mar 14.
Article in English | MEDLINE | ID: mdl-38596500

ABSTRACT

BACKGROUND: Crohn's disease (CD) is often misdiagnosed as intestinal tuberculosis (ITB). However, the treatment and prognosis of these two diseases are dramatically different. Therefore, it is important to develop a method to identify CD and ITB with high accuracy, specificity, and speed. AIM: To develop a method to identify CD and ITB with high accuracy, specificity, and speed. METHODS: A total of 72 paraffin wax-embedded tissue sections were pathologically and clinically diagnosed as CD or ITB. Paraffin wax-embedded tissue sections were attached to a metal coating and measured using attenuated total reflectance fourier transform infrared spectroscopy at mid-infrared wavelengths combined with XGBoost for differential diagnosis. RESULTS: The results showed that the paraffin wax-embedded specimens of CD and ITB were significantly different in their spectral signals at 1074 cm-1 and 1234 cm-1 bands, and the differential diagnosis model based on spectral characteristics combined with machine learning showed accuracy, specificity, and sensitivity of 91.84%, 92.59%, and 90.90%, respectively, for the differential diagnosis of CD and ITB. CONCLUSION: Information on the mid-infrared region can reveal the different histological components of CD and ITB at the molecular level, and spectral analysis combined with machine learning to establish a diagnostic model is expected to become a new method for the differential diagnosis of CD and ITB.


Subject(s)
Crohn Disease , Enteritis , Tuberculosis, Gastrointestinal , Humans , Crohn Disease/diagnosis , Crohn Disease/pathology , Spectroscopy, Fourier Transform Infrared , Diagnosis, Differential , Paraffin , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Gastrointestinal/pathology , Enteritis/diagnosis , Machine Learning , Ataxia Telangiectasia Mutated Proteins
7.
J Pediatr Gastroenterol Nutr ; 78(4): 878-885, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38591709

ABSTRACT

BACKGROUND: Recurrent upper endoscopies are essential for monitoring therapy response and disease activity in patients with eosinophilic esophagitis (EoE), leading to increased costs, procedural complications, and anesthesia exposure. The aim of this study was to examine an office-based model using serial sedation-free blind esophageal epithelial brushing (BEEB) to monitor therapy response through eosinophil-derived neurotoxin (EDN) levels and guide therapy plans in pediatric EoE patients. METHODS: EoE patients (≤21 years of age) were enrolled in this prospective study. Subjects were placed on dietary, pharmacologic, or combination therapy with the goal of inducing or maintaining remission. To assess response to sequential interventions, subjects underwent sequential sedation-free BEEBs through nasogastric tubes to measure EDN levels. Based on serial brushings, an individual plan of diet, medications, or a combination of both was created for each subject, and a final endoscopy was then performed to validate the accuracy of the individual plans. RESULTS: Twenty-four subjects completed the study. The average peak eosinophil count in patients with active EoE was 58.1 ± 30.8 eosinophils per high-power field and mean EDN level was 165.2 ± 191.3 µg/mL. A total of 42 BEEBs were completed. Individual therapy plans based on sequential BEEB were accurate in 19 out of the 24 patients (79%) and specifically nine out of 10 patients (90%) treated with elimination diets. CONCLUSION: This study suggests that office-based sedation-free BEEBs can be used to monitor therapy response and disease activity in pediatric EoE patients.


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Humans , Child , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/therapy , Pilot Projects , Prospective Studies , Eosinophils
8.
Pediatr Allergy Immunol ; 35(4): e14122, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38581140

ABSTRACT

PURPOSE: Neurodevelopmental disorders, such as autism spectrum disorder (ASD), have been increasingly associated with eosinophilic gastrointestinal disorders (EGID). However, the relationship between these diseases remains unclear. We performed a systematic review with meta-analysis to address this issue. METHODS: The search was performed according to the PRISMA guidelines using descriptors for ASD and EGIDs from the MEDLINE, Embase, PsycInfo, LILACS, and Web of Science databases. Observational studies with the prevalence of ASD in any EGID were included. The study protocol was registered on the PROSPERO platform under the number CRD42023455177. RESULTS: The total dataset comprised 766,082 participants. The result of the single-arm meta-analysis showed an overall prevalence of ASD in the population with EGID of 21.59% (95% CI: 10.73-38.67). There was an association between EGID and ASD (OR: 3.44; 95% CI: 1.25-2.21), also significant when restricted only to EoE (OR: 3.70; 95% CI: 2.71-5.70). DISCUSSION: Recent studies have implicated the influence of an inadequate epithelial barrier integrity in the pathogenesis of several diseases. The role of this mechanism can be extended to situations beyond allergic reactions, including other conditions with underlying immunological mechanisms. Several diseases are potentially related to the systemic effect of bacterial translocation in tissues with defective epithelial barriers. CONCLUSION: Our meta-analysis provides evidence that supports the consideration of EGID in patients with ASD and ASD in patients with EGID. Despite its limitations, the results should also be validated by future studies, preferably using multicenter prospective designs in populations with low referral bias.


Subject(s)
Autism Spectrum Disorder , Autistic Disorder , Enteritis , Eosinophilia , Gastritis , Humans , Autism Spectrum Disorder/epidemiology , Eosinophilia/epidemiology , Gastritis/epidemiology , Multicenter Studies as Topic
9.
Open Vet J ; 14(1): 324-334, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38633159

ABSTRACT

Background: Butyric acid and its derivatives support the immune system, lessen inflammation, and lessen oxidative stress in broilers in addition to preserving gut homeostasis and epithelial integrity. Broiler performance has also been demonstrated to rise with the addition of nucleotides to the diet. Aim: The purpose of the study was to ascertain the effects of butyric acid and nucleotides added to feed on the overall performance, immunity, oxidant/antioxidant enzyme levels, intestinal histology, and hepatic functions of broilers. Methods: Four experimental groups of thirty chickens, each were used in the present study. The groups were assigned as a control group that received normal diet without additives, butyrate (B) group received the diet supplemented with butyric acid (250 g/ton feed), nucleotides (N) group received the diet supplemented with nucleotides (200 g/ton feed), and the fourth group received the diet supplemented with a combination of butyrate and nucleotide (BN) (250 g/ton B feed, and 200 g/ton N feed, respectively). Necrotic enteritis was produced in ten birds from each group to assess the immune-modulatory effect of these supplements, antioxidant status, intestinal histology, and liver functions were measured in all experimental groups. Results: The addition of butyric acid and nucleotides to feed enhanced body weight, growth performance, hepatic functions, and antioxidant capabilities. Histological sections of the gut from challenged or unchallenged (with necrotic enteritis) groups in the BN group showed considerable improvement, as shown by strong proliferation in intestinal crypts and villus enterocytes. Conclusion: Nucleotides and butyric acid can be added to broiler feeding regimens to enhance growth and health.


Subject(s)
Chickens , Enteritis , Animals , Butyric Acid/pharmacology , Antioxidants , Nucleotides , Dietary Supplements , Enteritis/veterinary
10.
Mol Biol Rep ; 51(1): 512, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38622483

ABSTRACT

Bacterial enteritis has a substantial role in contributing to a large portion of the global disease burden and serves as a major cause of newborn mortality. Despite advancements gained from current animal and cell models in improving our understanding of pathogens, their widespread application is hindered by apparent drawbacks. Therefore, more precise models are imperatively required to develop more accurate studies on host-pathogen interactions and drug discovery. Since the emergence of intestinal organoids, massive studies utilizing organoids have been conducted to study the pathogenesis of bacterial enteritis, revealing new mechanisms and validating established ones. In this review, we focus on the advancements of several bacterial pathogenesis mechanisms observed in intestinal organoid/enteroid models, exploring the host response and bacterial effectors during the infection process. Finally, we address the features that warrant additional investigation or could be enhanced in existing organoid models in order to guide future research endeavors.


Subject(s)
Bacterial Infections , Enteritis , Animals , Intestines/microbiology , Bacteria , Organoids
11.
Immunol Allergy Clin North Am ; 44(2): 129-143, 2024 May.
Article in English | MEDLINE | ID: mdl-38575213

ABSTRACT

Most of the major clinical signs and consequences of eosinophilic esophagitis seem to be related to tissue remodeling. Important data on remodeling activity in patients with eosinophilic esophagitis are provided by a range of current and new biologic markers and diagnostics. To completely clarify the possible advantages and restrictions of therapeutic approaches, clinical studies should take into consideration the existence and reversibility of esophageal remodeling. The degree of mucosal or submucosal disease activity may not be reflected by epithelial eosinophilic inflammation, which is used to define one criterion of disease activity".


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Humans , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/therapy , Fibrosis
12.
Immunol Allergy Clin North Am ; 44(2): 157-171, 2024 May.
Article in English | MEDLINE | ID: mdl-38575215

ABSTRACT

The diagnosis of eosinophilic esophagitis (EoE) is based on clinical symptoms of esophageal dysfunction and eosinophil predominant esophageal inflammation. Clinical symptoms in children with EoE vary based on age and may be nonspecific. EoE has a male predominance with the majority having comorbid atopic disorders. At present, treatment options include medications (proton pump inhibition, swallowed topical steroids), dietary therapy or biologic therapy (dupilumab, approved for those ≥12 years of age). Outside of EoE in the context of oral immunotherapy, EoE is typically chronic requiring lifelong therapy. Long-term complications including feeding difficulties, malnutrition, and fibrostenotic disease.


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Child , Male , Humans , Female , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/therapy , Glucocorticoids/therapeutic use , Enteritis/drug therapy
13.
Immunol Allergy Clin North Am ; 44(2): 185-196, 2024 May.
Article in English | MEDLINE | ID: mdl-38575217

ABSTRACT

Adult patients with eosinophilic esophagitis (EoE) typically present with a history of dysphagia for solids, sometimes with additional reflux-like pain and a history of prior food impactions. In contrast to these alarming symptoms, the general appearance and physical examination of adult patients with EoE is in line with apparently healthy individuals. Therefore, the diagnosis is based on a history of solid-food dysphagia and eosinophilic tissue infiltration. Importantly, the increasing prevalence of EoE variants, that is, typical EoE symptoms in the absence of a relevant eosinophilia, and several studies with eosinophil-targeting drugs, call the pathogenic role of eosinophils into question.


Subject(s)
Deglutition Disorders , Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Adult , Humans , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/epidemiology , Eosinophilic Esophagitis/therapy , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Deglutition Disorders/pathology , Eosinophils , Inflammation/pathology
14.
Immunol Allergy Clin North Am ; 44(2): 205-221, 2024 May.
Article in English | MEDLINE | ID: mdl-38575219

ABSTRACT

Microscopic examination of esophageal biopsies is essential to diagnose eosinophilic esophagitis (EoE). Eosinophil inflammation is the basis for the diagnosis, but additional abnormalities may contribute to persistent symptoms and epithelial barrier dysfunction. Both peak eosinophil count and assessments of additional features should be included in pre-therapy and post-therapy pathology reports. Pathologic abnormalities identified in esophageal biopsies of EoE are reversible in contrast to esophageal strictures.


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Humans , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/therapy , Eosinophils , Biopsy
15.
Immunol Allergy Clin North Am ; 44(2): 173-184, 2024 May.
Article in English | MEDLINE | ID: mdl-38575216

ABSTRACT

Feeding is a complex skill requiring coordination of multiple body systems. Multiple factors are considered in feeding dysfunction in pediatric patients with eosinophilic gastrointestinal disorders, including overall development, nutritional status, mealtime behaviors, and medical comorbidities. Symptoms of feeding dysfunction vary by age, with maladaptive learned feeding behaviors spanning all age ranges. Knowledge of the normal acquisition of feeding skills is critical to interpret the impact of the disease and plan appropriate intervention. Assessment and treatment from a feeding and swallowing disorders specialist can dramatically impact successful outcomes in nutrition, growth, mealtime dynamics and ultimatly quality of life for children and their caregivers in home and social settings.


Subject(s)
Deglutition Disorders , Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Child , Humans , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/therapy , Quality of Life , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Deglutition Disorders/therapy
16.
Immunol Allergy Clin North Am ; 44(2): 311-327, 2024 May.
Article in English | MEDLINE | ID: mdl-38575226

ABSTRACT

Mast cells play a central role in the pathogenesis of eosinophilic gastrointestinal disorders (EGIDs), including eosinophilic esophagitis. Their interactions with immune and structural cells, involvement in tissue remodeling, and contribution to symptoms make them attractive targets for therapeutic intervention. More is being discovered regarding the intricate interplay of mast cells and eosinophils. Recent studies demonstrating that depletion of eosinophils is insufficient to improve symptoms of EGIDs have raised the question of whether other cells may play a role in symptomatology and pathogenesis of EGIDs.


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Humans , Mast Cells , Enteritis/therapy , Enteritis/diagnosis , Gastritis/diagnosis , Gastritis/therapy , Eosinophilic Esophagitis/therapy , Eosinophilic Esophagitis/diagnosis
17.
Immunol Allergy Clin North Am ; 44(2): 245-264, 2024 May.
Article in English | MEDLINE | ID: mdl-38575221

ABSTRACT

Proton pump inhibitors (PPIs), swallowed topical corticosteroids (STSs), and dupilumab are highly effective therapies for the treatment of eosinophilic esophagitis. Shared decision-making informs the choice of therapy and factors such as ease of use, safety, cost, and efficacy should be addressed. PPIs are the most common medication utilized early in the disease course; however, for nonresponders, STSs are an excellent alternative. Dupilumab is unlikely to replace PPIs or STSs as first-line therapy, except in highly specific circumstances. Identification of novel biologic pathways and the development of small molecules may lead to a wider range of treatment options in the future.


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Humans , Eosinophilic Esophagitis/drug therapy , Glucocorticoids/therapeutic use , Proton Pump Inhibitors/therapeutic use , Enteritis/drug therapy
18.
Immunol Allergy Clin North Am ; 44(2): 329-348, 2024 May.
Article in English | MEDLINE | ID: mdl-38575227

ABSTRACT

Eosinophilic gastrointestinal disorders (EGIDs) are becoming more common causing significant suffering and reduced quality of life. These conditions can affect different parts of the digestive system, either individually or in combination. Recognition of their link to allergic disorders or other gastrointestinal (GI) diseases has raised questions about their shared underlying mechanisms, which has had implications for diagnosis and management. The authors critically examine the current understanding of the connection between EGIDs and allergic conditions (ie, atopic dermatitis, allergic rhinitis, asthma, and food allergy) and GI diseases (ie, inflammatory bowel disease, celiac disease, gastroesophageal reflux disease, and motility disorders).


Subject(s)
Dermatitis, Atopic , Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Humans , Quality of Life , Eosinophilia/diagnosis , Eosinophilia/complications , Gastritis/diagnosis , Gastritis/complications , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/epidemiology , Eosinophilic Esophagitis/therapy
19.
Immunol Allergy Clin North Am ; 44(2): 265-280, 2024 May.
Article in English | MEDLINE | ID: mdl-38575222

ABSTRACT

Measuring health-related quality of life (HRQOL) gained relevance in research and clinical practice in patients with eosinophilic esophagitis. The physical discomfort and social and psychological consequences of this food-related disease substantially affect HRQOL. Determinant of an impaired HRQOL include symptom severity, disease duration, biological disease activity, and psychological factors. Patients prioritize symptom relief and improved HRQOL as treatment objectives. Available treatment options can address these goals; however, there is a suboptimal adherence to treatment. There is a need for enhanced patient guidance and education. The assessment of HRQOL will help to prioritize patient's needs in management.


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Humans , Quality of Life/psychology , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/therapy , Food
20.
Immunol Allergy Clin North Am ; 44(2): 293-298, 2024 May.
Article in English | MEDLINE | ID: mdl-38575224

ABSTRACT

Eosinophilic gastrointestinal diseases (EGIDs) including eosinophilic esophagitis (EoE) are rare diseases in which eosinophils abnormally infiltrate the gastrointestinal tract. Because these are rare diseases, there is limited information regarding race and ethnicity in EGIDs and even less is known about the impact of socioeconomic factors. There is some evidence that access to care in rural settings may be affecting epidemiologic understanding of EGIDs in the pediatric populations. Future work should try to evaluate bias in research and strive for representation in clinical trials and medicine.


Subject(s)
Enteritis , Eosinophilia , Eosinophilic Esophagitis , Gastritis , Child , Humans , Diversity, Equity, Inclusion , Rare Diseases , Eosinophilic Esophagitis/epidemiology , Eosinophilic Esophagitis/therapy
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