Database : MEDLINE
Search on : Eosinophilic and Esophagitis [Words]
References found : 2193 [refine]
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[PMID]: 29524399
[Au] Autor:Souza RF; Rubenstein J; Kao J; Hirano I
[Ad] Address:Department of Medicine, Division of Gastroenterology, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott and White Research Institute, Dallas, Texas.
[Ti] Title:Contributions From Gastroenterology: Acid Peptic Disorders, Barrett's Esophagus and Eosinophilic Esophagitis.
[So] Source:Gastroenterology;, 2018 Mar 07.
[Is] ISSN:1528-0012
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 2193 MEDLINE  
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[PMID]: 29522850
[Au] Autor:Molina-Infante J; Lucendo AJ
[Ad] Address:Department of Gastroenterology, Hospital Universitario San Pedro de Alcantara, Caceres, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. Electronic address: xavi_molina@hotmail.com.
[Ti] Title:Dietary therapy for eosinophilic esophagitis.
[So] Source:J Allergy Clin Immunol;, 2018 Mar 06.
[Is] ISSN:1097-6825
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Eosinophilic esophagitis (EoE) is a chronic, immune-mediated, esophageal disease triggered predominantly, but not excusively, by food antigens. Presently, available food allergy tests are suboptimal to predict food triggers for EoE, especially in adults. Elemental diet (exclusive feeding with aminoacid-based formulas) and empiric six-food elimination diet (6-FED; withdrawing milk, wheat, egg, soy, nuts and fish/seafood for 6 weeks), have consistently shown the best efficacy rates. However, their high level of restriction and need for multiple endoscopies have hampered their implementation in clinical practice. Currently, milk, wheat/gluten and egg are the most common food triggers in children and adults from US, Spain and Australia. Hence, less restrictive empiric schemes, like a four-food (4-FED; dairy, gluten-containing cereals, egg, and legumes) or a two-food (2-FED; dairy and gluten-containing cereals) have been lately developed with good efficacy rates (2-FED 43%; 4-FED adults 54%, children 64%). A step-up approach (2-4-6) may result in prompt recognition of a majority of responders with few food triggers, reducing the number of endoscopies and costs, and shortening the diagnostic process. Standardization of food reintroduction, novel food allergy testing and studies evaluating milk elimination diet in children and the long-term outcomes of dietary interventions are warranted.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  3 / 2193 MEDLINE  
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[PMID]: 29510130
[Au] Autor:Odiase E; Schwartz A; Souza RF; Spechler SJ; Martin J; Konda V
[Ad] Address:Baylor University Medical Center, and Baylor Scott & White Research Institute, Dallas, Texas.
[Ti] Title:New Eosinophilic Esophagitis Concepts Call for Change in Proton Pump Inhibitor Management Before Diagnostic Endoscopy.
[So] Source:Gastroenterology;, 2018 Mar 03.
[Is] ISSN:1528-0012
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:EDITORIAL
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 2193 MEDLINE  
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[PMID]: 29248734
[Au] Autor:Wechsler JB; Bolton S; Amsden K; Wershil BK; Hirano I; Kagalwalla AF
[Ad] Address:Northwestern University Feinberg School of Medicine, Chicago, Illinois; Eosinophilic Gastrointestinal Diseases Program, Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
[Ti] Title:Eosinophilic Esophagitis Reference Score Accurately Identifies Disease Activity and Treatment Effects in Children.
[So] Source:Clin Gastroenterol Hepatol;, 2017 Dec 15.
[Is] ISSN:1542-7714
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND & AIMS: The endoscopic reference score (EREFS) is used to determine severity of 5 endoscopic findings: edema, rings, exudates, furrows, and strictures. Little is known about the relationship between EREFSs and histologic markers of disease activity in children with eosinophilic esophagitis (EoE). We aimed to determine whether the EREFS can be used to identify children with EoE and how it changes with treatment. METHODS: We performed a prospective study of consecutive children (ages 2-17 years) undergoing diagnostic or post-treatment endoscopy scored real-time with EREFS from December 2012 through 2016. Findings from 192 diagnostic endoscopies and 229 post-treatment endoscopies were evaluated, from 371 children. Incident EoE cases were diagnosed based on 2011 consensus guidelines. Patients were treated with either elimination diet or topical steroids. Subjects who underwent endoscopy for symptoms of esophageal dysfunction but had normal esophageal findings from histology analysis were used as controls. EREFS and receiver operating characteristic curves were determined for incident EoE cases (n = 77) vs controls (n = 115), patients with active EoE (n = 101) vs inactive EoE after treatment (n = 128), and paired pre- and post-treatment cases of EoE (n = 85). Component and composite scores were correlated with eosinophilia. RESULTS: Visual detection of more than 1 esophageal abnormality during the diagnostic endoscopy identified children with EoE with 89.6% sensitivity and 87.9% specificity. EREFS correlated with peak level of eosinophilia (P < .001) at all esophageal levels. Children who responded to therapy had mean EREFSs of 0.5 compared to 2.4 in non-responders. In comparing pre-treatment vs post-treatment data from 85 patients, we found a significant reduction in the composite EREFS (from 2.4 to 0.7) (P < .001) among patients who responded to treatment; 92% of responders had a reduced EREFSs after treatment. EREFSs identified children with EoE with an area under the curve value (AUC) of 0.93. EREFSs identified children with active EoE following treatment with an AUC of 0.81 before treatment and an AUC of 0.79 after treatment. CONCLUSIONS: In a prospective study of children undergoing diagnostic or post-treatment endoscopy, we found the EREFS to accurately identify those with EoE. Children who responded to therapy had lower EREFS scores than non-responders. EREFSs can be used to measure outcomes of pediatric patients, in conjunction with histology findings, and assess treatments for children with EoE.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  5 / 2193 MEDLINE  
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[PMID]: 29519719
[Au] Autor:Willenbring BA; Schnitker CK; Stellpflug SJ
[Ad] Address:Department of Emergency Medicine, Regions Hospital, Saint Paul, Minnesota.
[Ti] Title:Oral Nitroglycerin Solution May Be Effective for Esophageal Food Impaction.
[So] Source:J Emerg Med;, 2018 Mar 05.
[Is] ISSN:0736-4679
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Esophageal food impaction is a common illness presenting to emergency departments (ED), and is frequently resistant to pharmacologic therapy. Several medications have been promoted for this indication, but so far have not proven effective. Endoscopic removal is frequently required to resolve the impaction, resulting in risks from anesthesia and the physical procedure, and in prolonged hospital stay for recovery. Oral nitroglycerin solution was recently used in two such cases and may represent a new therapeutic option. CASE REPORTS: A 49-year-old man presented to an ED with dysphagia 30 min after eating steak. He was given 0.4 mg nitroglycerin dissolved in 10 mL tap water orally, and obtained complete relief of symptoms within 2 min. A 43-year-old man with eosinophilic esophagitis and two prior food impaction episodes presented to a community ED with dysphagia and epigastric discomfort 110 min after eating steak. Five hours after symptom onset and after failure of intravenous glucagon, he was given 0.4 mg nitroglycerin sublingually, which resulted in headache but no relief in dysphagia. Twenty-nine minutes later he received 0.4 mg nitroglycerin solution, as above, with symptom resolution within 2 min. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The cases presented above demonstrate close temporal relationships between administration of oral nitroglycerin solution and symptom relief. Oral nitroglycerin solution for esophageal food impaction seemed effective in these cases, but further research on this therapeutic option is warranted.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  6 / 2193 MEDLINE  
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[PMID]: 29278655
[Au] Autor:Ishimura N; Kinoshita Y
[Ad] Address:Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
[Ti] Title:Eosinophilic esophagitis in Japan: Focus on response to acid suppressive therapy.
[So] Source:J Gastroenterol Hepatol;, 2017 Dec 26.
[Is] ISSN:1440-1746
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:Eosinophilic esophagitis (EoE) is a chronic inflammatory condition characterized by esophageal dysfunction and dense eosinophilic infiltration of esophageal epithelium. According to clinical consensus and guidelines published in 2011, esophageal eosinophilia was classified into two entities based on response to proton pump inhibitor (PPI) administration: EoE and PPI-responsive esophageal eosinophilia (PPI-REE). We have performed a series of investigations to determine whether EoE is actually different from PPI-REE. Consistent with Western reports, more than half of our examined patients with symptomatic esophageal eosinophilia suggestive of EoE achieved histological remission with single PPI therapy. Furthermore, our comparisons of clinical, endoscopic, and histopathological findings between patients with EoE and those with PPI-REE revealed nearly no differences between them. We also compared gene expression profiles in mucosal biopsy specimens between those groups and found that microarray findings obtained from PPI-REE patients substantially overlapped with those from EoE patients, suggesting that both represent the same condition or are variations of a single disease. In addition, we have noted that more than half of EoE patients who show resistance to a PPI therapy respond to vonoprazan, a novel potassium-competitive acid blocker that has been shown to provide more potent and sustained suppression of gastric acid secretion than PPIs. Our results indicate that PPI-REE may constitute a subtype of EoE. Based on novel evidence including results obtained in our studies, the most recently updated guidelines have included responders to PPI therapy within the spectrum of EoE, abandoning the term PPI-REE.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1111/jgh.14079

  7 / 2193 MEDLINE  
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[PMID]: 29509636
[Au] Autor:Gutiérrez-Junquera C; Fernández-Fernández S; Cilleruelo ML; Rayo A; Echeverría L; Borrell B; Román E
[Ad] Address:Pediatric Gastroenterology Unit, Department of Pediatrics, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda.
[Ti] Title:Long-term Treatment With Proton Pump Inhibitors Is Effective in Children With Eosinophilic Esophagitis.
[So] Source:J Pediatr Gastroenterol Nutr;, 2018 Mar 05.
[Is] ISSN:1536-4801
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Proton pump inhibitor (PPI)-responsive eosinophilic esophagitis (EoE) is frequently observed in children, but data on long-term treatment are scarce. The objective of this study is to evaluate the long-term efficacy and safety of PPIs in children with EoE. METHODS: This prospective study enrolled children with EoE and histological remission to an 8-week esomeprazole trial (1 mg/kg/dose, twice daily). Esomeprazole was maintained at 1 mg/kg/day for 1 year. Symptom recurrence and adverse events were monitored and a follow-up endoscopy was performed at 12 months. Complete histological remission was defined as ≤5 eosinophils/high-power field (eos/hpf), and partial histological remission as >5 and <15 eos/hpf. Patients had no concomitant dietary restrictions or topical steroid. RESULTS: Fifty-seven children were included. Histological remission on maintenance PPI therapy was present in 40 children (70.1%; 95% CI 56.5-81.5). Long-term remission rate was higher in children with initial complete histological remission than in those with partial remission (81% vs 50%, P = 0.014). Forty-nine children (86%) remained asymptomatic. Pretreatment clinical and histological findings and median PPI dose/kg/day were similar between relapsers and nonrelapsers. Eleven out of 12 children (91.6%) receiving esomeprazole 0.5 mg ·â€Škg ·â€Š day for 12 additional months remained in remission. Mild and transient side effects without requiring PPI avoidance were observed in 5 children. CONCLUSIONS: Up to 70% of children with PPI-responsive EoE remain in histological and clinical remission on a low-dose maintenance treatment at 1-year follow-up, with adequate safety profile. Complete histological remission to an 8-week PPI trial was associated with higher probability of histological remission on maintenance therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1097/MPG.0000000000001952

  8 / 2193 MEDLINE  
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[PMID]: 29509633
[Au] Autor:Mohammad N; Avinashi V; Chan E; Vallance BA; Portales-Casamar E; Bush JW
[Ad] Address:Department of Pathology and Laboratory Medicine.
[Ti] Title:Pediatric Eosinophilic Esophagitis Is Associated With Increased Lamina Propria Immunoglobulin G4-Positive Plasma Cells.
[So] Source:J Pediatr Gastroenterol Nutr;, 2018 Mar 05.
[Is] ISSN:1536-4801
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Eosinophilic esophagitis (EoE) is considered a TH2-mediated food allergy disease that leads to submucosal esophageal fibrosis and strictures. Recent studies focused on adults with EoE identified a strong association with elevated esophageal IgG4 immunostaining. Our study aimed to determine the association of IgG4 with EoE in pediatric patients. METHODS: Using our local EoE research registry, we identified 41 adequate biopsies from EoE patients. We used 10 age- and sex-matched patients with no diagnostic abnormalities at endoscopy or on biopsy. Using a monoclonal antibody to Immunoglobulin G4 (IgG4), we determined the maximum density of IgG4-positive plasma cells (IgG4-PC) per high-power field (hpf). Using a semi-quantitative assessment, we also graded the noncellular staining of the lamina propria and epithelium. RESULTS: Our EoE cohort consisted predominantly of boys with an average age of 5.9 years and 63% had a documented IgE-based food allergy. Median peak eosinophilia was 40 eosinophils/hpf and the median IgG4-PC density was 39/hpf in the active esophagitis patients, compared with a median of 0 IgG4-PC/hpf in the non-EoE patients (P = 0.0001). EoE patients with a food allergy showed a significantly higher IgG4-PC density (44.5/hpf) than those without a food allergy (8/hpf; P = 0.0385). There was no significant association between IgG4-PC density and peak eosinophilia (r = 0.0011). CONCLUSIONS: We demonstrate that active esophagitis in pediatric EoE patients is associated with elevated levels of IgG4-positive plasma cells, which was more significant in EoE patients with a documented food allergy. Our study also adds to the growing literature that EoE may involve more than just an exaggerated TH2 immune response.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1097/MPG.0000000000001949

  9 / 2193 MEDLINE  
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[PMID]: 29424023
[Au] Autor:Vimalathas P; Farris A; Letner D; Deshpande V; Yajnik V; Shreffler W; Garber J
[Ad] Address:Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA.
[Ti] Title:Integrin αM activation and upregulation on esophageal eosinophils and periostin-mediated eosinophil survival in eosinophilic esophagitis.
[So] Source:Immunol Cell Biol;, 2018 Feb 09.
[Is] ISSN:1440-1711
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Eosinophilic esophagitis (EoE) is an increasingly recognized allergic disease associated with dysphagia and esophageal fibrosis. We aimed to determine expression patterns of specific eosinophil integrins that promote eosinophilic infiltration of the esophageal epithelium, and to determine how key EoE-related cytokines influence eosinophil activation and survival. Esophageal and peripheral eosinophils were isolated from 20 adult subjects with EoE for immunophenotyping and integrin profiling using multicolor flow cytometry and immunohistochemistry. Expression signatures of eosinophil integrins were further assessed by immunohistochemistry using serial sections of esophageal biopsy specimens. Purified eosinophils were used to assess the effect of EoE-relevant cytokines and recombinant periostin on expression of known eosinophil integrins and eosinophil survival and activation. We found that resting eosinophils express high levels of the ß2-pairing integrins αL and αM, and lower levels of α4, α6 and α4ß7. The migration of peripheral eosinophils to the esophagus is characterized by the specific induction of αM, and a significant increase in the proportion of αM in high-activity conformation. Periostin, a secreted extracellular matrix protein that is significantly overexpressed in EoE, enhances eosinophil survival, and this effect is mediated by αM interaction. Integrin αM is a specific marker of activated tissue eosinophils in EoE, and promotes eosinophil survival through interactions with periostin. The ability of αMß2 to mediate eosinophil tissue residency via periostin represents a key mechanism for disease development and a potential therapeutic target in EoE.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1111/imcb.12018

  10 / 2193 MEDLINE  
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[PMID]: 29397272
[Au] Autor:Petroni D; Spergel JM
[Ad] Address:Division of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle, Washington.
[Ti] Title:Eosinophilic esophagitis and symptoms possibly related to eosinophilic esophagitis in oral immunotherapy.
[So] Source:Ann Allergy Asthma Immunol;120(3):237-240.e4, 2018 Mar.
[Is] ISSN:1534-4436
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Data-Review


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