Eosinophilic esophagitis phenotypes: Ready for prime time?

Abstract

Eosinophilic Oesophagitis (EoE) is one of the most common causes of reflux like symptoms and feeding problems in children and food impaction and dysphagia in adults with a prevalence of 1:2500. Therapeutic options include diet, use of swallowed corticosteroids or dilation. In the last several years, recent clinical and translational research have identified some common and distinctive features, for example, the varying response to diet and medications. As EoE shares some characteristics with both asthma and inflammatory bowel disease, the advances in these fields suggests that various phenotypes may also exist in patients with EoE. Here we provide a rationale for EoE phenotypes and provide some suggestions for potential phenotypes based on histology, molecular signature, response to therapy or dietary therapy.

Incidence of Childhood Eosinophilic Esophagitis in Central Brazil: How Many Are We Missing?

“…The clinical and endoscopic characteristics of EoE in PPI responders and nonresponders in our study are similar to those reported elsewhere [20][21][22][23][24]. This reinforces the recent consensus that considered EoE and PPI-REE as different diseases on the same spectrum that should be recognized as EoE [2,[23][24][25][26][27].…”

Phenotypes and endotypes in eosinophilic esophagitis

“…As proposed by Atkins et al, 16 understanding the extent of a patient's response to therapy could add information to their phenotype and disease severity. 16 In work by Shoda et al, 17 3 groups of EoE patients could be identified.…”

“…As proposed by Atkins et al, 16 understanding the extent of a patient's response to therapy could add information to their phenotype and disease severity. 16 In work by Shoda et al, 17 3 groups of EoE patients could be identified. 17,18 A mild form was identified that responded to all forms of treatment, including PPIs (these patients may have been defined as PPI-responsive esophageal eosinophilia or PPI-REE in the recent past).…”

Editor's Choice

“…In this article, Atkins et al. discuss potential paradigms for subtyping EoE using the lessons learned from asthma and inflammatory bowel disease. They propose different scenarios allowing for potential separation of mild, moderate, and severe phenotypes based on symptoms, histology, or molecular pathways.…”