A Gap in Care Leads to Progression of Fibrosis in Eosinophilic Esophagitis Patients

Chang, Nicole C.; Thakkar, Kisan; Ketchem, Corey J.; Eluri, Swathi; Reed, Craig C.; Dellon, Evan S.

doi:10.1016/j.cgh.2021.10.028

Cited by 27 publications

(12 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…62,99 Second, EoE appears to progress to fibrostenosis in many, although not all, patients with EoE, as evidenced by increasing stricture rates with longer symptom duration before diagnosis in adults, longer durations without therapeutic response after diagnosis, and modification of the esophageal transcriptome from inflammatory to epithelial differentiation pathways. 60,86,[100][101][102][103][104][105] Third, because treating the inflammatory component of the disease alone may not adequately alleviate symptoms, it is important to recognize fibrostenosis and consider performing esophageal dilation in symptomatic patients. 106,107 Finally, an ultimate goal should be to diagnose and treat EoE early enough, such that patients neither develop nor progress to fibrostenosis.…”

Section: Meeting Summariesmentioning

confidence: 99%

A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

Dellon

Khoury²,

Muir³

et al. 2022

Gastroenterology

Self Cite

View full text Add to dashboard Cite

Section: Meeting Summariesmentioning

confidence: 99%

A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

Dellon

Khoury²,

Muir³

et al. 2022

Gastroenterology

Self Cite

View full text Add to dashboard Cite

“…4). Auch bei Patienten mit bekannter Diagnose, die sich der medizinischen Behandlung entziehen, kann es zu einer Progredienz der Erkrankung kommen [9]. Ein erhöhtes Risiko für Malignome ist nicht bekannt.…”

Section: Verlauf Und Prognoseunclassified

“…Bei Patienten, die sich der medizinischen Behandlung entziehen, kommt es zu einer erneuten Krankheitsprogression und steigender Strikturrate [9]. Umgekehrt führt eine engere Nachsorge (alle 12-18 Monate) zu einer frühzeitigeren Entdeckung eines histologischen Rezidivs und zu einer niedrigeren Strikturrate [19].…”

Section: Monitoringunclassified

Eosinophile Ösophagitis

Miehlke¹

2022

Gastroenterologie up2date

View full text Add to dashboard Cite

“…Delay in EoE diagnosis is also associated with increase in stricture in a time-dependent manner ( 20 ). Moreover, while gaps in clinical care of EoE patients are associated with progression to fibrostenosis ( 21 ), close follow-up is associated with a decrease in stricture in EoE patients ( 22 ). Taken together, these findings support the paradigm that chronic EoE inflammation promotes progression to fibrostenosis ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

A role for age-associated alterations in esophageal epithelium in eosinophilic esophagitis-associated fibrosis

Klochkova

Fuller²,

Miller³

et al. 2022

Front. Allergy

View full text Add to dashboard Cite

Subepithelial fibrosis occurs in a subset of eosinophilic esophagitis (EoE) patients and is associated with esophageal stricture. While mechanisms driving EoE fibrosis remain incompletely understood, findings from experimental systems support roles for epithelial-fibroblast crosstalk in this type of tissue remodeling. The current paradigm presents EoE as a progressive fibrostenotic disease in which aged patients develop fibrosis as a function of disease chronicity. In the current study we provide evidence that altered epithelial biology in the aging esophagus may also contribute to EoE-associated fibrosis. We find that induction of EoE inflammation in young and aged mice using the MC903/Ovalbumin protocol for the same time period results in increased lamina propria thickness uniquely in aged animals. Additionally, epithelial cells from aged mice less efficiently limit fibroblast contractility in collagen plug contraction assays compared to those from their young counterparts. Finally, to identify potential mechanisms through which aged esophageal epithelial cells may stimulate fibrotic remodeling, we perform cytokine array experiments in young and aged mice. These studies are significant as identification of age-associated factors that contribute to fibrotic remodeling may aid in the design of strategies toward early detection, prevention, and therapy of fibrostenotic EoE.

show abstract

A Gap in Care Leads to Progression of Fibrosis in Eosinophilic Esophagitis Patients

Cited by 27 publications

References 32 publications

A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

Eosinophile Ösophagitis

A role for age-associated alterations in esophageal epithelium in eosinophilic esophagitis-associated fibrosis

Contact Info

Product

Resources

About