An in-depth characterization of a large cohort of adult patients with eosinophilic esophagitis

Leigh, Lyvia; Spergel, Jonathan M.

doi:10.1016/j.anai.2018.09.452

Cited by 39 publications

(38 citation statements)

References 40 publications

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“…The exact mechanisms underlying the increased production of pro-inflammatory cytokines and allergy-associated Th2 cytokines in autistic individuals are yet to be elucidated. However, a potential explanation of these findings might be sought in the observation that allergy, especially food allergy, and eosinophilic esophagitis are often reported in ASD patients (34, 35). A food-induced allergic disease is an unfavorable immune reaction that can occur on exposure to specific food components, particularly proteins (36).…”

Section: The Gut-brain Axis In Autism Spectrum Disordermentioning

confidence: 99%

The Gut-Immune-Brain Axis in Autism Spectrum Disorders; A Focus on Amino Acids

Sadelhoff

Perez‐Pardo

et al. 2019

Front. Endocrinol.

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Autism spectrum disorder (ASD) is a range of neurodevelopmental conditions that affect communication and social behavior. Besides social deficits, systemic inflammation, gastrointestinal immune-related problems, and changes in the gut microbiota composition are characteristic for people with ASD. Animal models showed that these characteristics can induce ASD-associated behavior, suggesting an intimate relationship between the microbiota, gut, immune system and the brain in ASD. Multiple factors can contribute to the development of ASD, but mutations leading to enhanced activation of the mammalian target of rapamycin (mTOR) are reported frequently. Hyperactivation of mTOR leads to deficits in the communication between neurons in the brain and to immune impairments. Hence, mTOR might be a critical factor linking the gut-brain-immune axis in ASD. Pharmacological inhibition of mTOR is shown to improve ASD-associated behavior and immune functions, however, the clinical use is limited due to severe side reactions. Interestingly, studies have shown that mTOR activation can also be modified by nutritional stimuli, in particular by amino acids. Moreover, specific amino acids are demonstrated to inhibit inflammation, improve gut barrier function and to modify the microbiota composition. In this review we will discuss the gut-brain-immune axis in ASD and explore the potential of amino acids as a treatment option for ASD, either via modification of mTOR activity, the immune system or the gut microbiota composition.

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Section: The Gut-brain Axis In Autism Spectrum Disordermentioning

confidence: 99%

The Gut-Immune-Brain Axis in Autism Spectrum Disorders; A Focus on Amino Acids

Sadelhoff

Perez‐Pardo

et al. 2019

Front. Endocrinol.

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“…Few studies have evaluated the prevalence and impact of anxiety or depression in adult patients with EoE (Tables 1 and 2). A 2019 study sought to characterize a cohort of adult EoE patients through a retrospective medical record review, which included assessing the prevalence of several psychiatric comorbidities using ICD-9 and ICD-10 codes 10. Overall, 31% of patients had at least one psychiatric or neuropsychiatric comorbidity, with 12% of the sample demonstrating a diagnosis of depression, followed by anxiety, which was reported by 9.3% of patients.…”

Section: Adult Patients With Eoementioning

confidence: 99%

<p>Anxiety and Depression in Eosinophilic Esophagitis: A Scoping Review and Recommendations for Future Research</p>

Taft

Guadagnoli

Edlynn³

2019

JAA

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Eosinophilic esophagitis (EoE) is a rapidly emerging chronic disease with limited treatments. Impacting both children and adults, EoE and its treatments have the potential to significantly reduce psychological functioning, including increasing anxiety and depression. In this paper, we provide a scoping review of the scientific literature on anxiety and depression in both pediatric and adult patients. We aim to document the current state of research, identify knowledge gaps, recognize unique challenges that EoE patients may face as they relate to psychosocial function, and offer suggestions for future research directions. Based on the current review, both adult and pediatric patients with EoE are at risk for anxiety and depression symptoms, both due to the disease process and the prevailing dietary treatments. Significant gaps exist in the current understanding of anxiety and depression in EoE, providing ample opportunity for future studies to address this important issue.

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“…Eosinophilic esophagitis (EoE), first described in the 1970s, often manifests with dysphagia, chest pain, and food impaction in adults, whereas children typically present with failure to thrive, difficulty feeding, nausea, and vomiting . This predominantly male disorder has a prevalence of 0.05‐0.1% in the United States, although rates appear to be increasing . Considering the rising importance of EoE, an understanding of its pathophysiology is critical to guide improvements in diagnosis and treatment.…”

mentioning

confidence: 99%

“…Individuals with EoE often have a personal or family history of atopy, with asthma, eczema, rhinitis, or food allergy being common comorbidities . Previous studies reported a personal atopic history in 50‐60% of individuals with EoE .…”

mentioning

confidence: 99%

Esophageal IgE, IgG4, and mucosal eosinophilia in individuals with dysphagia

Ramaswamy¹,

Anderson

et al. 2019

Int Forum Allergy Rhinol

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Background Eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus, producing failure to thrive in infants and dysphagia with food impaction in older children and adults. Although most people with EoE manifest atopic/allergic disease, the specific allergens to which immunoglobulin E (IgE) is directed, if any, have not yet been characterized. Methods Mucosal brush biopsy (MBB) and solid tissue biopsy (STB) specimens were prospectively obtained from 25 individuals with dysphagia and suspicion of EoE. Specific IgE (sIgE) against 112 epitopes from airborne and food proteins, antigens known to cause a polyclonal IgE response and IgG4 to food allergens, were measured. Results There was no difference in total IgE harvested between the 2 biopsy methods (p > 0.05) or between the EoE‐positive (N = 12) and EoE‐negative (N = 13) groups (p > 0.05). None of the samples in either group contained measurable serum IgE to any of the airborne or food proteins tested, but low levels of IgE specific to Candida and Staphylococcus enterotoxins were detected. Low levels of IgG4 specific to wheat, soy, peanut, and egg were also detected. Conclusions Both MBB and STB are able to harvest measureable levels of IgE and IgG4 from the esophageal mucosa. Low levels of serum‐specific IgE suggest that other inflammatory mechanisms, besides type I, IgE‐mediated, allergen‐specific hypersensitivity, may act as the primary catalyst for mucosal eosinophilia. Clarifying the role of both IgE‐mediated and non‒IgE‐mediated inflammatory mechanisms will help identify more targeted diagnostic and treatment strategies for individuals who present with dysphagia and esophageal eosinophilia.

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An in-depth characterization of a large cohort of adult patients with eosinophilic esophagitis

Cited by 39 publications

References 40 publications

The Gut-Immune-Brain Axis in Autism Spectrum Disorders; A Focus on Amino Acids

The Gut-Immune-Brain Axis in Autism Spectrum Disorders; A Focus on Amino Acids

<p>Anxiety and Depression in Eosinophilic Esophagitis: A Scoping Review and Recommendations for Future Research</p>

Esophageal IgE, IgG4, and mucosal eosinophilia in individuals with dysphagia

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