Eosinophilic colitis in children: a new and elusive enemy?

Raffaele, Alessandro; Vatta, Fabrizio; Votto, Martina; Licari, Amelia; Ruffoli, Maria; Brunero, Marco; Riccipetitoni, Giovanna

doi:10.1007/s00383-020-04832-8

Cited by 14 publications

(22 citation statements)

References 11 publications

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“…Eosinophilic colitis frequently presents with diarrhea, abdominal pain, anorexia, and weight loss. It has a bimodal age presentation, namely in infancy (at approximately 60 days of age) and during adolescence and early adulthood 45 . Also, it has been associated with a wide range of atopic disorders, including drug allergy, allergic rhinitis, asthma, and food allergy 46 ,.…”

Section: Methodsmentioning

confidence: 99%

“…It has a bimodal age presentation, namely in infancy (at approximately 60 days of age) and during adolescence and early adulthood. 45 Also, it has been associated with a wide range of atopic disorders, including drug allergy, allergic rhinitis, asthma, and food allergy. 46,47 In a US administrative database study, Jensen et al evaluated 404 adult patients with eosinophilic colitis, finding that co-existing allergic conditions were common, being present in 41.8% of the patients.…”

Section: Eosinophilic Colitismentioning

confidence: 99%

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Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

Rossi

Lenti

Merli

et al. 2022

Clinical & Translational All

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Primary eosinophilic gastrointestinal disorders (EGID) are increasingly prevalent, immune‐mediated, chronic conditions which primarily affect pediatric and young adult patients, leading to substantial disease burden, and poor quality of life. EGID may either involve single portions of the gastrointestinal tract (i.e., esophagus, stomach, small bowel, and colon) or a combination. Their strong association with allergic disorders has been recently recognized, and although their shared pathophysiological basis remains partly elusive, this feature greatly impacts the diagnostic and treatment work‐up. We herein critically discuss the current knowledge on the association of EGID and allergic disorders, including atopic dermatitis, allergic rhinitis, allergic asthma, and food or drug allergy. In particular, we reviewed the literature focusing on their epidemiology, pathophysiological basis and mechanisms, and diagnostic strategies. Finally, we discuss the currently ongoing clinical trials targeting EGID and allergic diseases, including, among others the monoclonal antibodies dupilumab, mepolizumab, benralizumab, and lirentelimab.

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Section: Methodsmentioning

confidence: 99%

Section: Eosinophilic Colitismentioning

confidence: 99%

Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

Rossi

Lenti

Merli

et al. 2022

Clinical & Translational All

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“…The wide range of variability of GI symptoms, affecting from 9 to 70% of the ASD patients, is probably explained by differences in the populations studied and by different assessment tools [ 209 ]. Moreover, the rare eosinophilic enterocolitis is more frequent in ASD than in the general population [ 211 ]. This is a difficult challenge in clinical practice, since this eosinophilic enterocolitis often causes severe pain but not a significant increase in biomarkers of inflammation.…”

Section: Much More Than Behavioral Abnormalities In People With Asdmentioning

confidence: 99%

Dynamic and Systemic Perspective in Autism Spectrum Disorders: A Change of Gaze in Research Opens to A New Landscape of Needs and Solutions

Panisi¹,

Marini

2022

Brain Sciences

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The first step for a harmonious bio-psycho-social framework in approaching autism spectrum disorders (ASD) is overcoming the conflict between the biological and the psychosocial perspective. Biological research can provide clues for a correct approach to clinical practice, assuming that it would lead to the conceptualization of a pathogenetic paradigm able to account for epidemiologic and clinical findings. The upward trajectory in ASD prevalence and the systemic involvement of other organs besides the brain suggest that the epigenetic paradigm is the most plausible one. The embryo-fetal period is the crucial window of opportunity for keeping neurodevelopment on the right tracks, suggesting that women’s health in pregnancy should be a priority. Maladaptive molecular pathways beginning in utero, in particular, a vicious circle between the immune response, oxidative stress/mitochondrial dysfunction, and dysbiosis-impact neurodevelopment and brain functioning across the lifespan and are the basis for progressive multisystemic disorders that account for the substantial health loss and the increased mortality in ASD. Therefore, the biological complexity of ASD and its implications for health requires the enhancement of clinical skills on these topics, to achieve an effective multi-disciplinary healthcare model. Well-balanced training courses could be a promising starting point to make a change.

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“…However, it has been hypothesized that GI symptoms in autism have a functional, rather than an organic origin, which means that the condition results from behaviors, medications, or dietary habits (Ibrahim et al, 2009;Gorrindo et al, 2012). On the other hand, a recently published retrospective study of pediatric patients undergoing colonoscopy showed that of the 50 patients qualified for the diagnosis of eosinophilic colitis (EC), 22 of them were ASD children (the prevalence of ASD in the group of patients with EC was 44%) (Raffaele et al, 2021). This is another justification for the selection of the comparator group, because IBD, also infections with Salmonella, E. coli, H. pylori, and C. difficile (apart from parasitic infections, which are frequent in children), cause hypereosinophilia (Rogowska, 2012;Raffaele et al, 2021).…”

Section: Gastrointestinal Disorders In Asdmentioning

confidence: 99%

“…On the other hand, a recently published retrospective study of pediatric patients undergoing colonoscopy showed that of the 50 patients qualified for the diagnosis of eosinophilic colitis (EC), 22 of them were ASD children (the prevalence of ASD in the group of patients with EC was 44%) (Raffaele et al, 2021). This is another justification for the selection of the comparator group, because IBD, also infections with Salmonella, E. coli, H. pylori, and C. difficile (apart from parasitic infections, which are frequent in children), cause hypereosinophilia (Rogowska, 2012;Raffaele et al, 2021). Bearing in mind that the cause-and-effect chain in life sciences is neither one-way nor linear (Boem and Amedei, 2019), in addition to genetic factors that may rudiment this group of disorders (de la Torre-Ubieta et al, 2016;Feliciano et al, 2019;Łaczman´ska et al, 2020), environmental factors such as gut microbiota seems to be relevant (Pulikkan et al, 2019).…”

Section: Gastrointestinal Disorders In Asdmentioning

confidence: 99%

Future Directions in Reducing Gastrointestinal Disorders in Children With ASD Using Fecal Microbiota Transplantation

Żebrowska

Łaczmańska

Łaczmański

2021

Front. Cell. Infect. Microbiol.

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Research on the use of fecal microbiota transplantation (FMT) in the treatment of disorders related to digestive system ailments in children with autism spectrum disorders (ASDs) is a new attempt in a therapeutic approach. There are very little scientific evidences available on this emerging alternative method. However, it appears to be interesting not only because of its primary outcome, relieving the gastrointestinal (GI) symptoms, but also secondary therapeutic effect of alleviating autistic behavioral symptoms. FMT seems to be also promising method in the treatment of another group of pediatric patients, children with inflammatory bowel disease (IBD). The aim of this study is to discuss the potential use of FMT and modified protocols (MTT, microbiota transfer therapy) in the treatment of GI disorders in ASD children supported by reports on another disease, IBD concerning pediatric patients. Due to the few reports of the use of FMT in the treatment of children, these two patients groups were selected, although suffering from distant health conditions: neurodevelopmental disorder and gastrointestinal tract diseases, because of the the fact that they seem related in aspects of the presence of GI symptoms, disturbed intestinal microbiota, unexplained etiology of the condition and age range of patients. Although the outcomes for all are promising, this type of therapy is still an under-researched topic, studies in the group of pediatric patients are sparse, also there is a high risk of transmission of infectious and noninfectious elements during the procedure and no long-term effects on global health are known. For those reasons all obtained results should be taken with a great caution. However, in the context of future therapeutic directions for GI observed in neurodevelopmental disorders and neurodegenerative diseases, the topic seems worthy of attention.

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Eosinophilic colitis in children: a new and elusive enemy?

Cited by 14 publications

References 11 publications

Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

Dynamic and Systemic Perspective in Autism Spectrum Disorders: A Change of Gaze in Research Opens to A New Landscape of Needs and Solutions

Future Directions in Reducing Gastrointestinal Disorders in Children With ASD Using Fecal Microbiota Transplantation

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