Su1828 Remission in Proton Pump Inhibitors-Responsive Esophageal Eosinophilia Correlates With Downregulation of Eotaxin-3 and TH2 Cytokines, Similarly to Eosinophilic Esophagitis After Steroids

Letter: PPI‐responsive oesophageal eosinophilia – from initial scepticism to consistent prospective data

“…Current thinking suggests that eosinophilic oesophagitis is an immune-mediated, antigen-driven disorder; 3 thus, diet elimination and/or corticosteroid therapy would seem the fitting therapeutic strategy. 4 There is now, however, confirmatory evidence available, including our study 2 and their data, 5,6 as well as other studies, [7][8][9][10][11][12][13][14][15] that symptomatic patients with oesophageal eosinophilic infiltration, which is phenotypically indistinguishable from eosinophilic oesophagitis, respond to PPI therapy. In further support of Drs.…”

Letter: PPI‐responsive oesophageal eosinophilia – from initial skepticism to consistent prospective data; authors' reply

“…Current thinking suggests that eosinophilic oesophagitis is an immune-mediated, antigen-driven disorder; 3 thus, diet elimination and/or corticosteroid therapy would seem the fitting therapeutic strategy. 4 There is now, however, confirmatory evidence available, including our study 2 and their data, 5,6 as well as other studies, [7][8][9][10][11][12][13][14][15] that symptomatic patients with oesophageal eosinophilic infiltration, which is phenotypically indistinguishable from eosinophilic oesophagitis, respond to PPI therapy. In further support of Drs.…”

“…2,5 The magnitude of the response rates is robust (at least 33%, and as much as 75%). 2,[5][6][7]15 The improvement seems unrelated to the type of PPI used (at least two PPIs have been examined, namely omeprazole and rabeprazole). 2,5 Finally, higher PPI dose does not necessarily result in superior response rates, 6 although only one study has examined the concept of higher doses.…”

“…2,[5][6][7]15 The improvement seems unrelated to the type of PPI used (at least two PPIs have been examined, namely omeprazole and rabeprazole). 2,5 Finally, higher PPI dose does not necessarily result in superior response rates, 6 although only one study has examined the concept of higher doses. Taken together, these findings highlight the existence of an oesophageal esosinophilia PPI-responsive population that is clinically and endoscopically indistinguishable from eosinophilic oesophagitis.…”

Editorial: is eosinophilic oesophagitis different to proton pump inhibitor‐responsive oesophageal eosinophilia?

“…Basophil and mast cell epithelial infiltration was significantly higher in both groups, but not in gastrooesophageal reflux (GERD) patients or control subjects. Several recent studies [2][3][4][5][6][7][8] have failed to find distinguishing features between EoE and PPI-REE (Table 1). The study by Iwakura et al 1 aligns with the evolving concept that both entities share the same pathogenesis.…”