Volume : 12, Issue : 06, June – 2025

Title:

IMMUNOLOGIC DRIVERS OF EOSINOPHILIC ESOPHAGITIS: A REVIEW

Authors :

Zainab Mohammed Alali, Ghazy Radhy Taher Al Hamad

Abstract :

Eosinophilic esophagitis is a complex immune-mediated disorder characterized by an accumulation of eosinophils in the esophagus, leading to significant challenges with swallowing and an increased risk of food obstruction. Proper diagnosis and appropriate treatment are essential to manage symptoms and improve the quality of life for individuals impacted by this condition. In the last ten years, accumulating evidence from genetic research, mucosal immunology, and clinical trials of targeted biologics has illuminated critical aspects of EoE pathogenesis: (1) disruption of the epithelial barrier allowing antigen entry, (2) an epithelial-derived alarmin response that skews local immunity towards a T2 phenotype, (3) the recruitment and activation of eosinophils and other effector cells (mast cells, basophils), and (4) chronic tissue remodeling driven by profibrotic mediators. The environmental factors that contribute to EoE are varied, include airborne allergens, food allergens, early-life exposures, and wider ecological changes. Examining these elements is essential for developing effective prevention and management approaches for EoE. This review consolidates current mechanistic insights and underscores therapeutic implications.

Keywords: Eosinophilic esophagitis (EoE), Environmental triggers, Genetic predisposition

Cite This Article:

Please cite this article in press Zainab Mohammed Alali et al,. Immunologic Drivers Of Eosinophilic Esophagitis: A Review., Indo Am. J. P. Sci, 2025; 12(07).

Number of Downloads : 10

References:

1. Park H: An overview of eosinophilic esophagitis. Gut and liver. 2014, 8:590.
2. Mungan Z, Pinarbaşi B, Kaymakoğlu S: Eosinophilic esophagitis: case report. Turkish Journal of Gastroenterology. 2007, 18:100-102.
3. Furuta GT, Straumann A: Eosinophilic esophagitis: an emerging clinicopathologic disease of children and adults. Gastroenterology & Hepatology. 2006, 2:371.
4. Massironi S, Mulinacci G, Gallo C, et al.: Mechanistic Insights into Eosinophilic Esophagitis: Therapies Targeting Pathophysiological Mechanisms. Cells. 2023, 12. 10.3390/cells12202473
5. Farah A, Assaf T, Hindy J, et al.: The Dynamic Evolution of Eosinophilic Esophagitis. Diagnostics (Basel). 2025, 15. 10.3390/diagnostics15030240
6. Stanbery AG, Shuchi S, Jakob von M, Tait Wojno ED, Ziegler SF: TSLP, IL-33, and IL-25: Not just for allergy and helminth infection. J Allergy Clin Immunol. 2022, 150:1302-1313. 10.1016/j.jaci.2022.07.003
7. Blanchard C, Wang N, Stringer KF, et al.: Eotaxin-3 and a uniquely conserved gene-expression profile in eosinophilic esophagitis. J Clin Invest. 2006, 116:536-547. 10.1172/jci26679
8. Underwood B, Troutman TD, Schwartz JT: Breaking down the complex pathophysiology of eosinophilic esophagitis. Annals of Allergy, Asthma & Immunology. 2023, 130:28-39. 10.1016/j.anai.2022.10.026
9. Dellon ES, Rothenberg ME, Collins MH, et al.: Dupilumab in Adults and Adolescents with Eosinophilic Esophagitis. New England Journal of Medicine. 2022, 387:2317-2330. doi:10.1056/NEJMoa2205982
10. Davis B: Pathophysiology of Eosinophilic Esophagitis. Clinical Reviews in Allergy & Immunology. 2018, 55. 10.1007/s12016-017-8665-9
11. Green DJ, Cotton CC, Dellon ES: The role of environmental exposures in the etiology of eosinophilic esophagitis: a systematic review. In Mayo Clinic Proceedings. Volume 90. Elsevier; 2015:1400-1410.
12. Nance D, Rappazzo KM, Jensen ET, et al.: Increased risk of eosinophilic esophagitis with poor environmental quality as measured by the Environmental Quality Index. Dis Esophagus. 2021, 34. 10.1093/dote/doab041