Abstract
Eosinophilic gastrointestinal disorders (EGID) are food allergen-induced allergic gastrointestinal disorders, characterized by accumulation of highly induced eosinophils in different segments of gastrointestinal tract along with eosinophil microabssess and extracellular eosinophilic granules in the epithelial layer. EGID are both IgE- and cell-mediated group of diseases that include eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE) and eosinophilic colitis (EC). Despite the increased incidences and considerable progress made in understanding EGID pathogenesis. The mechanism is still not well understood. It has been shown that IL-4, IL-5, IL-13, IL-15, IL-18, eotaxin-1, eotaxin-2 and eotaxin-3 play a critical role in EGID pathogenesis. Currently, the only criterion for diagnosing EoE, EGE and EC are repetitive endoscopic and histopathological evaluation of biopsies along with other clinical characteristics/manifestations. Antigen elimination and corticosteroid therapies are the most effective therapies currently in practice for the treatment of EGID. The cytokines (anti-IL-5 and anti-IL-13) therapy trials were not very successful in case of EoE. Most recently, a clinical trial using anti-IL-13 reported only 60% reduced esophageal eosinophilia without achieving primary endpoint. This clinical finding is not surprising and is in accordance with our earlier report indicating that IL-13 is not critical in the initiation of EoE. Notably, EGID still has no reliable noninvasive diagnostic biomarkers. Hence, there is a great necessity to identify novel noninvasive diagnostic biomarkers that can easily diagnose EGID and provide an effective therapy. Now, the attention is required to target cell types like iNKT cells that produce eosinophil active cytokines and is found induced in the pathogenesis of both experimental and human EoE. iNKT cell neutralization is shown to protect allergen-induced EoE in experimental model. In this review, we have discussed the key elements that are critical in the disease initiation, progression, pathogenesis and important for future diagnostic and therapeutic interventions for EGID.
Highlights
Eosinophils are an important subtype of blood leukocytes and are differentiated from multipotent hematopoietic stem cells in the bone marrow from myeloid lineage myeloblasts [1,2]
We presented a detailed understanding on eosinophil associated gastrointestinal disorders in this review to understand the development of eosinophilic gastrointestinal disorders (EGID) pathogenesis (Figure 6)
We have provided the evidence for the involvement of eosinophils, mast cells and basophils in tissue remodeling during the development of EGID pathogenesis
Summary
Eosinophils are an important subtype of blood leukocytes and are differentiated from multipotent hematopoietic stem cells in the bone marrow from myeloid lineage myeloblasts [1,2]. Eosinophils; EoE; EGE; EGID; Food allergy; Interleukin; iNKT cells Increased level of eosinophilic accumulation in tissue or blood (Figure 1) with marked degranulation is reported in a number of inflammatory diseases; like asthma, eosinophilic dermatitis, gastroesophageal reflux, celiac disease, inflammatory bowel disease, allergic colitis, food allergy and parasitic infections, In normal conditions eosinophils are found in each segment of the GI tract from the stomach to the colon in the lamina propria except the esophagus, Peyer’s patches, or intra-epithelial locations [4,5,11,12,13,14,15,16,17,18,19,20].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
