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Allergies and Eosinophilic Esophagitis-Current Updates for the Pediatric Gastroenterologist

机译:儿科胃肠学家的过敏和嗜酸性食管炎电流更新

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Purpose of Review The purpose of this article is to review recent developments demonstrating the role of allergies, the utility of allergy testing, and the role of the allergist in eosinophilic esophagitis (EoE) management. Recent Findings The majority of patients with EoE have concurrent atopic disorders including food anaphylaxis, asthma, allergic rhinitis, and eczema. An atopic population likely is at greater risk for EoE. Delayed type hypersensitivity to food antigens is the most common pathogenic mechanism. Aeroallergens and pollen-food cross-reactivity also can trigger EoE. Th2 cell-mediated adaptive and innate immunity in response to epithelial damage occurs via IL-13- and IL-4-producing T cells and innate lymphoid cells. While IgE testing for foods is insufficient to build an elimination diet, IgE-mediated allergy may play a role in EoE severity and clinical course. Summary There is strong evidence that Th2 immunity drives EoE. Optimal EoE management should include elucidating and managing EoE triggers and concurrent atopic diatheses.
机译:审查本文的目的是审查最近的发展,证明了过敏,过敏测试的效用以及过敏症在嗜酸性食管炎(EOE)管理中的作用的作用。最近发现大多数eoe患者具有同时的特应疾病,包括食物过敏性,哮喘,过敏性鼻炎和湿疹。特应性人口可能是更大的eo的风险。对食品抗原的延迟型超敏反是最常见的致病机制。 Aeroallergens和花粉 - 食物交叉反应性也可以触发eoe。 Th2细胞介导的适应性和先天免疫响应上皮损伤,通过IL-13-和IL-4产生的T细胞和先天淋巴细胞发生。虽然对食物的IgE测试不足以构建消除饮食,但IgE介导的过敏可能在EoE严重程度和临床过程中发挥作用。摘要有强有力的证据表明TH2免疫驱动互联网。最佳EOE管理应包括阐明和管理EOE触发器和同时的特应疗法。

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