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Mechanisms and clinical management of eosinophilic oesophagitis: an overview

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NATURE PORTFOLIO
DOI: 10.1038/s41575-022-00691-x

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This review provides an updated overview of the pathogenesis and clinical management of EoE, discussing treatment options and pointing out unresolved issues.
Since the first description of eosinophilic oesophagitis (EoE) less than three decades ago, we have observed a striking increase in the number of patients diagnosed with EoE and the understanding of its clinical and immunopathogenic background. Nonetheless, a plethora of open questions await elucidation. In this Review, we discuss the current state of knowledge regarding the underlying mechanisms, particularly environmental factors and their interaction with genetic susceptibility. Subsequently, we discuss how to translate these factors into the diagnostic and therapeutic management of this chronic, immune-mediated disorder. Finally, we dissect the still long list of unmet needs, such as reasons for and handling refractory EoE and atypical clinical presentations. These open questions can guide us through future research steps and potentially foster reconsideration of the diagnostic guidelines of EoE. Eosinophilic oesophagitis (EoE) is a chronic inflammatory disease of the oesophagus with distinct clinicopathological features and a relationship to other atopic diseases. This Review provides an updated overview of the pathogenesis and clinical management of EoE and discusses treatment options.

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