Primary eosinophilic disorders of the gastrointestinal tract

B M Yan
May 2009
Gut;May2009, Vol. 58 Issue 5, p721
Academic Journal
Eosinophils are important effector cells of the innate immune system. Eosinophilic infiltrative disorders of the gastrointestinal tract, though recognised for decades, have recently witnessed a resurgence of interest, particularly for oesophageal disease. A more comprehensive basis for eosinophilic infiltration and activation has identified interleukin 5 (IL5) as a key cytokine for the differentiation and proliferation of eosinophils, while eotaxins promote the recruitment of mature eosinophils to the gut. When activated, eosinophils release multiple cytotoxic agents and immunomodulatory cytokines, resulting in local inflammation and tissue damage. Although eosinophils normally convey a defence against unwanted interlopers such as parasites, in the absence of such inciting agents, their accumulation and activation can elicit the primary infiltrative disorders of the gut: eosinophilic oesophagitis, gastroenteritis and colitis. Diagnosis of these disorders is dependent on the clinical presentation, endoscopic findings (particularly for eosinophilic oesophagitis), and most importantly, histological confirmation. Dietary modifications and topical corticosteroids are first-line treatments for eosinophilic oesophagitis. Systemic corticosteroids are the mainstay of treatment for eosinophilic gastroenteritis; surgery may be required depending on the layer of mucosa involved. Eosinophilic colitis most often occurs in infants; removal of the causative allergen usually results in a complete response. Steroids may be required for older children/adolescents or adults. This review summarises current knowledge on the trafficking of eosinophils to the gastrointestinal tract and the clinical management of the primary disorders of eosinophilic oesophagitis, eosinophilic gastroenteritis and eosinophilic colitis.


Related Articles

  • JunD regulates lymphocyte proliferation and T helper cell cytokine expression. Meixner, Arabella; Karreth, Florian; Kenner, Lukas; Wagner, Erwin F. // EMBO Journal;3/24/2004, Vol. 23 Issue 6, p1325 

    Transgenic mice broadly expressing JunD (Ubi-junDm) appear phenotypically normal, but have strongly reduced numbers of peripheral lymphocytes. JunD overexpression in lymphocytes does not protect from numerous apoptotic insults; however, transgenic T cells proliferate poorly and exhibit impaired...

  • An Aquaporin 3-Notch1 Axis in Keratinocyte Differentiation and Inflammation. Guo, Liqiong; Chen, Hongxiang; Li, Yongsheng; Zhou, Qixing; Sui, Yang // PLoS ONE;Nov2013, Vol. 8 Issue 11, p1 

    Aquaporin 3 (AQP3) is an aquaglyceroporin which transports water, glycerol and small solutes across the plasma membrane. Its functions are not limited to fluid transport but also involve the regulation of cell proliferation, migration, skin hydration, wound healing and tumorigenesis. While AQP3...

  • Tumor necrosis factor and cancer, buddies or foes? Xia WANG; Yong LIN // Acta Pharmacologica Sinica;Nov2008, Vol. 29 Issue 11, p1275 

    Tumor necrosis factor (TNF) is a multifunctional cytokine that plays important roles in diverse cellular events such as cell survival, proliferation, differentiation, and death. As a pro-inflammatory cytokine, TNF is secreted by inflammatory cells, which may be involved in...

  • Production of hemo- and immunoregulatory cytokines by erythroblast antigen+ and glycophorin A+ cells from human bone marrow. Sennikov, Sergey V.; Injelevskaya, Tatyana V.; Krysov, Sergey V.; Silkov, Alexandr N.; Kovinev, Igor B.; Dyachkova, Natalya J.; Zenkov, Anton N.; Loseva, Mary I.; Kozlov, Vladimir A. // BMC Cell Biology;2004, Vol. 5, p1 

    Background: Erythroid nuclear cells (ENC) of the bone marrow (BM) have not previously been considered as important producers of wide spectrum of haemo- and immunoregulatory cytokines. The aim of the current work was to confirm the production of the main hemo- and immunoregulatory cytokines in...

  • mir-155 regulates cardiac allograft rejection by targing the expression of suppressor of cytokine signaling-1 (DOCS1) in dendritic cells. Yi Gao; Fang Liu; Qiwei Zhou; Meng Guo; Mingjian Zhang; Wenyuan Guo; Liming Wang; Liping Hu; Chaozhou Hu; Yongzhao Shi; Quanxing Wang // International Journal of Clinical & Experimental Medicine;2014, Vol. 7 Issue 11, p4572 

    Previously, we observed that mir-155 is induced during dendritic cell (DC) differentiation. We now demonstrated convincing evidence indicating that mir-155 promotes DC maturation and regulates its capacity for antigen presentation and induction of alloreactive T cell activation. Interestingly,...

  • Macrophages Contribute to the Progression of Infantile Hemangioma by Regulating the Proliferation and Differentiation of Hemangioma Stem Cells. Zhang, Wei; Chen, Gang; Wang, Feng-Qin; Ren, Jian-Gang; Zhu, Jun-Yi; Cai, Yu; Zhao, Ji-Hong; Jia, Jun; Zhao, Yi-Fang // Journal of Investigative Dermatology;Dec2015, Vol. 135 Issue 12, p3163 

    Macrophage infiltration has been implicated in infantile hemangioma (IH), the most common tumor of infancy. However, the exact role of macrophages in IH remains unknown. This study aims to clarify the functional significance of macrophages in the progression of IH. The distribution of...

  • Seasonal Distribution in Newly Diagnosed Cases of Eosinophilic Esophagitis in Adults. Almansa, Cristina; Krishna, Murli; Buchner, Anna M.; Ghabril, Marwan S.; Talley, Nicholas; DeVault, Kenneth R.; Wolfsen, Herbert; Raimondo, Massimo; Guarderas, Juan C.; Achem, Sami R. // American Journal of Gastroenterology;Apr2009, Vol. 104 Issue 4, p828 

    OBJECTIVES:The etiology of eosinophilic esophagitis (EoE) is not well understood. It has been proposed that eosinophils migrate to the esophagus in response to various ingested and inhaled allergens. Recent reports in children found an increased proportion of cases of EoE during months with...

  • The ERK-dependent signalling is stage-specifically modulated by FSH, during primary Sertoli cell maturation. Crépieux, Pascale; Marion, Sébastien; Martinat, Nadine; Fafeur, Véronique; Vern, Yves Le; Kerboeuf, Dominique; Guillou, Florian; Reiter, Eric // Oncogene;8/2/2001, Vol. 20 Issue 34, p4696 

    Primary cultures of Sertoli cells provide an interesting model to study how signalling pathways induced by a single hormone in a single cell type evolve, depending on the developmental stage. In vivo, follicle-stimulating hormone (FSH) induces proliferation of Sertoli cells in neonate and...

  • Eosinophilic disorders of the gastrointestinal tract: imaging features.  // Inflammatory Bowel Disease Monitor;2012, Vol. 12 Issue 4, p159 

    The authors discuss the clinical presentation of eosinophilic disorders of the gastrointestinal tract. They state that the four clinical cases with diverse clinical signs and symptoms have underlined the long-standing difficulties of obtaining a correct diagnosis. The authors further suggest...


Read the Article


Sign out of this library

Other Topics