Received 10 October 2003; received in revised form 15 October 2003; accepted 20 October 2003.
Abstract
Primary eosinophilic gastrointestinal disorders are defined as disorders that selectively affect the gastrointestinal tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia (eg, drug reactions, parasitic infections, and malignancy). These disorders include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis, and eosinophilic colitis and are occurring with increasing frequency. Significant progress has been made in elucidating that eosinophils are integral members of the gastrointestinal mucosal immune system and that eosinophilic gastrointestinal disorders are primarily polygenic allergic disorders that involve mechanisms that fall between pure IgE-mediated and delayed TH2-type responses. Preclinical studies have identified a contributory role for the cytokine IL-5 and the eotaxin chemokines, providing a rationale for specific disease therapy. An essential question is to determine the cellular and molecular basis for each of these clinical problems and the best treatment regimen, which is the main subject of this review.
Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
Reprint requests: Marc E. Rothenberg, MD, PhD, Cincinnati Children's Hospital Medical Center, Division of Allergy and Immunology, Department of Pediatrics, 3333 Burnet Ave, MLC 7028, Cincinnati, OH 45229-3039
☆Series editors: William T. Shearer, MD, PhD, Lanny J. Rosenwasser, MD, and Bruce S. Bochner, MD
This activity is available for CME credit. See page 41A for important information.
Supported in part by the Burroughs Wellcome Fund, the Human Frontier Science Program RG 264/99, the International Life Science Institute, National Institutes of Health/National Institutes of Allergy and Infectious Disease R01 AI42242 and AI45898, and the kind support of Martin Schlaff.
Disclosure of potential conflict of interest: M. E. Rothenberg has a consultant arrangement with Cambridge Antibody Technology and receives grants/ research support from Burroughs Wellcome.
ABSTRACT