Eosinophilic gastrointestinal disorders (EGID)☆

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 T_H2-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.

Keywords:  Eosinophil, gastrointestinal, inflammation, pathogenesis, therapy

Abbreviations:  ECP, Eosinophil cationic protein, EDN, Eosinophil-derived neurotoxin, EE, Eosinophilic esophagitis, EGID, Eosinophilic gastrointestinal disorder, EPO, Eosinophil peroxidase, GERD, Gastroesophageal reflux disease, HES, Hypereosinophilic syndrome, hpf, High-powered field, IBD, Inflammatory bowel disease, LT, Leukotriene, MAdCAM, Mucosal addressin cell adhesion molecule, MBP, Major basic protein, MCP, Monocyte chemoattractant protein, PDGFRA, Platelet-derived growth factor α, VLA, Very late antigen