Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec;25(12):380-389.
doi: 10.1007/s11894-023-00904-6. Epub 2023 Nov 11.

Barrier Dysfunction in Eosinophilic Esophagitis

Emily C McGowan  1 , Roopesh Singh  2 , David A Katzka  3
Affiliations
Review

Barrier Dysfunction in Eosinophilic Esophagitis

Emily C McGowan et al. Curr Gastroenterol Rep. 2023 Dec.

Abstract

Purpose of review: Compelling evidence over the past decade supports the central role of epithelial barrier dysfunction in the pathophysiology of eosinophilic esophagitis (EoE). The purpose of this review is to summarize the genetic, environmental, and immunologic factors driving epithelial barrier dysfunction, and how this impaired barrier can further promote the inflammatory response in EoE.

Recent findings: Common environmental exposures, such as detergents, may have a direct impact on the esophageal epithelial barrier. In addition, the effects of IL-13 on barrier dysfunction may be reduced by 17β-estradiol, Vitamin D, and the short chain fatty acids butyrate and propionate, suggesting novel therapeutic targets. There are many genetic, environmental, and immunologic factors that contribute to epithelial barrier dysfunction in EoE. This leads to further skewing of the immune response to a "Th2" phenotype, alterations in the esophageal microbiome, and penetration of relevant antigens into the esophageal mucosa, which are central to the pathophysiology of EoE.

Keywords: Eosinophilic Esophagitis; Epithelial cell; Esophageal barrier; TSLP.

PubMed Disclaimer

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Dobbins JW, Sheahan DG, Behar J. Eosinophilic gastroenteritis with esophageal involvement. Gastroenterology. 1977;72(6):1312–6. - DOI - PubMed
    1. Kerlin P, Jones D, Remedios M, Campbell C. Prevalence of eosinophilic esophagitis in adults with food bolus obstruction of the esophagus. J Clin Gastroenterol. 2007;41(4):356–61. https://doi.org/10.1097/01.mcg.0000225590.08825.77 . - DOI - PubMed
    1. Kirchner GI, Zuber-Jerger I, Endlicher E, Gelbmann C, Ott C, Ruemmele P, et al. Causes of bolus impaction in the esophagus. Surg Endosc. 2011;25(10):3170–4. https://doi.org/10.1007/s00464-011-1681-6 . - DOI - PubMed
    1. Diniz LO, Towbin AJ. Causes of esophageal food bolus impaction in the pediatric population. Dig Dis Sci. 2012;57(3):690–3. https://doi.org/10.1007/s10620-011-1911-8 . - DOI - PubMed
    1. Dellon ES, Liacouras CA, Molina-Infante J, Furuta GT, Spergel JM, Zevit N, et al. Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference. Gastroenterology. 2018;155(4):1022-33.e10. https://doi.org/10.1053/j.gastro.2018.07.009 . - DOI - PubMed

Substances

LinkOut - more resources