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Review
. 2024 May;44(2):281-291.
doi: 10.1016/j.iac.2024.01.001. Epub 2024 Feb 14.

The Relationship Between Eosinophilic Esophagitis and Immunotherapy

Bridget E Wilson  1 , Maria A Sacta  2 , Benjamin L Wright  3 , Jonathan Spergel  2 , Nicole Wolfset  2
Affiliations
Review

The Relationship Between Eosinophilic Esophagitis and Immunotherapy

Bridget E Wilson et al. Immunol Allergy Clin North Am. 2024 May.

Abstract

Immunotherapy is a treatment approach based on the principle of incremental allergen exposure to achieve desensitization. Recently, oral immunotherapy has been introduced as a treatment of IgE-mediated food allergy. Some patients receiving oral immunotherapy for food allergy may develop eosinophilic esophagitis. Here, we summarize the literature examining this association, its treatment, and outcomes and discuss possible explanations for this clinical phenomenon. We further identify potential associations with aeroallergen sensitivity and other forms of immunotherapy including subcutaneous immunotherapy and sublingual immunotherapy. Finally, we discuss management of immunotherapy-induced eosinophilic esophagitis. Epicutaneous immunotherapy is highlighted as an area of therapeutic investigation.

Keywords: Adverse effects; Allergy shots; Eosinophil; Eosinophilic gastrointestinal disease; Oral immunotherapy.

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Conflict of interest statement

Disclosure B.L. Wright has received in-kind support from Regeneron in the form of study drug for an ongoing clinical trial investigating the role of dupilumab as an adjunct to milk oral immunotherapy. J. Spergel has consulting agreements with Regeneron, Sanofi, Novartis, and Alladapt, and he has royalties with UpToDate. J. Spergel and N. Wolfset have received in-kind support from Regeneron, United States in the form of study drug for an ongoing clinical trial investigating the role of dupilumab in eosinophilic esophagitis. All other authors report no conflicts of interest.

References

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