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
. 2025 May 14:18:91-102.
doi: 10.2147/CEG.S511469. eCollection 2025.

Expert Opinion on the Management, Challenges, and Knowledge Gaps Pertaining to Eosinophilic Esophagitis Among Adults in the Greater Gulf Region

Ahmad Jazzar  1 , Ahmed Al-Darmaki  2 , Evan Samuel Dellon  3 , Mohamad Miqdady  4   5 , Mohammed Attieh Alzahrani  6   7 , Mohammed S Khan  8 , Mona Al Ahmad  9 , Osama Yousef  10 , Sameer Al Awadhi  11 , Wesam Al Masri  12 , Naglaa M Kamal  13
Affiliations
Review

Expert Opinion on the Management, Challenges, and Knowledge Gaps Pertaining to Eosinophilic Esophagitis Among Adults in the Greater Gulf Region

Ahmad Jazzar et al. Clin Exp Gastroenterol. .

Abstract

Eosinophilic esophagitis (EoE) is a type 2 inflammatory esophageal disease that presents in adults as dysphagia and food impaction. EoE is characterized by a predominance of T helper 2 cells among the T cell population. Environmental agents, including food antigens and aeroallergens, trigger EoE. EoE exhibits immunoglobulin E- (IgE-) and non-IgE-mediated allergic responses to these environmental allergens. Local antigen-specific IgE can also trigger mast cell degranulation, thereby worsening EoE. Individuals with atopic dermatitis, asthma, IgE-mediated food allergy, or allergic rhinitis are at a higher risk of developing EoE. EoE treatment aims to achieve clinical improvement, endoscopic mucosal healing, and reduction in or resolution of histological inflammation. However, attaining and maintaining "deep remission" with conventional treatments can be challenging, underscoring the need for targeted therapies. This expert opinion focuses on the latest global recommendations for using novel therapies to improve outcomes in patients with EoE. It also highlights current practices in the Greater Gulf region to manage EoE, identify challenges, and address future educational gaps.

Keywords: Greater Gulf; dupilumab; eosinophilic esophagitis; esophageal disease; expert opinion; monoclonal antibody.

PubMed Disclaimer

Conflict of interest statement

AAD received consulting fees from AbbVie, Janssen, Takeda, and Ferring; received payment or honoraria for lectures from Janssen, AbbVie, Takeda, and Ferring; received all support for the present manuscript from Sanofi; and received support for attending meetings/travel from Takeda and Pfizer. ESD received grants/contracts from Adare/Ellodi, Allakos, Arena/Pfizer, AstraZeneca, Eupraxia, Ferring, GSK, Meritage, Miraca, Nutricia, Celgene/Receptos/BMS, Regeneron, Revolo, Shire/Takeda; received consulting fees from Abbott, AbbVie, Adare/Ellodi, Aimmune, Akesobio, Alfasigma, ALK, Allakos, Amgen, Aqilion, Arena/Pfizer, Aslan, AstraZeneca, Avir, Biorasi, Calypso, Celgene/Receptos/BMS, Celldex, Eli Lilly, EsoCap, Eupraxia, Dr. Falk Pharma, Ferring, GSK, Gossamer Bio, Holoclara, Invea, Knightpoint, Landos, LucidDx, Morphic, Nexstone Immunology/Uniquity, Nutricia, Parexel/Calyx, Phathom, Regeneron, Revolo, Robarts/Alimentiv, Salix, Sanofi, Shire/Takeda, Target RWE, and Upstream Bio; received all support for the present manuscript from Regeneron and Sanofi (research grants to the university and consulting fees to author); and has other financial or nonfinancial interest with Allakos, Aqilion, Holoclara, Invea (Educational grant to university). MM received support for attending meetings/travel from AstraZeneca, Abbott, Nestle, Danone, and Sanofi. MAA received payment or honoraria for lectures from Sanofi, GSK, and AstraZeneca; received grants/contracts from Kuwait University; and received support for attending meetings/travel from Sanofi and AstraZeneca. NMK received all support for the present manuscript from Sanofi and received an honorarium from Sanofi to act as an advisor in the meeting from which this manuscript was prepared but was not paid to write the publications. Sanofi has provided honoraria for the chairman, moderator, and speakers of the meeting, but no authors were paid to write the publication. The authors report no other conflicts of interest in this work.

Similar articles

See all similar articles

References

    1. Dellon ES, Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology. 2018;154(2):319–332.e3. doi:10.1053/j.gastro.2017.06.067 - DOI - PMC - PubMed
    1. Dellon ES, Liacouras CA, Molina-Infante J, et al. Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference. Gastroenterology. 2018;155(4):1022–1033.e10. doi:10.1053/j.gastro.2018.07.009 - DOI - PMC - PubMed
    1. Nhu QM, Aceves SS. Current state of biologics in treating eosinophilic esophagitis. Ann Allergy Asthma Immunol. 2023;130(1):15–20. doi:10.1016/j.anai.2022.10.004 - DOI - PubMed
    1. Spergel JM, Dellon ES, Liacouras CA, et al. Summary of the updated international consensus diagnostic criteria for eosinophilic esophagitis. Ann Allergy Asthma Immunol. 2018;121(3):281–284. doi:10.1016/j.anai.2018.05.035 - DOI - PMC - PubMed
    1. Von Arnim U. Eosinophilic esophagitis—from definition to therapy. Allergo J Int. 2024;33:1–8. doi:10.1007/s40629-023-00265-6 - DOI

LinkOut - more resources