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
. 2025 Jul;62(2):110-127.
doi: 10.1111/apt.70222. Epub 2025 Jun 5.

Systematic Review: Use of Artificial Intelligence and Unmet Needs in Eosinophilic Oesophagitis

Ester Castagnaro  1 , Enrico Felici  2 , Roberta Spaccapelo  3 , Mariangela Amoroso  4 , Devis Moretti  4 , Jean Pierre Saab  4 , Annalisa Stassaldi  4 , Andrea Tassone  4 , Osvaldo Borrelli  5 , Nicola De Bortoli  6 , Giulio Del Corso  7 , Edward Gaynor  5 , Leanne Goh  8   9 , Salvatore Oliva  10 , Francesca Rea  11 , Sara Renzo  12 , Claudio Romano  13 , Edoardo V Savarino  14 , Pierfrancesco Visaggi  6
Affiliations

Systematic Review: Use of Artificial Intelligence and Unmet Needs in Eosinophilic Oesophagitis

Ester Castagnaro et al. Aliment Pharmacol Ther. 2025 Jul.

Abstract

Background: Artificial intelligence (AI) has been applied extensively to eosinophilic oesophagitis (EoE), but its clinical impact and comprehensiveness remain unclear.

Aims: To summarise the state of the art of applications of AI in EoE, identify gaps in the literature and disclose unmet needs.

Methods: We performed a systematic review of applications of AI in diagnosis, prognosis, precision medicine and follow-up in EoE. We searched MEDLINE, Embase and Embase Classic (via Ovid) from inception until 28th February 2025. Clinical trials, cohort, case-control, cross-sectional and case series studies were eligible for inclusion.

Results: We identified 28 studies on AI in EoE, with 18 focusing on diagnosis. AI was used for histology image analysis in digital pathology in seven and endoscopic image analysis in three studies. AI-based non-invasive diagnostic predictive models showed high accuracy in detecting EoE. As a prognostic tool, AI showed potential in predicting food impaction, histologic disease severity and fibrosis. AI was used in precision medicine for biomarker discovery, endotype prediction based on transcriptomics and treatment personalisation, as well as in disease monitoring and follow-up. Unmet needs included insufficient studies on children/adolescents, prediction of treatment response and improvement of study designs.

Conclusions: Although AI showed promise at improving EoE management across various domains, most tools require validation on larger, independent and prospective cohorts. Several challenges, including algorithmic bias, data privacy, explainability and regulatory hurdles, need to be addressed for clinical implementation. Future studies should focus on developing non-invasive diagnostic tools for younger populations, treatment response prediction and disease monitoring.

Keywords: artificial intelligence; deep learning; diagnosis; eosinophilic oesophagitis; machine learning; precision medicine; prognosis.

PubMed Disclaimer

References

    1. N. de Bortoli, P. Visaggi, R. Penagini, et al., “The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis—Definition, Clinical Presentation and Diagnosis,” Digestive and Liver Disease 56 (2024): 951–963.
    1. E. V. Savarino, G. Barbara, M. B. Bilò, et al., “Eosinophilic Esophagitis in Adults and Adolescents: Epidemiology, Diagnostic Challenges, and Management Strategies for a Type 2 Inflammatory Disease,” Therapeutic Advances in Gastroenterology 17 (2024): 17562848241249570.
    1. G. Marasco, P. Visaggi, M. Vassallo, et al., “Current and Novel Therapies for Eosinophilic Gastrointestinal Diseases,” International Journal of Molecular Sciences 24 (2023): 15165.
    1. G. D. Sciumè, P. Visaggi, A. Sostilio, et al., “Eosinophilic Esophagitis: Novel Concepts Regarding Pathogenesis and Clinical Manifestations,” Minerva Gastroenterologica e Dietologica 68 (2022): 23–39.
    1. J. Amil‐Dias, S. Oliva, A. Papadopoulou, et al., “Diagnosis and Management of Eosinophilic Esophagitis in Children: An Update From the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN),” Journal of Pediatric Gastroenterology and Nutrition 79 (2024): 394–437.

Publication types

LinkOut - more resources