RESUMO
No disponible
Assuntos
Humanos , Masculino , Criança , Esofagite Eosinofílica/diagnóstico por imagem , Esofagite Eosinofílica/tratamento farmacológico , Esofagite Eosinofílica/história , Hipersensibilidade Alimentar , Transtornos de DeglutiçãoRESUMO
Impedance has traditionally been employed in esophageal disease as a means to assess bolus flow and reflux episodes. Recent and ongoing research has provided new and novel applications for this technology. Measurement of esophageal mucosal impedance, via either multichannel intraluminal impedance catheters or specially designed endoscopically deployed impedance catheters, provides a marker of mucosal integrity. Mucosal impedance has been shown to segregate gastroesophageal reflux disease (GERD) and eosinophilic esophagitis from non-GERD controls and may play a role in predicting response to reflux intervention. More data are needed with regard to other esophageal subgroups, outcome studies, and functional disease. Our paper reviews the history of impedance in esophageal disease, the means of assessing baseline and mucosal impedance, data with regard to the newly developed mucosal impedance probes, the clinical utility of mucosal impedance in specific clinical conditions, and limitations in our existing knowledge, along with suggestions for future studies.
Assuntos
Impedância Elétrica/história , Esofagite Eosinofílica , Mucosa Esofágica/fisiopatologia , Esofagoscopia/história , Refluxo Gastroesofágico , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/história , Esofagite Eosinofílica/fisiopatologia , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/história , Refluxo Gastroesofágico/fisiopatologia , História do Século XX , História do Século XXI , HumanosAssuntos
Esofagite Eosinofílica/história , Intestinos/imunologia , Células Th2/imunologia , Animais , Anticorpos Monoclonais/uso terapêutico , Ensaios Clínicos como Assunto , Esofagite Eosinofílica/terapia , História do Século XX , História do Século XXI , Humanos , Interleucina-13/imunologia , Guias de Prática Clínica como Assunto , Receptores de Interleucina-4/imunologiaAssuntos
Esôfago de Barrett , Pesquisa Biomédica , Esofagite Eosinofílica , Gastroenterologia , Úlcera Péptica , Esôfago de Barrett/diagnóstico , Esôfago de Barrett/etiologia , Esôfago de Barrett/história , Esôfago de Barrett/terapia , Pesquisa Biomédica/história , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/etiologia , Esofagite Eosinofílica/história , Esofagite Eosinofílica/terapia , Gastroenterologia/história , História do Século XX , História do Século XXI , Humanos , Úlcera Péptica/diagnóstico , Úlcera Péptica/etiologia , Úlcera Péptica/história , Úlcera Péptica/terapia , Prognóstico , Fatores de RiscoRESUMO
Initial case series describing children and adults with symptoms related to esophageal dysfunction and dense esophageal eosinophilia lead to recognition of a "new" disease, eosinophilic esophagitis (EoE). Clinical, basic, and translational studies have provided a deeper understanding of this somewhat enigmatic disease that mechanistically is defined as an antigen-driven condition limited to the esophagus. This article summarizes many of the key historical features of EoE and provides a glimpse of potential future developments.
Assuntos
Esofagite Eosinofílica/história , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/terapia , História do Século XX , História do Século XXI , HumanosRESUMO
Eosinophilic esophagitis (EoE) is a clinicopathological condition characterized clinically by symptoms of esophageal dysfunction in the absence of acid reflux, with typical endoscopic findings and eosinophilia on biopsy. This article looks into the historical clinical recognition and description of EoE, in particular clinical manifestations, natural history, and epidemiology. Additionally, the evolution of endoscopic recognition and development of clinical trials are described: EoE is an isolated disease of the esophagus, although it is associated with other antigen-driven diseases such as asthma, rhinitis, and atopic dermatitis. After initial case reports which were mostly not typical of the disease state now described, the first case series were described in 1993 and 1994 in adults, and 1995 in children. Although rarely seen before 2000, the disease is now commonly recognized. Randomized clinical trials have now been performed on topical steroids, and on biological agents targeted against IL-5, IL-13, and other mediators. Therapy with dilatation may be best guided by measures of compliance and distensibility. Work is needed on biomarkers of the disease's severity and progression, and predictive indexes of complications. EoE is a relatively new disease of increasing importance. It represents an important diagnosis in patients with upper gastrointestinal symptoms and must be considered in all patients with dysphagia where the diagnosis is not certain and in all patients who have an assumed diagnosis of reflux but are not responding to standard reflux therapy.