dc.description.abstract | Eosinophilic Esophagitis (EoE) is an emerging disease. It is a chronic, allergen-mediated disease, characterized by the accumulation of eosinophils in the esophageal epithelium. The impaired barrier function, caused by genetic predisposition, exposure to environmental factors and inflammation is a hallmark of the disease. The disrupted epithelial barrier allows for the passage of allergens, triggering an inflammatory immune response. The chronic inflammation may eventually lead to remodeling of the esophageal epithelium in EoE patients. Although the role of many components in the EoE pathogenesis have been well defined, there are still many parts that remain unclear. It is important to unravel the exact mechanism of EoE, since the key components in the disease mechanism form a target for EoE treatment strategies. Currently, EoE treatments consist of elimination diets, proton pump inhibitors (PPIs), swallowed topical corticosteroids (STCs) and endoscopic dilation. Recently also dupilumab (a monoclonal antibody blocking IL-4Rα) was approved by the Food and Drug Administration (FDA) and the European Commission (EC) as the first biologic in the treatment of EoE. However, these therapies do not offer an effective remedy for every individual, which is why several biologics are being tested in clinical trials for the treatment of EoE. Most of them block a part of the immune response and thereby diminish eosinophilic inflammation of the esophagus. The current and upcoming treatments all have their benefits and limitations. This is why EoE treatment should be personalized for every individual patient, taking into account their EoE phenotype and personal preferences. Research into the mechanism and new therapies of EoE, will provide more and better options for EoE patients. | |