Eosinophilic esophagitis due to aeroallergens: A Systematic Review, update, and our experience
Gratacós Gómez AR, Gómez Torrijos E
Allergology Section. Hospital General Universitario. Ciudad Real. Spain
J Investig Allergol Clin Immunol 2022; Vol. 33(6)
Eosinophilic esophagitis is a chronic antigen-mediated esophageal disease characterized by symptoms related to esophageal dysfunction and histologically by Th2 inflammation (at least15 eosinophils/high power field) when other secondary systemic and local causes of esophageal eosinophilia are excluded. Though this disease was initially ascribed to a delayed reaction to food allergens, emerging evidence suggests that aeroallergens may also play roles in his pathogenesis and evolution.
Some studies support seasonal variation in Eosinophilic esophagitis diagnosis and disease exacerbations about the increase in aeroallergens to which patients are sensitized. It is also known that this disease can be generated after an extensive, identifiable aeroallergen exposure and after treatment with specific immunotherapy with food or aeroallergens. Recently, it has been postulated that treatment of allergic rhinoconjunctivitis may improve Eosinophilic esophagitis symptoms, though data is limited to case reports and small series. Currently, biomarkers and biologic therapies are not helpful for diagnosis or inducing clinical and histological remission of the disease. Although there are high hopes for dupilumab
This review aims to give visibility to the involvement of aeroallergens in the triggering and exacerbation of eosinophilic esophagitis since many of them, in addition to being in the air and being able to inhale them, can also ingest them as part of the food. It is essential to highlight that we must try to discover the cause of the disease since it is crucial for its remission.
Key words: Eosinophilic esophagitis, Aeroallergens, Rhinitis, Pollen, Asthma