Adult eosinophilic esophagitis and advances in its treatment

Eosinophilic esophagitis(EoE)is a chronic eosinophil inflammation that seems to be T helper type 2 antigen-driven.The disease is one of several eosinophilic gastrointestinal disorders in which there appears to be inflammation of the gastrointestinal tract without any apparent underlying causes.Differential diagnosis needs to be made with gastroesophageal reflux,which is characterized by chronic inflammation due to gastric refluxate from disorders related to motility.EoE,however,is considered a chronic allergic inflammatory disorder related to destructive tissue remodeling.There seems to be a higher prevalence of EoE in Western countries.It is typically found in atopic male individuals.Physiopathological risk factors include atopy,environmental factors,esophageal epithelial barrier dysfunctions,etc.EoE can cause several symptoms that include retrosternal burning sensation,dysphagia,food impaction,chronic reflux symptoms,nausea,and vomiting.Early diagnosis,which requires a biopsy to assess for esophageal inflammation,is essential for proper treatment.The aim of our brief overview is to summarize the current literature regarding the characteristics,diagnosis,complications,mechanisms of pathology,clinical features,influence of comorbidities,and treatment in patients with EoE.

Serum macrophage migration inhibitory factor as a potential biomarker to evaluate therapeutic response in patients with allergic asthma:an exploratory study

Background:Previous studies have shown that macrophage migration inhibitory factor(MIF)is involved in the pathogenesis of asthma.This study aimed to investigate whether serum MIF reflects a therapeutic response in allergic asthma.Methods:We enrolled 30 asthmatic patients with mild-to-moderate exacerbations and 20 healthy controls,analyzing the parameter levels of serum MIF,serum total immunoglobulin E(tIgE),peripheral blood eosinophil percentage(EOS%),and fractional exhaled nitric oxide(FeNO).Lung function indices were used to identify disease severity and therapeutic response.Results:Our study showed that all measured parameters in patients were at higher levels than those of controls.After one week of treatment,most parameter levels decreased significantly except for serum tIgE.Furthermore,we found that serum MIF positively correlated with EOS%as well as FeNO,but negatively correlated with lung function indices.Receiver operator characteristic(ROC)curve analysis indicated that among the parameters,serum MIF exhibited a higher capacity to evaluate therapeutic response.The area under the curve(AUC)of MIF was 0.931,with a sensitivity of 0.967 and a specificity of 0.800.Conclusions:Our results suggested that serum MIF may serve as a potential biomarker for evaluating therapeutic response in allergic asthma with mild-to-moderate exacerbations.