Summary
Purpose
Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease. Most EoE patients have atopic comorbidities and they test positive when allergy tests are performed. Our aim is to critically assess the relation of allergens detected by allergy tests with clinically confirmed triggers of EoE.
Methods
A systemic review and meta-analysis will be conducted, which will involve searching electronic databases using predetermined search terms, in order to identify relevant studies. Studies will be independently screened against predefined eligibility criteria and subgroup analysis will be used for the outcomes.
Results and conclusion
The findings of this review are going to help clinicians and allied health professionals in treatment decisions.
Similar content being viewed by others
References
Attwood SEA, Smyrk TC, Demeester TR, Jones JB. Esophageal eosinophilia with dysphagia—a distinct clinicopathologic syndrome. Dig Dis Sci. 1993;38:109–16.
Straumann A, Spichtin HP, Bernoulli R, Loosli J, Vögtlin J. Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings. Schweiz Med Wochenschr. 1994;124:1419–29.
Dellon ES, Jensen ET, Martin CF, Shaheen NJ, Kappelman MD. Prevalence of eosinophilic esophagitis in the United States. Clin Gastroenterol Hepatol. 2014;12:589–96.
Hruz P, Straumann A, Bussmann C, Heer P, Simon HU, Zwahlen M, et al. Escalating incidence of eosinophilic esophagitis: a 20-year prospective, population-based study in Olten County, Switzerland. J Allergy Clin Immunol. 2011;128:1349–50.
Arias Á, Lucendo AJ. Prevalence of eosinophilic oesophagitis in adult patients in a central region of Spain. Eur J Gastroenterol Hepatol. 2013;25:208–12.
Lucendo AJ, Molina-Infante J, Arias Á, von Arnim U, Bredenoord AJ, Bussmann C, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017;5:335–58.
McGowan EC, Platts-Mills TA. Eosinophilic esophagitis from an allergy perspective: how to optimally pursue allergy testing & dietary modification in the adult population. Curr Gastroenterol Rep. 2016;18(11):58.
Cianferoni A, Spergel J. Eosinophilic esophagitis: a comprehensive review. Clin Rev Allergy Immunol. 2016;50:159–74.
Markowitz JE, Spergel JM, Ruchelli E, Liacouras CA. Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents. Am J Gastroenterol. 2003;98:777–82.
Peterson KA, Boynton KK. Which patients with eosinophilic esophagitis (EoE) should receive elemental diets versus other therapies? Curr Gastroenterol Rep. 2014;16:364.
Spergel JM, Beausoleil JL, Mascarenhas M, Liacouras CA. The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis. J Allergy Clin Immunol. 2002;109:363–8.
Spergel JM, Brown-Whitehorn TF, Cianferoni A, Shuker M, Wang M‑L, Verma R, et al. Identification of causative foods in children with eosinophilic esophagitis treated with an elimination diet. J Allergy Clin Immunol. 2012;130:461–7.
Henderson CJ, Abonia JP, King EC, Putnam PE, Collins MH, Franciosi JP, et al. Comparative dietary therapy effectiveness in remission of pediatric eosinophilic esophagitis. J Allergy Clin Immunol. 2012;129:1570–8.
Pascual JMR, Caballer BDLH, Verge CR, Cepeda ST, Ariño GR, López JMR, et al. Allergy assessment in children with eosinophilic esophagitis. J Investig Allergol Clin Immunol. 2011;21:59–65.
Al-Hussaini A, Al-Idressi E, Al-Zahrani M. The role of allergy evaluation in children with eosinophilic esophagitis. J Gastroenterol. 2013;48:1205–12.
Simon D, Straumann A, Wenk A, Spichtin H, Simon H‑U, Braathen LR. Eosinophilic esophagitis in adults—no clinical relevance of wheat and rye sensitizations. Allergy. 2006;61:1480–3.
Molina-Infante J, Martin-Noguerol E, Alvarado-Arenas M, Porcel-Carreño SL, Jimenez-Timon S, Hernandez-Arbeiza FJ. Selective elimination diet based on skin testing has suboptimal efficacy for adult eosinophilic esophagitis. J Allergy Clin Immunol. 2012;130:1200–2.
Syrigou E, Angelakopoulou A, Zande M, Panagiotou I, Roma E, Pitsios C. Allergy-test-driven elimination diet is useful in children with eosinophilic esophagitis, regardless of the severity of symptoms. Pediatr Allergy Immunol. 2015;26:323–9.
Shamji MH, Kappen JH, Akdis M, Jensen-Jarolim E, Knol EF, Kleine-Tebbe J, et al. Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma: an EAACI position paper. Allergy. 2017;72:1156–73.
Clayton F, Fang JC, Gleich GJ, Lucendo AJ, Olalla JM, Vinson LA, et al. Eosinophilic esophagitis in adults is associated with IgG4 and not mediated by IgE. Gastroenterology. 2014;147:602–9.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.
Philpott H, Nandurkar S, Royce SG, Thien F, Gibson PR. Allergy tests do not predict food triggers in adult patients with eosinophilic oesophagitis. A comprehensive prospective study using five modalities. Aliment Pharmacol Ther. 2016;44:223–33.
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan‑a web and mobile app for systematic reviews. Syst Rev. 2016;5:210.
Sterne J, Savović J, Page M, Elbers RG, Blencowe NS, Bourton I et al. RoB 2: a revised tool for assessing risk of bias in randomized trials. BMJ. 2019;366:i4898.
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.
Cochran WG. The comparison of percentages in matched samples. Biometrika. 1950;37:256–66.
Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557.
Arias Á, González-Cervera J, Tenias JM, Lucendo AJ. Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis. Gastroenterology. 2014;146:1639–48.
Anyane-Yeboa A, Wang W, Kavitt RT. The role of allergy testing in eosinophilic esophagitis. Gastroenterol Hepatol. 2018;14:463–9.
Philpott H, Thien F. The role of allergy testing in eosinophilic esophagitis: an update of the evidence. Curr Treat Options Gastroenterol. 2017;15:26–34.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
A. Nowak-Wegzryn reports grants from NIH NIAID, grants from DBV Technologies, grants from FARE, personal fees from Regeneron-Sanofi Aventis, personal fees from Gerber Nutrition Institute, grants from Nutricia, grants from Nestle, personal fees from UpToDate, personal fees from Ann All Asthma Immunol, outside the submitted work. C. Pitsios, K. Pantavou, I. Terreehorst, A. Cianferoni, C. Vidal, E. Vassilopoulou, M. Papachristodoulou, G. P. Tsigkrelis, S. Bonovas and G.K. Nikolopoulos declare that they have no competing interests.
Rights and permissions
About this article
Cite this article
Pitsios, C., Pantavou, K., Terreehorst, I. et al. Use of allergy tests to identify dietary and environmental triggers of eosinophilic esophagitis: protocol for a systematic review. Allergo J Int 29, 280–283 (2020). https://doi.org/10.1007/s40629-020-00141-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40629-020-00141-7