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Aktuelle Konzepte zur eosinophilen Ösophagitis

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Zusammenfassung

Hintergrund

Bei der eosinophilen Ösophagitis (EoE, „eosinophilic esophagitis“) handelt es sich um eine in den 1990er-Jahren erstmals beschriebene Erkrankung mit steigender Inzidenz, die klinisch durch eine Dysfunktion des Ösophagus und histologisch durch eine auffällige Eosinophileninfiltration gekennzeichnet ist.

Methoden

In diesem Artikel diskutieren wir neue Aspekte zur Pathogenese, Klinik, Diagnostik und Behandlung der EoE.

Ergebnisse

Die EoE betrifft sowohl Kinder als auch Erwachsene und ist häufig mit atopischen Erkrankungen und IgE-Sensibilisierungen assoziiert. Als pathogenetisch wichtige Faktoren werden Barrierefunktionsstörungen und eine T-Helfer-2-Entzündung angesehen. Kürzlich wurden die PPI („proton pump inhibitors“, Protonenpumpenhemmer)-sensitive EoE und eine EoE-ähnliche Erkrankung neu beschrieben.

Fazit

Die Forschung der letzten Jahre hat zu einem besseren Verständnis des Krankheitsspektrums, der Pathogenese einschließlich genetischer Dispositionen beigetragen und damit auch die Grundlagen für innovative Therapieansätze gegeben.

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Abbreviations

EETs:

Eosinophiles extrazelluläres (DNA-)Netz

EoE:

Eosinophile Ösophagitis

GERD:

Gastroösophageale Refluxkrankheit

HPF:

Hauptgesichtsfeld

IgE:

Immunglobulin E

IL:

Interleukin

LEKTI:

Lympho-epithelial Kazal-type-related inhibitor

mRNA:

Boten-Ribonukleinsäure

PRR:

Mustererkennungsrezeptor

PPI:

Protonenpumpenhemmer

PPI-REE:

Protonenpumpenhemmer sensitive ösophageale Eosinophilie

SNP:

Einzelnukleotid-Polymorphismus

TGF:

transformierender Wachstumsfaktor

TNF:

Tumornekrosefaktor

TSLP:

Thymic stromal lymphopoietin (Zytokin)

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Authors and Affiliations

  1. Universitätsklinik für Dermatologie, Inselspital, Universitätsspital Bern, Bern, Schweiz

    Dagmar Simon

  2. Swiss EoE Study Group, Olten, Schweiz

    Alex Straumann

  3. Abteilung Gastroenterologie und Hepatologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Schweiz

    Alain M. Schoepfer

  4. Institut für Pharmakologie, Universität Bern, Bern, Schweiz

    Hans-Uwe Simon

  5. Universitätsklinik für Dermatologie Inselspital, Freiburgstrasse 34, 3010, Bern, Schweiz

    Dagmar Simon

  6. Institut für Pharmakologie Inselspital, INO-F Universität Bern, Freiburgstrasse 8, 3010, Bern, Schweiz

    Hans-Uwe Simon

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  1. Dagmar Simon
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  2. Alex Straumann
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  3. Alain M. Schoepfer
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  4. Hans-Uwe Simon
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Correspondence to Dagmar Simon.

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Zitierweise

Simon D, Straumann A, Schoepfer AM, Simon HU. Current concepts in eosinophilic esophagitis. Allergo J Int 2017; 26:258-66 https://doi.org/10.1007/s40629-017-0037-8

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Simon, D., Straumann, A., Schoepfer, A.M. et al. Aktuelle Konzepte zur eosinophilen Ösophagitis. Allergo J 26, 24–33 (2017). https://doi.org/10.1007/s15007-017-1457-y

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