Eosinophillic esophagitis (EoE) is a disorder of the esophagus (aka the windpipe) that’s characterized by chronic inflammation. The inflammatory cascade is triggered by the consumption of certain foods, and each patient experiences hypersensitivities to specific foods that cause this reaction. When triggered, EoE causes the accumulation of white blood cells as part of the immune response. When these white blood cells accumulate, they actually end up doing more harm than good. The condition can lead to acid reflux, vomiting, dysphagia (trouble swallowing), scarring of the esophagus, and even the formation of strictures along the esophageal lining.
Until just recently, researchers and physicians were unsure about the mechanisms causing EoE. Set on solving this mystery, researchers at the Cincinnati Children’s Hospital used computer bioinformatics to conduct a study that examined and analyzed millions of genetic variants among thousands of participants – both with and without EoE. The researchers found that a specific gene was only expressed in the esophagus, and this gene encodes a specific molecule in the esophagus that is part of the disease process. By using a technologically advanced analysis of human DNA, researchers are finally able to explain why patients develop EoE. The most exciting part of this finding is that there are already drugs available that inhibit this specific molecule – opening up potential therapeutic routes for future research.
The scientists report that the epithelial cells that line the esophagus first become exposed to a molecule that activates EoE (a pro-inflammatory signaling molecule known as IL-13). IL-13 then causes an up-regulation of the molecule that begins the disease process in EoE patients. While IL-13 was identified years ago as a mediator in EoE, it was thought of as simply a contributor to the allergic reaction seen in EoE patients. Recent research has added to this understanding, identifying several related genes and pathways associated with the disease. The above-mentioned study is groundbreaking because it has uncovered a specific pathway found only in the esophagus. The researchers explain that EoE is essentially genetic susceptibility matched with elements of allergic sensitization pathways. This means that future research should focus on therapeutic routes that address both genetic susceptibility and the allergy component of EoE.
After additional research, the team hopes to help develop new drugs that are able to inhibit the expression of the molecule that encourages EoE progression. Studying this specific molecule further will allow scientists to understand its function and at what point it should be blocked for most effective treatment. Current treatments for EoE include dietary therapy, medications (typically steroids), and even experimental therapies. EoE is a condition that must be treated strategically, as patients are at risk for bleeding and tearing of the esophagus. Because treatments are limited, many patients turn to alternative therapies, including herbal remedies, relaxation therapies, and even acupuncture in their search for relief. However, one of the most effective natural remedies is often overlooked. Systemic enzymes are clinically proven to help regulate immune dysfunction like the type seen in EoE. Furthermore, systemic enzymes are capable of decreasing the production and accumulation of inflammatory molecules, even IL-13 – the pro-inflammatory signaling molecule that regulates the progression of EoE.