PRACA PRZEGLĄDOWA
Eozynofilowe zapalenie przełyku – omówienie aktualnego stanu wiedzy i nowe możliwości leczenia biologicznego
Więcej
Ukryj
1
University Clinical Hospital of the Military Academy of Medicine – Central Veterans Hospital, Polska
2
Uniwersytet Medyczny w Łodzi, Polska
3
Szpital Zakonu Bonifratrów św. Jana Grandego, Polska
Autor do korespondencji
Aleksander Gras-Ozimek
University Clinical Hospital
of the Military Academy of Medicine – Central Veterans Hospital, ul. Żeromskiego
Med Og Nauk Zdr. 2024;30(1):1-6
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
Wprowadzenie i cel:
Eozynofilowe zapalenie przełyku jest chorobą o podłożu immunologicznym. Klinicznie charakteryzuje
się dysfunkcją przełyku, natomiast histologicznie – zapalnym naciekiem eozynofilów w ścianie tego narządu. Przewlekły stan zapalny w ścianie przełyku prowadzi do zmian strukturalnych i wtórnie – do narastających objawów dysfagii. Celem niniejszej pracy jest omówienie aktualnej wiedzy na temat eozynofilowego zapalenia przełyku oraz nowych możliwości leczenia tej choroby.
Metody przeglądu:
Do przeglądu piśmiennictwa użyto bazy PubMed. Elektroniczne wyszukiwanie literatury przeprowadzono
z ograniczeniem do konkretnych lat publikacji (2007–2023), przy użyciu terminów wyszukiwania w postaci następujących fraz w języku angielskim: „eosinophilic esophagitis”, „eosinophilic esophagitis treatment”, „eosinophilic esophagitis biological treatment”, „eosinophilic esophagitis epidemiology”. Wszystkie wyszukane artykuły poddano analizie. Do przeglądu włączono zarówno prace oryginalne, jak i badania randomizowane podwójnie zaślepione, kontrolowane placebo.
Opis stanu wiedzy:
Etiologia eozynofilowego zapalenia przełyku wciąż nie jest dokładnie określona. Uważa się, że bezpośrednią przyczyną tej choroby jest upośledzenie funkcji nabłonka przełyku oraz eozynofilów. Dotychczas stosowane leki, takie jak IPP oraz GKS, nie dają w pełni satysfakcjonujących efektów dla pacjentów, trwają zatem dalsze poszukiwania optymalnej terapii.
Podsumowanie:
Eozynofilowe zapalenie przełyku jest chorobą istotnie obniżającą komfort życia pacjentów, a obecne
opcje terapeutyczne nie zawsze pozwalają na długotrwałą remisję jej objawów. Coraz lepsze zrozumienie patomechanizmu choroby umożliwia wprowadzanie precyzyjnie ukierunkowanego leczenia. Duże nadzieje pokłada się w terapii biologicznej.
Introduction and objective:
Eosinophilic esophagitis is an immune-mediated disease. Clinically, it is characterized by esophageal dysfunction, and histologically – by inflammatory infiltration of eosinophils in the wall of this organ. Chronic inflammation in the esophageal wall leads to structural changes and, secondarily, to increasing symptoms of dysphagia. The aim of this study is to discuss current knowledge about eosinophilic esophagitis and new treatment options for this disease.
Review methods:
The PubMed database was used to review the literature. An electronic literature search was conducted,
limited to specific years of publication (2007–2023), using search terms in the form of the following phrases in English: „Eosinophilic esophagitis“, „Eosinophilic esophagitis treatment“, „Eosinophilic esophagitis biological treatment“, „Eosinophilic esophagitis epidemiology“. All retrieved articles were analyzed. The review included original studies, as well as randomized, double-blind, placebo-controlled studies.
Brief description of the state of knowledge:
The etiology of eosinophilic esophagitis has still not been precisely defined. It is believed that the direct cause of eosinophilic esophagitis is impaired function of the esophageal epithelium and eosinophils. Drugs used so far, such as PPIs and GCs, do not provide fully satisfactory results for patients, hence the search for a more optimal therapy is ongoing.
Summary:
Eosinophilic esophagitis is a disease that significantly reduces the quality of life of patients – current
therapeutic options do not always permit long-term remission of symptoms. An increasingly better understanding of the pathomechanism of the disease allows for the introduction
of precisely targeted treatment. Great hopes are placed on biological therapy.
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