Advances in Management of Eosinophilic Esophagitis in Pediatrics

Dellon ES, Muir AB, Katzka DA, Shah SC, Sauer BG, Aceves SS, et al. ACG clinical guideline: diagnosis and management of eosinophilic esophagitis. Am J Gastroenterol. 2025;120:31–59. https://doi.org/10.14309/ajg.0000000000003194.

Article  CAS  PubMed  Google Scholar 

Hahn JW, Lee K, Shin JI, Cho SH, Turner S, Shin JU, et al. Global incidence and prevalence of eosinophilic esophagitis, 1976-2022: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2023;21:3270-84.e3277. https://doi.org/10.1016/j.cgh.2023.06.005.

Article  PubMed  Google Scholar 

Navarro P, Arias Á, Arias-González L, Laserna-Mendieta EJ, Ruiz-Ponce M, Lucendo AJ. Systematic review with meta-analysis: the growing incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther. 2019;49:1116–25. https://doi.org/10.1111/apt.15231.

Article  PubMed  Google Scholar 

Jensen ET, Kappelman MD, Martin CF, Dellon ES. Health-care utilization, costs, and the burden of disease related to eosinophilic esophagitis in the United States. Am J Gastroenterol. 2015;110:626–32. https://doi.org/10.1038/ajg.2014.316.

Article  PubMed  Google Scholar 

Mukkada V, Falk GW, Eichinger CS, King D, Todorova L, Shaheen NJ. Health-related quality of life and costs associated with eosinophilic esophagitis: a systematic review. Clin Gastroenterol Hepatol. 2018;16:495-503.e498. https://doi.org/10.1016/j.cgh.2017.06.036.

Article  PubMed  Google Scholar 

Chang JW, Rubenstein JH, Mellinger JL, Kodroff E, Strobel MJ, Scott M, et al. Motivations, barriers, and outcomes of patient-reported shared decision making in eosinophilic esophagitis. Dig Dis Sci. 2021;66:1808–17. https://doi.org/10.1007/s10620-020-06438-5.

Article  PubMed  Google Scholar 

Hirano I, Collins MH, Katzka DA, Mukkada VA, Falk GW, Morey R, et al. Budesonide oral suspension improves outcomes in patients with eosinophilic esophagitis: results from a phase 3 trial. Clin Gastroenterol Hepatol. 2022;20:525-34.e510. https://doi.org/10.1016/j.cgh.2021.04.022.

Article  CAS  PubMed  Google Scholar 

Dellon ES, Rothenberg ME, Collins MH, Hirano I, Chehade M, Bredenoord AJ, et al. Dupilumab in adults and adolescents with eosinophilic esophagitis. N Engl J Med. 2022;387:2317–30. https://doi.org/10.1056/NEJMoa2205982.

Article  CAS  PubMed  Google Scholar 

Furuta GT, Liacouras CA, Collins MH, Gupta SK, Justinich C, Putnam PE, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007;133:1342–63. https://doi.org/10.1053/j.gastro.2007.08.017.

Article  CAS  PubMed  Google Scholar 

Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128(1):3-20.e26. https://doi.org/10.1016/j.jaci.2011.02.040.

Article  PubMed  Google Scholar 

Lucendo AJ, Arias A, Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14:13-22.e11. https://doi.org/10.1016/j.cgh.2015.07.041.

Article  CAS  PubMed  Google Scholar 

Dellon ES, Liacouras CA, Molina-Infante J, Furuta GT, Spergel JM, Zevit N, et al. Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference. Gastroenterology. 2018;155:1022-33.e1010. https://doi.org/10.1053/j.gastro.2018.07.009.

Article  PubMed  PubMed Central  Google Scholar 

Franciosi JP, Mougey EB, Dellon ES, Gutierrez-Junquera C, Fernandez-Fernandez S, Venkatesh RD, et al. Proton pump inhibitor therapy for eosinophilic esophagitis: history, mechanisms, efficacy, and future directions. J Asthma Allergy. 2022;15:281–302. https://doi.org/10.2147/jaa.S274524.

Article  PubMed  PubMed Central  Google Scholar 

Yoshida N, Yoshikawa T, Tanaka Y, Fujita N, Kassai K, Naito Y, et al. A new mechanism for anti-inflammatory actions of proton pump inhibitors: inhibitory effects on neutrophil-endothelial cell interactions. Aliment Pharmacol Ther. 2000;14(1):74–81. https://doi.org/10.1046/j.1365-2036.2000.014s1074.x.

Article  CAS  PubMed  Google Scholar 

Odiase E, Zhang X, Chang Y, Nelson M, Balaji U, Gu J, et al. In esophageal squamous cells from eosinophilic esophagitis patients, Th2 cytokines increase eotaxin-3 secretion through effects on intracellular calcium and a non-gastric proton pump. Gastroenterology. 2021;160:2072-88.e2076. https://doi.org/10.1053/j.gastro.2021.02.016.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Zhang X, Cheng E, Huo X, Yu C, Zhang Q, Pham TH, et al. Omeprazole blocks STAT6 binding to the eotaxin-3 promoter in eosinophilic esophagitis cells. PLoS ONE. 2012;7:e50037. https://doi.org/10.1371/journal.pone.0050037.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Rochman M, Xie YM, Mack L, Caldwell JM, Klingler AM, Osswald GA, et al. Broad transcriptional response of the human esophageal epithelium to proton pump inhibitors. J Allergy Clin Immunol. 2021;147:1924–35. https://doi.org/10.1016/j.jaci.2020.09.039.

Article  CAS  PubMed  Google Scholar 

Sayej WN, Patel R, Baker RD, Tron E, Baker SS. Treatment with high-dose proton pump inhibitors helps distinguish eosinophilic esophagitis from noneosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2009;49:393–9. https://doi.org/10.1097/MPG.0b013e31819c4b3e.

Article  CAS  PubMed  Google Scholar 

Dranove JE, Horn DS, Davis MA, Kernek KM, Gupta SK. Predictors of response to proton pump inhibitor therapy among children with significant esophageal eosinophilia. J Pediatr. 2009;154:96–100. https://doi.org/10.1016/j.jpeds.2008.07.042.

Article  CAS  PubMed  Google Scholar 

Schroeder S, Capocelli KE, Masterson JC, Harris R, Protheroe C, Lee JJ, et al. Effect of proton pump inhibitor on esophageal eosinophilia. J Pediatr Gastroenterol Nutr. 2013;56:166–72. https://doi.org/10.1097/MPG.0b013e3182716b7a.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Rea F, Caldaro T, Tambucci R, Romeo EF, Caloisi C, Torroni F, et al. Eosinophilic esophagitis: is it also a surgical disease? J Pediatr Surg. 2013;48:304–8. https://doi.org/10.1016/j.jpedsurg.2012.11.006.

Article  PubMed  Google Scholar 

Gutiérrez-Junquera C, Fernández-Fernández S, Cilleruelo ML, Rayo A, Echeverría L, Quevedo S, et al. High prevalence of response to proton-pump inhibitor treatment in children with esophageal eosinophilia. J Pediatr Gastroenterol Nutr. 2016;62:704–10. https://doi.org/10.1097/mpg.0000000000001019.

Article  PubMed  Google Scholar 

Gómez Torrijos E, Donado Palencia P, Sanchez Miranda MP, Moreno Lozano L, Extremera Ortega AM, Borja Segade JM, et al. Eosinophilic esophagitis: treatment with different doses of omeprazole in children under 16 years. J Investig Allergol Clin Immunol. 2018;28:191–2. https://doi.org/10.18176/jiaci.0230.

Article  PubMed  Google Scholar 

Harris BR, Hon E, Gupta SK. Implementation of guidelines in eosinophilic esophagitis at an academic pediatric practice. Dis Esophagus. 2018. https://doi.org/10.1093/dote/doy029.

Article  PubMed  Google Scholar 

Vieira GG, Ribeiro LBM, Truppel SK, Rosário Filho NA, Vieira MC. Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non-responsive to proton pump inhibitors. J Pediatr Rio J. 2020;96:638–43. https://doi.org/10.1016/j.jped.2019.05.005.

Article  PubMed  Google Scholar 

Rosen I, Mahamed A, Garah J, Magen-Rimon R, Shaoul R. The management and course of eosinophilic oesophagitis in Israeli children. Acta Paediatr. 2021;110:1653–7. https://doi.org/10.1111/apa.15746.

Article  PubMed  Google Scholar 

Gutiérrez-Junquera C, Fernández-Fernández S, Domínguez-Ortega G, Vila Miravet V, García-Puig R, La Orden-Izquierdo E, et al. Proton pump inhibitor therapy in pediatric eosinophilic esophagitis: predictive factors and long-term step-down efficacy. J Pediatr Gastroenterol Nutr. 2023;76:191–8. https://doi.org/10.1097/mpg.0000000000003660.

Article  PubMed  Google Scholar 

Lucendo AJ, Gutiérrez-Ramírez L, Tejera-Muñoz A, Molina-Infante J, Arias Á. Proton pump inhibitors for inducing and maintaining remission in eosinophilic esophagitis: an updated systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2025;23:2115-27.e2121. https://doi.org/10.1016/j.cgh.2025.01.016.

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