PMID- 36118171
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220920
IS  - 2673-6101 (Electronic)
IS  - 2673-6101 (Print)
IS  - 2673-6101 (Linking)
VI  - 3
DP  - 2022
TI  - Pediatric eosinophilic esophagitis outcomes vary with co-morbid eczema and pollen 
      food syndrome.
PG  - 981961
LID - 10.3389/falgy.2022.981961 [doi]
LID - 981961
AB  - BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic immune-mediated 
      inflammatory disease characterized by eosinophil inflammation of the esophagus. 
      It has been described as a component of the Allergic March and is often seen with 
      other atopic diseases. Some atopic diseases, including asthma, are known to be 
      heterogenous with endotypes that guide treatment. Similarly, we propose that EoE 
      is a heterogenous disease with varying phenotypes and endotypes that might impact 
      response to therapy. METHODS: A single-center retrospective review of pediatric 
      patients </=18 years of age diagnosed with EoE was conducted. All gastrointestinal 
      clinic visits and esophagogastroduodenoscopies (EGD) from disease presentation 
      through the first three years after diagnosis were reviewed. Histologic remission 
      rate and therapies utilized [proton pump inhibitor (PPI), topical steroid, 
      dietary elimination] were assessed. RESULTS: One hundred and thirty-seven 
      patients were included, 80% of whom had at least one concurrent atopic condition 
      at diagnosis, with food allergies being the most common (57%) followed by eczema 
      (34%), and asthma (29%). The remission rate of the overall cohort was 65%, and by 
      concurrent allergy, comorbid pollen food syndrome and eczema had the highest 
      remission rates at 100% and 81%, respectively followed by asthma (62%), food 
      allergies (62%), seasonal allergic rhinitis (60%), and history of anaphylaxis 
      (56%). Kaplan-Meier curves for each atopic condition show that patients with 
      eczema and pollen food syndrome achieve histologic remission faster than those 
      without. All treatment modalities were more successful in patients with eczema 
      than those without, and PPI was most effective treatment at inducing remission. 
      CONCLUSIONS: In a real-world pediatric cohort, 80% of patients with EoE had an 
      underlying atopic condition. Patients with eczema and pollen food syndrome had a 
      swifter response and were more likely to achieve histologic remission than 
      patients with other atopic conditions. This study suggests that EoE, like other 
      allergic diseases, may have heterogenous phenotypes that could affect response to 
      treatment. There is currently a knowledge gap in classifying EoE based on 
      endotypes and phenotypes at diagnosis and correlating responses to various 
      treatment modalities.
CI  - (c) 2022 Sessions, Purington, Wang, McGhee, Sindher, Goyal and Khavari.
FAU - Sessions, Julia
AU  - Sessions J
AD  - Stanford School of Medicine, Stanford Medicine, Stanford, CA, United States.
AD  - Department of Pediatrics, University of Virginia, Charlottesville, VA, United 
      States.
FAU - Purington, Natasha
AU  - Purington N
AD  - Stanford Quantitative Sciences Unit, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Wang, Yiwen
AU  - Wang Y
AD  - Stanford Quantitative Sciences Unit, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - McGhee, Sean
AU  - McGhee S
AD  - Division of Allergy, Immunology, & Rheumatology, Stanford Medicine, Stanford, CA, 
      United States.
FAU - Sindher, Sayantani
AU  - Sindher S
AD  - Division of Allergy, Immunology, & Rheumatology, Stanford Medicine, Stanford, CA, 
      United States.
FAU - Goyal, Alka
AU  - Goyal A
AD  - Pediatric Gastroenterology, Hepatology, & Nutrition, Stanford Medicine, Stanford, 
      CA, United States.
FAU - Khavari, Nasim
AU  - Khavari N
AD  - Pediatric Gastroenterology, Hepatology, & Nutrition, Stanford Medicine, Stanford, 
      CA, United States.
LA  - eng
PT  - Journal Article
DEP - 20220902
PL  - Switzerland
TA  - Front Allergy
JT  - Frontiers in allergy
JID - 9918227355906676
PMC - PMC9478188
OTO - NOTNLM
OT  - allergy
OT  - atopic dermatitis
OT  - eczema
OT  - eosinophilic esophagitis (EoE)
OT  - oral allergy syndrome (OAS)
OT  - outcomes
OT  - pollen food allergy syndrome (PFAS)
OT  - pollen food syndrome (PFS)
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/09/20 06:00
MHDA- 2022/09/20 06:01
PMCR- 2022/09/02
CRDT- 2022/09/19 04:06
PHST- 2022/06/29 00:00 [received]
PHST- 2022/08/15 00:00 [accepted]
PHST- 2022/09/19 04:06 [entrez]
PHST- 2022/09/20 06:00 [pubmed]
PHST- 2022/09/20 06:01 [medline]
PHST- 2022/09/02 00:00 [pmc-release]
AID - 10.3389/falgy.2022.981961 [doi]
PST - epublish
SO  - Front Allergy. 2022 Sep 2;3:981961. doi: 10.3389/falgy.2022.981961. eCollection 
      2022.