Effects of allergen sensitization on response to therapy in children with eosinophilic esophagitis
| Autor: | Robert D. Pesek, Amy M. Scurlock, Sheva Chervinskiy, Tamara T. Perry, Peggy Chandler, Sarah Beckwith, Joshua L. Kennedy, Troy Gibbons, Stacie M. Jones, Chunqiao Luo, Maryelle Vonlanthen, Mallikarjuna Rettiganti, Erin O'Brien, Caroline Daniel, Helen B. Casteel, Stephen C. Fiedorek, Rebecca A. Levy |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Allergy Adolescent Immunology medicine.disease_cause Article Allergic sensitization 03 medical and health sciences 0302 clinical medicine Allergen Esophagus Internal medicine Eosinophilic medicine Hypersensitivity Immunology and Allergy Humans Medical history Longitudinal Studies Prospective Studies Eosinophilic esophagitis Child Sensitization Arkansas business.industry Proton Pump Inhibitors Environmental Exposure Eosinophilic Esophagitis Eosinophil Allergens medicine.disease Eosinophils medicine.anatomical_structure Treatment Outcome 030228 respiratory system Child Preschool 030211 gastroenterology & hepatology Female Immunization Particulate Matter Seasons business |
| Zdroj: | Annals of allergy, asthmaimmunology : official publication of the American College of Allergy, Asthma,Immunology. 119(2) |
| ISSN: | 1534-4436 |
| Popis: | Background In children with eosinophilic esophagitis (EoE) foods are the most common disease triggers, but environmental allergens are also suspected culprits. Objective To determine the effects of environmental allergen sensitization on response to treatment in children with EoE in the southeastern United States. Methods Patients 2 to 18 years old who were referred to the Arkansas Children's Hospital Eosinophilic Gastrointestinal Disorders Clinic from January 2012 to January 2016 were enrolled in a prospective, longitudinal cohort study with collection of demographics, clinical symptoms, medical history, allergy sensitization profiles, and response to treatment over time. Comparisons were made between complete responders (peak esophageal eosinophil count 25 eosinophils per HPF) after treatment with diet elimination alone, swallowed corticosteroids alone, or diet elimination and swallowed corticosteroids. Sensitization patterns to environmental allergens found in the southeastern United States were analyzed for the effect on treatment response. Results A total of 223 individuals were enrolled. Of these, 182 had environmental allergy profiling and at least one endoscopy while receiving proton pump inhibitor (PPI) therapy. Twenty-nine individuals had PPI-responsive EoE and were excluded from further analysis, leaving 123 individuals with non–PPI-responsive EoE who were further analyzed; 72 (58.5%) were complete responders and 33 (26.8%) were nonresponders. Seventeen individuals (13.8%) were partial responders (≥1 but ≤25 eosinophils per HPF) and excluded from further analysis. Nonresponders were more likely to be sensitized to perennial allergens ( P = .02). There was no significant difference in response based on seasonal allergen sensitization. Individuals with mold or cockroach sensitization were more likely to fail combination diet and swallowed corticosteroid treatment ( P = .02 and P = .002). Conclusion Perennial allergen and mold sensitization may lead to nonresponse to EoE treatment in some patients. Additional studies are needed to further understand the effect of environmental allergens on EoE. Trial Registration ClinicalTrials.gov identifier: NCT01779154. |
| Databáze: | OpenAIRE |
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