References

nogr

Экспериментальная и клиническая гастроэнтерология

Experimental and Clinical Gastroenterology

1682-8658

«Global Media Technologies»

10.31146/1682-8658-ecg-219-11-138-145

nogr-2609

Research Article

КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ

CLINICAL CASES

Эозинофильный эзофагит и коморбидная патология: современное состояние проблемы

Eosinophilic esophagitis and comorbid pathology: current state of the problem

https://orcid.org/0000-0002-7517-4027

Зайкова-Хелимская

И. В.

Zaikova-Khelimskaya

I. V.

irinavh@mail.ru

https://orcid.org/0009-0003-6068-3704

Банк

М. Ю.

Bank

M. Yu.

noemail@neicon.ru

Хелимский

А. А.

Khelimskiy

A. A.

noemail@neicon.ru

Федеральное государственное бюджетное образовательное учреждение высшего образования «Дальневосточный государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFar Eastern State Medical UniversityRussian Federation

Федеральное государственное бюджетное образовательное учреждение высшего образования "МИРЭА - Российский технологический университет"РоссияMIREA - Russian Technological UniversityRussian Federation

2023

26032024

011138145

2024

Зайкова-Хелимская И.В., Банк М.Ю., Хелимский А.А.

Zaikova-Khelimskaya I.V., Bank M.Y., Khelimskiy A.A.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nogr.org/jour/article/view/2609

Эозинофильный эзофагит и бронхиальная астма нередко встречаются в рамках коморбидной патологии у детей и взрослых наряду с другими проявлениями атопии. Эти два заболевания имеют сходную патофизиологию, обусловленную ответами Т-хелперов 2-типа, общие подходы к лечению, такие как использование глюкокортикостероидов и таргетной антицитокиновой биологической терапии. У пациентов с эозинофильным эзофагитом как и при астме часто наблюдаются повышение сывороточных маркеров атопии, включая уровни IgE, количество периферических эозинофилов и цитокинов, связанных с Т-хелперами 2- типа. Обзор литературы показывает, что истинная частота эозинофильного эзофагита остается недостаточно изученной, в связи со сложностью диагностики данной патологии, имеющей маску гастроэзофагеального рефлюксной болезни. Доказано, что гастроэзофагеальная рефлюксная болезнь влияет на астму через микроаспирацию, гиперреактивность дыхательных путей и повышение тонуса блуждающего нерва. Понимание взаимосвязи между гастроэзофагеальным рефлюксом и эозинофильным эзофагитом в настоящее время также активно изучается. Множество работ позывает высокую эффективности ИПП в первоначальной терапии эозинофильного эзофагита и гастроэзофагеальной рефлюксной болезни. Разработка новых клинико-диагностических критериев эозинофильного эзофагита повысит дифференциальный диагноз данного заболевания и совершенство терапевтических стратегий ведения данной патологии, особенно в сочетании с бронхиальной астмой.

Eosinophilic esophagitis and asthma are often found as part of comorbid pathology in children and adults, along with other manifestations of atopy. The two diseases share similar pathophysiology due to T-helper type 2 responses, common treatment approaches such as the use of glucocorticosteroids and targeted anti-cytokine biologic therapy. Patients with eosinophilic esophagitis, as with asthma, often have elevated serum markers of atopy, including IgE levels, peripheral eosinophil counts, and T-helper type 2-associated cytokines. A review of the literature shows that the true incidence of eosinophilic esophagitis remains poorly understood due to the difficulty of diagnosing this pathology, which has a mask of gastroesophageal reflux disease. Gastroesophageal reflux disease has been shown to influence asthma through microaspiration, airway hyperresponsiveness, and increased vagal tone. Understanding the relationship between gastroesophageal reflux and eosinophilic esophagitis is also being actively explored. Many works show the high efficacy of PPIs in the initial treatment of eosinophilic esophagitis and gastroesophageal reflux disease. The development of new clinical diagnostic criteria for eosinophilic esophagitis will improve the differential diagnosis of this disease and the improvement of therapeutic strategies for managing this pathology, especially in combination with asthma.

эозинофильный эзофагитбронхиальная астмагастроэзофагеальная рефлюксная болезнь

eosinophilic esophagitisasthmagastroesophageal reflux disease

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The authors declare that there are no conflicts of interest present.