Journal of Asthma and Allergy (Feb 2022)
Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions
Abstract
James P Franciosi,1,2 Edward B Mougey,3 Evan S Dellon,4 Carolina Gutierrez-Junquera,5 Sonia Fernandez-Fernandez,6 Rajitha D Venkatesh,7 Sandeep K Gupta8 1Division of Gastroenterology, Nemours Children’s Hospital, Orlando, FL, USA; 2College of Medicine, University of Central Florida, Orlando, FL, USA; 3Center for Pharmacogenomics and Translational Research, Nemours Children’s Health System, Jacksonville, FL, USA; 4Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA; 5Pediatric Gastroenterology Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Autonomous University of Madrid, Madrid, Spain; 6Pediatric Gastroenterology Unit, Hospital Universitario Severo Ochoa, Madrid, Spain; 7Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children’s Hospital, Columbus, OH, USA; 8Section of Pediatric Gastroenterology, Hepatology and Nutrition, Riley Hospital for Children, Indiana University School of Medicine and Community Health Network, Indianapolis, IN, USACorrespondence: James P Franciosi, Division of Gastroenterology, Nemours Children’s Hospital, 6535 Nemours Parkway, Orlando, FL, 32827, USA, Tel +1 407 567 3832 ; +1 407 335 9908, Email [email protected]: Over the past decade, the role of proton pump inhibitor (PPI) medication has evolved from a diagnostic tool for Eosinophilic Esophagitis (EoE), by excluding patients with PPI responsive esophageal eosinophilia (PPI-REE), to a therapy for EoE. This transition resulted from the Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the Appraisal of Guidelines for Research and Evaluation II (AGREE) Conference to support PPI therapy for EoE in children and adults. Additional recent advances have suggested a role for genetic variations that might impact response to PPI therapy for EoE. This review article will explore a brief background of EoE, the evolution of PPI therapy for EoE and its proposed mechanisms, efficacy and safety in children and adults, and considerations for future PPI precision medicine in patients with EoE.Keywords: eosinophilic esophagitis, EoE, proton pump inhibitor medication, PPI, precision medicine
