Continued research could eradicate the disease.
A recently conducted study at Tulane University, published in Communications Biology, sheds light on a groundbreaking approach to alleviate a chronic inflammatory condition that often hinders children from eating.
Eosinophilic esophagitis (EoE), triggered by food or airborne allergens, causes the accumulation of eosinophils (a specific type of white blood cell) in the esophageal lining. This accumulation results in the thickening of the esophageal wall, making swallowing difficult and causing food to get stuck in the throat.
Identifying symptoms in children is challenging and carries higher risks due to feeding difficulties leading to malnutrition, weight loss, and growth issues. The study links EoE to the protein interleukin-18 (IL-18), part of the innate immune response, which causes inflammation when overproduced.
When exposed to a food allergen, the body initiates a pathway controlling the innate immune system, releasing proinflammatory proteins like IL-18, resulting in harmful eosinophil buildup in the esophagus.
The research discovered that blocking the NLRP3 pathway, responsible for IL-18 release, prevented EoE triggered by both food and airborne allergens.
Anil Mishra, PhD, the study’s lead author and director of Tulane University School of Medicine’s Eosinophilic Disorder Center, highlighted the increasing prevalence of EoE globally, particularly among children, over the last few decades.
The disease, characterized by chronic inflammation and tissue fibrosis in the esophagus, is strongly linked to food allergies and can lead to progressive esophageal dysfunction dominated by eosinophils.
The study, conducted in mice, identified the NLRP3/caspase1/IL-18 pathway’s role in EoE development, offering potential treatment insights. An existing medication, VX-765, was identified as a potential inhibitor effective in curbing IL-18-induced eosinophils, preserving other essential white blood cells generated by IL-5 for innate immunity.
Clinical trials in humans are the next step to assess the treatment’s safety and efficacy.
Lauren Mahesri, RDN, LD, a pediatric dietitian not involved in the study, emphasized the lack of effective EoE treatments, often leaving patients to navigate highly restrictive diets, impacting their nutrition and quality of life.
Mahesri highlighted the study’s potential to revolutionize EoE treatment by targeting its root causes instead of managing symptoms, potentially reducing the need for restrictive diets.
Atul Tandon, PhD, president of NeoBiotechnologies, underscored the study’s implications in developing inhibitors to counter EoE’s damaging immune response, potentially offering a transformative treatment approach.
While promising, further clinical trials are essential to validate the effectiveness and safety of these inhibitors. If successful, this research could significantly enhance the quality of life for individuals affected by EoE.
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