ArticleThe American journal of gastroenterology2018
Eosinophilic Esophagitis: Relationship of Subepithelial Eosinophilic Inflammation With Epithelial Histology, Endoscopy, Blood Eosinophils, and Symptoms.
Article in The American journal of gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Systematic Review: Variability in Definitions of Fibrostenosis in Eosinophilic Oesophagitis.Alimentary pharmacology & therapeutics · 2025Pooled it
- BRAZILIAN GASTROENTEROLOGY FEDERATION (FBG) CLINICAL GUIDELINE: DIAGNOSIS AND TREATMENT OF EOSINOPHILIC ESOPHAGITIS IN ADULTS AND ADOLESCENTS.Arquivos de gastroenterologia · 2025Guideline
- AGA Clinical Practice Update on Esophageal Dysfunction Due to Disordered Immunity and Infection: Expert Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Guideline
- Effectiveness of Potassium-Competitive Acid Blockers and Proton Pump Inhibitors on Esophageal Wall Thickening in Eosinophilic Esophagitis.Gut and liver · 2026Article
- Modeling Epithelial Homeostasis and Perturbation in Three-Dimensional Human Esophageal Organoids.Biomolecules · 2024Article
- Eosinophilic esophagitis: Current concepts in diagnosis and management.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2024Review
- Eosinophilic esophagitis: absolute eosinophilic count, peak eosinophilic count, and potential biomarkers of eosinophilic degranulation products-an in-depth systematic review.Translational pediatrics · 2024Review
- Review article: Emerging insights into the epidemiology, pathophysiology, diagnostic and therapeutic aspects of eosinophilic oesophagitis and other eosinophilic gastrointestinal diseases.Alimentary pharmacology & therapeutics · 2024Review
- The role of hypervigilance in chronic esophageal diseases: a scoping review.Translational gastroenterology and hepatology · 2024Article
- Characterization of lamina propria remodeling in pediatric eosinophilic esophagitis using second harmonic generation microscopy.Translational medicine communications · 2024Article
- Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances.Diagnostics (Basel, Switzerland) · 2022Review
- Validation of the Achalasia Patient-Reported Outcomes Questionnaire.Alimentary pharmacology & therapeutics · 2022Article
- Esophageal Hypervigilance and Symptom-Specific Anxiety in Patients with Eosinophilic Esophagitis.Gastroenterology · 2021Article
- Factors Associated With Adequate Lamina Propria Sampling and Presence of Lamina Propria Fibrosis in Children with Eosinophilic Esophagitis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Article
- Single-Organ and Multisystem Hypereosinophilic Syndrome Patients with Gastrointestinal Manifestations Share Common Characteristics.The journal of allergy and clinical immunology. In practice · 2020Article
- Eosinophilic esophagitis: imaging features with endoscopic and pathologic correlation.Abdominal radiology (New York) · 2020Review
- Clinical relevance of esophageal subepithelial activity in eosinophilic esophagitis.Journal of gastroenterology · 2020Review
- Eosinophils in Eosinophilic Esophagitis: The Road to Fibrostenosis is Paved With Good Intentions.Frontiers in immunology · 2020Review
- A Conceptual Approach to Understanding Treatment Response in Eosinophilic Esophagitis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2019Review
- Pathophysiology of eosinophilic esophagitis: recent advances and their clinical implications.Expert review of clinical immunology · 2019Review
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFor technical reasons, the histologic characterization of eosinophilic esophagitis (EoE)-specific alterations is almost exclusively based on those found in the esophageal epithelium, whereas little is known about subepithelial abnormalities. In this study, we aimed to systematically assess the nature of subepithelial histologic alterations, and analyze their relationship with epithelial histologic findings, endoscopic features, and symptoms.
methodsAdult patients with established EoE diagnosis were prospectively included during a yearly follow-up visit. Patients underwent assessment of clinical, endoscopic, and histologic disease activity using EoE-specific scores.
resultsWe included 200 EoE patients (mean age 43.5±15.7 years, 74% males) with a median peak count of 36 intraepithelial eosinophils/hpf (IQR 14-84). The following histologic features were identified in the subepithelial layer: eosinophilic infiltration (median peak count of 20 eosinophils/hpf (IQR 10-51)), eosinophil degranulation (43%), fibrosis (82%), and lymphoid follicles (56%). Peak intraepithelial eosinophil counts were higher, identical, and lower when compared to the subepithelial layer in 62.5%, 7%, and 30.5% of patients, respectively. Anti-eosinophilic treatment at inclusion did not influence the relation between subepithelial and epithelial peak eosinophil counts. Subepithelial histologic activity correlated with epithelial histologic activity (rho 0.331, P<0.001), endoscopic severity (rho 0.208, P=0.003), and symptom severity (rho 0.179, P=0.011). Forty percent (21/52) of patients with <15 intraepithelial eosinophils/hpf had subepithelial peak counts of ≥15/hpf.
conclusionsThere is a significant but modest correlation between subepithelial histologic activity and epithelial histologic activity, endoscopic severity, and symptom severity. The long-term clinical impact of assessing subepithelial alterations in EoE needs to be further elucidated.
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