{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:56:02Z","timestamp":1791618962280,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Proton pump inhibitors (PPIs) are effective therapies for eosinophilic oesophagitis (EoE), but the mechanism of action is uncertain. At on\u2010PPI impedance\u2010pH monitoring, improvement in oesophageal chemical clearance assessed with post\u2010reflux swallow\u2010induced peristaltic wave (PSPW) index characterises PPI\u2010responsive EoE and reflux disease. Off\u2010PPI, higher efficacy of the oesophago\u2010salivary reflex as measured with PSPW\u2010associated pH increments characterises PPI\u2010responsive reflux disease and could typify PPI\u2010responsive EoE as well.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To establish whether PPI responsiveness in EoE is associated with higher efficacy of the oesophago\u2010salivary reflex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective multicentre study in EoE patients investigated with impedance\u2010pH monitoring before starting PPI. Impedance\u2010pH parameters in PPI\u2010responsive and PPI\u2010refractory cases were compared. PPI response was defined histologically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Considerable PSPW\u2010associated pH increments (median 1.4 units) were found in 80 EoE patients, with significantly higher values in 48 PPI\u2010responsive than in 32 PPI\u2010refractory cases (1.8 vs 1.0, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Mucosal integrity, as measured with mean nocturnal baseline impedance was more severely impaired in the distal oesophagus in PPI\u2010responsive cases, the gradient between mid and distal oesophagus being significantly higher (546 vs 137\u00a0\u2126, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0002). PSPW\u2010associated pH increments and the baseline impedance gradient between mid and distal oesophagus were independently associated with histological response at multivariable logistic regression; at receiver operating characteristic analysis, the area under the curve of PPI response calculated by combined assessment was 0.88.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Higher efficacy of oesophago\u2010salivary reflex and more severe mucosal damage in the distal oesophagus are associated with EoE response to PPIs, implying an anti\u2010reflux mechanism of action as most likely.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16371","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T09:27:11Z","timestamp":1634808431000},"page":"1183-1189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Response of eosinophilic oesophagitis to proton pump inhibitors is associated with impedance\u2010pH parameters implying anti\u2010reflux mechanism of action"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8608-1563","authenticated-orcid":false,"given":"Marzio","family":"Frazzoni","sequence":"first","affiliation":[{"name":"Digestive Pathophysiology Unit and Digestive Endoscopy Unit Baggiovara Hospital Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7084-6157","authenticated-orcid":false,"given":"Leonardo","family":"Frazzoni","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department of Medical and Surgical Sciences University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"De Bortoli","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technology in Medicine and Surgery University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Russo","sequence":"additional","affiliation":[{"name":"Digestive Pathophysiology Unit and Digestive Endoscopy Unit Baggiovara Hospital Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Tolone","sequence":"additional","affiliation":[{"name":"General and Bariatric Surgery Unit Department of Surgery 2nd University of Napoli Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Arsi\u00e8","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Conigliaro","sequence":"additional","affiliation":[{"name":"Digestive Pathophysiology Unit and Digestive Endoscopy Unit Baggiovara Hospital Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6918-9479","authenticated-orcid":false,"given":"Roberto","family":"Penagini","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department of Surgery, Oncology and Gastroenterology University of Padova Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640616689525"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2016.11.012"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.03.016"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.07.041"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13537"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15957"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.314"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.01.024"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.363"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04922.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302250"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(87)90270-8"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12080"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.06.026"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000379"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0044-5"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"e14085","DOI":"10.1111\/nmo.14085","article-title":"Esophageal pH increments associated with post\u2010reflux swallow\u2010induced peristaltic waves show the occurrence and relevance of esophago\u2010salivary reflex in clinical setting","volume":"00","author":"Frazzoni M","year":"2021","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.07.056"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2020.04.031"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12299"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322627"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12947"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-016-1226-9"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-020-01732-5"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.07.055"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-020-00783-0"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.276"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.12.032"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302645"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13777"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.05.044"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.08.050"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.05.045"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2018.29"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2020.04.020"},{"key":"e_1_2_9_37_1","first-page":"e14043","article-title":"European Society for Neurogastroenterology and Motility (ESNM) recommendations for the use of high\u2010resolution manometry of the esophagus","volume":"00","author":"Tack J","year":"2020","journal-title":"Neurogastroenterol Motil"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.16371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apt.16371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.16371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T04:32:12Z","timestamp":1693542732000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.16371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,15]]},"references-count":36,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1111\/apt.16371"],"URL":"https:\/\/doi.org\/10.1111\/apt.16371","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,15]]},"assertion":[{"value":"2021-02-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}