{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T19:30:24Z","timestamp":1787859024778,"version":"build-2784847793"},"reference-count":77,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory condition of the esophagus characterized by eosinophilic infiltration, and hallmark symptoms of esophageal dysfunction such as dysphagia and food impaction. Over the past three decades, EoE has been recognized as a distinct clinical entity, distinguished from gastroesophageal reflux disease (GERD) through advancements in diagnostic techniques, particularly endoscopy with biopsy. The rising global prevalence of EoE reflects enhanced diagnostic awareness, evolving criteria, and environmental along with lifestyle changes. The etiology of EoE is multifactorial, involving genetic predispositions, immune dysregulation, the gut microbiome, and environmental triggers, including dietary allergens and aeroallergens. Key mechanisms include a type 2 helper T-cell (Th2)-driven immune response, epithelial barrier dysfunction, and genetic variants such as CAPN14 and TSLP. Chronic inflammation leads to tissue remodeling, fibrosis, and esophageal narrowing, contributing to disease progression and complications. Management strategies have evolved to include dietary elimination, proton pump inhibitors, topical corticosteroids, biologics, and endoscopic interventions for fibrostenotic complications. Emerging therapies targeting cytokines such as interleukin (IL)-4, IL-5, and IL-13, alongside novel diagnostic tools like the esophageal string test and Cytosponge, offer promising avenues for improved disease control and non-invasive monitoring. Long-term surveillance combining endoscopic and histological evaluations with biomarkers and non-invasive tools is critical to optimizing outcomes and preventing complications. Future research should address gaps in understanding the role of the esophageal microbiome, refine therapeutic approaches, and develop personalized strategies to improve disease management and patient quality of life.<\/jats:p>","DOI":"10.3390\/diagnostics15030240","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T06:53:32Z","timestamp":1737442412000},"page":"240","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Dynamic Evolution of Eosinophilic Esophagitis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3522-7292","authenticated-orcid":false,"given":"Amir","family":"Farah","sequence":"first","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Assaf","sequence":"additional","affiliation":[{"name":"Department of Surgery, Holy Family Hospital, Nazareth 1601001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad","family":"Hindy","sequence":"additional","affiliation":[{"name":"The Proteomic Unit, Bnai Zion Medical Center, Haifa 3339419, Israel"},{"name":"Cancer Research Center, The Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3525433, Israel"},{"name":"Department of Gastroenterology and Hepatology, Bnai Zion Medical Center, Haifa 3339419, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wisam","family":"Abboud","sequence":"additional","affiliation":[{"name":"Department of Surgery, EMMS Nazareth Hospital, Nazareth Hospital, Nazareth 1613101, Israel"},{"name":"Faculty of Medicine, Bar Ilan University, Ramat Gan 5290002, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Mahamid","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Meir Medical Centre, Kefar Sava 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-2894","authenticated-orcid":false,"given":"Edoardo Vincenzo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Mari","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bar Ilan University, Ramat Gan 5290002, Israel"},{"name":"Department of Gastroenterology, EMMS Nazareth Hospital, Nazareth Hospital, Nazareth 1613101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"ref_1","first-page":"254","article-title":"Eosinophilic esophagitis: Update in diagnosis and management. 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