From Genetics to Treatment of Eosinophilic Esophagitis

Epidemiology

Several epidemiological studies have revealed that EoE is a highly hereditable atopic disease that affect mainly Caucasian men regardless of their age. EoE affects children and adults from all continents; however, the western world has a highest prevalence, with a north–south and west–east gradients similar to the one described for the incidence of atopic diseases. In children in the Unite States, EoE has prevalence of 50.5/10000, equivalent to pediatric inflammatory bowel disease.

The epidemiological data suggest both atopic and genetic components in patients with EoE:

1. 
   Patients with EoE are highly atopic (Table 1). The most common comorbidity is the allergic rhinitis, but also the rate of IgE-mediated food allergy is 10 times higher than the general population. Unlike classic food allergy that typically involves a limited set of foods, EoE patients are often sensitized to a myriad of foods, often including food groups not typically considered to elicit IgE-mediated food allergy.
   
2. 
   EoE affects predominantly men with a male to female ratio of 3 : 1 in both children and adults.
   
3. 
   Family history, especially in men, is very frequent with nearly 10% of parents of EoE patients having a history of esophageal strictures and about 8% having biopsy-proven EoE. EoE also shows a sibling-risk ratio of 80, meaning that having a sibling with the disease increase 80 times the risk of developing a similar disease in other siblings. This is extremely high compared with the one for related atopic diseases such as asthma that has a sibling-risk ratio of about 2.
   

All together, the epidemiological data suggest a strong atopic and genetic component in EoE development.