Data of pH-impedance monitoring in eosinophilic esophagitis patients

One of the key factors in the pathogenesis of eosinophilic esophagitis is the disruption of the epithelial barrier integrity, leading to deep penetration of environmental allergens into the esophageal mucosa. The causes of dilated intercellular spaces in eosinophilic esophagitis are recognized as inflammatory processes induced by type T2cytokines (IL-4, 5, 13), as well as a genetically determined impairment in the synthesis of tight junction proteins. At the same time, the contribution of pathological gastroesophageal refluxes to mucosal damage and increased permeability of the esophagus cannot be ruled out. Given the high prevalence of gastroesophageal reflux disease in the population, this may play an important role in the pathogenetic processes occurring in the esophageal wall of patients with eosinophilic esophagitis. Aim. To study the parameters of 24-hour pH-impedance monitoring in patients with eosinophilic esophagitis in order to assess the role of gastroesophageal refluxes in the pathogenesis of eosinophilic esophagitis and to determine treatment strategies for patients with eosinophilic esophagitis. Material and methods. 24-hour esophageal pH-impedance monitoring was performed on 57 patients aged 18 to 52 years with a previously confirmed diagnosis of "eosinophilic esophagitis," who provided signed voluntary informed consent. The study results were evaluated in comparison with pH-impedance monitoring data from patients with gastroesophageal reflux disease (60 individuals) and healthy volunteers (23 individuals). Results. Pathological gastroesophageal refluxes (primarily acidic) likely play a significant role in the pathogenesis of eosinophilic esophagitis, as they were detected in this study in 21.1% of patients with eosinophilic esophagitis. Routine pH-impedance monitoring is not indicated for eosinophilic esophagitis but may be used as an additional diagnostic method in patients when determining therapeutic strategy (prescribing antisecretory therapy or topical corticosteroids). Assessment of basal nocturnal impedance may be an important additional marker of inflammatory process activity in patients with EoE.

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