Eosinophilic oesophagitis (EoE) is a chronic, immune-mediated condition characterised by eosinophilic infiltration of the oesophagus, leading to significant morbidity due to oesophageal dysfunction. The pathogenic course of EoE begins with tissue injury, marked by the intricate interplay of oesophageal barrier dysfunction and T helper 2-mediated inflammation. In response to tissue damage, a subsequent phase of tissue remodelling features a complex interaction between epithelial cells and stromal cells, aimed at tissue repair. The persistence of inflammation drives these mechanisms towards oesophageal fibrostenosis, mainly through the transforming growth factor-dependent, myofibroblast-driven accumulation of the extracellular matrix. Currently, treatment options for EoE are limited, with dietary intervention, proton pump inhibitors and oral steroids serving as first-line therapies. Dupilumab, an antiinterleukin (IL) 4/IL-13 agent, is the only biologic that has been approved by European and American regulatory authorities. However, emerging OMIC technologies significantly advance our understanding of EoE pathogenesis, revealing novel cellular and molecular mechanisms driving the disease. This progress has accelerated the identification of new therapeutic targets and agents, some already under clinical investigation, potentially expanding our therapeutic arsenal and paving the way for more personalised approaches. In this evolving landscape, artificial intelligence (AI) has shown great potential to further elaborate on the complexities of EoE heterogeneity, offering standardised tools for diagnosis, disease phenotyping, and prediction of treatment response. Though still in their early stages, integrating OMICs and AI marks a pivotal step towards precision medicine in EoE.

中文翻译：

---

了解嗜酸性粒细胞性食管炎的组织损伤和重塑：个性化医疗的发展


嗜酸性粒细胞性食管炎 （EoE） 是一种慢性免疫介导的疾病，其特征是嗜酸性粒细胞浸润食管，由于食管功能障碍导致严重的并发症。EoO 的致病过程始于组织损伤，其特征是食管屏障功能障碍和辅助性 T 细胞 2 介导的炎症之间错综复杂的相互作用。为了响应组织损伤，组织重塑的后续阶段以上皮细胞和基质细胞之间的复杂相互作用为特征，旨在组织修复。炎症的持续性驱动这些机制走向食管纤维狭窄，主要是通过转化生长因子依赖性、肌成纤维细胞驱动的细胞外基质积累。目前，EoO 的治疗选择有限，饮食干预、质子泵抑制剂和口服类固醇是一线疗法。Dupilumab 是一种抗白细胞介素 （IL） 4/IL-13 药物，是唯一获得欧洲和美国监管机构批准的生物制剂。然而，新兴的组学技术显着促进了我们对 EoO 发病机制的理解，揭示了驱动该疾病的新细胞和分子机制。这一进展加速了新治疗靶点和药物的确定，其中一些已经在临床研究中，这可能会扩大我们的治疗库并为更加个性化的方法铺平道路。在这个不断发展的环境中，人工智能 （AI） 显示出进一步阐述 EoO 异质性复杂性的巨大潜力，为诊断、疾病表型和治疗反应预测提供标准化工具。尽管仍处于早期阶段，但整合组学和 AI 标志着 EoE 中朝着精准医疗迈出的关键一步。