AbstractIntroductionEosinophilic oesophagitis (EoE) is an immune‐mediated, chronic disease characterized by eosinophilic inflammation and esophageal dysfunction. Specific food allergens including cow's milk protein, are partially causative to disease progression, and dietary management forms three main options; the elemental diet (ED), the empirical elimination diet (EED), and the targeted elimination diet (TED). The dietary choice should be individualized, however, the European Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines recommend an ED for pediatric EoE with multiple food allergies, failure to thrive, unresponsive disease or unable to follow a highly restricted diet. The aim of this narrative review was to explore the effectiveness of the ED (using amino acid formula [AAF]), in the management of pediatric EoE.MethodsLiterature searches were performed to identify eligible studies that described outcomes including eosinophil count, clinical symptoms, growth, and medications.ResultsOverall, 10 eligible studies were found, with n = 462 patients assigned to receive AAF from a total of n = 748 (average age 6.7 years), for a duration of 4 to 8 weeks. The use of AAF reduced eosinophil levels and demonstrated remission (defined as ≤10 eosinophils per high power field) in 75%‐100% of children with improvements, if not resolution, in clinical symptoms. AAF was more clinically effective than the use of the EED or TED, where remission rates were 75%‐81% and 40%‐69%, respectively. Few studies collected growth outcomes, however where documented these were positive for those on AAF. The long‐term impacts of each diet were not thoroughly explored.ConclusionsThe use of AAF is a clinically effective management option for pediatric EoE, and further research is required to guide long‐term management.

中文翻译：

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使用氨基酸营养饲料对小儿嗜酸性食管炎的饮食管理有效


摘要：简介嗜酸性粒细胞性食管炎（EoE）是一种免疫介导的慢性疾病，其特征是嗜酸性炎症和食管功能障碍。包括牛奶蛋白在内的特定食物过敏原是导致疾病进展的部分原因，饮食管理形成了三个主要选择；基本饮食（ED）、经验消除饮食（EED）和目标消除饮食（TED）。饮食选择应该个体化，但是，欧洲儿科胃肠病学、肝病学和营养学会指南建议对患有多种食物过敏、发育迟缓、疾病反应迟钝或无法遵循高度限制饮食的儿科 EoE 进行急诊科治疗。本叙述性综述的目的是探讨 ED（使用氨基酸配方 [AAF]）在儿科 EoE 管理中的有效性。方法进行文献检索，以确定描述结果（包括嗜酸性粒细胞计数、临床症状、生长）的合格研究结果总体而言，发现了 10 项符合条件的研究，其中 n = 462 名患者被分配接受 AAF，总共 n = 748 名患者（平均年龄 6.7 岁），持续时间为 4 至 8 周。 AAF 的使用降低了嗜酸性粒细胞水平，并在 75%‐100% 的儿童中表现出缓解（定义为每个高倍视野 ≤ 10 个嗜酸性粒细胞），临床症状即使没有缓解也有所改善。 AAF 在临床上比使用 EED 或 TED 更有效，缓解率分别为 75%‐81% 和 40%‐69%。很少有研究收集生长结果，但有记录表明这些结果对 AAF 治疗的人来说是积极的。每种饮食的长期影响尚未得到彻底探讨。结论使用 AAF 是临床上有效的儿科 EoE 治疗选择，需要进一步研究来指导长期治疗。