Differential diagnosis of eosinophilic infiltrate in esophageal mucosa by applying molecular biology method

Ćelije imunskog sistema imaju važnu ulogu u očuvanju barijere gastrointestinalnog trakta. Savremeni način života, izloženost različitim alergenima i genetska predispozicija mogu da dovedu do narušavanja odnosa i broja ćelija imunskog sistema, čime se remeti homeostaza na nivou crevne sluznice i omogućava razvoj bolesti. Povećanje broja eozinofilnih leukocita u sluznici i narušavanje barijere gastrointestinalnog trakta karakteristika je različitih primarnih i sekundarnih eozinofilnih gastrointestinalnih bolesti (EGIB). Usled čestog preklapanja u histološkom nalazu klinički različitih entiteta (kao što su eozinofilni ezofagitis, gastroezofagusna refluksna bolest i eozinofilni gastroentritis) postoji konstantna potreba za otkrivanjem novih markera diferencijacije, kao i veze između kliničkih karakteristika i patofizioloških mehanizama bolesti. Identifikacija EGIB transkriptoma i razlučivanje imunopatogeneze različitih EGIB oboljenja omogućava identifikaciju novih molekularnih markera. Molekularno profilisanje gena specifičnih za određeno oboljenje poboljšava dijagnozu i kliničko praćenje, omogućava brz odabir adekvatnog terapijskog pristupa, kao i personalizovani medicinski pristup obolelima. Iako postoji značajan broj studija koje se bave validacijom novih lekova kod EGIB obolelih, većina njih je još uvek u vidu preliminarnih istraživanja, te je neophodna dalja verifikacija efekata ispitivanih lekova u kliničkoj praksi.The cells of the immune system play an important role in preserving the barrier of the gastrointestinal tract. Modern lifestyle, exposure to various allergens and genetic predisposition can lead to a disruption of the relationship and the number of cells of the immune system, which disturb homeostasis at the level of the intestinal mucosa and enables the development of the disease. An increase in the number of eosinophilic leukocytes in the mucosa and disruption of the gastrointestinal tract barrier is a characteristic of various primary and secondary eosinophilic gastrointestinal diseases (EGIB). Due to the frequent overlap in the histological findings of clinically different entities (such as eosinophilic esophagitis, gastroesophageal reflux disease and eosinophilic gastroentritis), there is a constant need to discover new markers of differentiation, as well as the relationship between clinical characteristics and pathophysiological mechanisms of the disease. Identification of EGIB transcriptoma and differentiation of immunopathogenesis of different EGIB diseases enables identification of new molecular markers. Molecular profiling of disease-specific genes improves diagnosis and clinical monitoring, enables rapid selection of an adequate therapeutic approach, as well as a personalized medical approach to patients. Although there are a significant number of studies regarding the validation of new drugs in EGIB patients, most of them are still in the form of preliminary research, and further verification of the effects of the tested drugs in clinical practice is necessary