Adolfo A. Ocampo's research while affiliated with Microbiome Core Facility USA and other places
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Publications (25)
Background
The presentation of eosinophilic esophagitis (EoE) is heterogeneous, but trends over time are not known.
Aim
To determine whether clinical and endoscopic phenotypes at EoE diagnosis have changed over the past 2 decades.
Methods
In this retrospective cohort study, adults and children with newly diagnosed EoE were phenotyped as follows:...
Introduction
Differences in EoE presentation and outcomes by ethnicity or race remain understudied. We aimed to determine whether EoE patients of Hispanic/Latinx ethnicity or non-White race have differences in presentation at diagnosis or response to topical corticosteroid (tCS) treatment.
Methods
This retrospective cohort study included subjects...
Objectives:
Feeding tubes can provide a temporary or long-term solution for nutritional therapy. Little is known regarding the use of feeding tubes in patients with eosinophilic esophagitis (EoE). We sought to describe the characteristics and outcomes in EoE patients requiring tube feeding.
Methods:
This was a retrospective cohort study of EoE p...
It is not known whether esophageal mast cells may be a cause of unexplained esophageal symptoms. We aimed to determine the prevalence of esophageal mastocytosis in patients without other underlying causes of symptoms and assess the relationship between symptoms and mast cells. In this retrospective study, we identified adults with esophageal sympto...
Background:
Patients with eosinophilic esophagitis (EoE) commonly have concomitant atopic conditions, but whether there are differences in presentation or treatment response by number of atopic diseases is unknown.
Objective:
To determine whether EoE patients with multiple atopic conditions have differences in presentation or response to topical...
Background
Understanding which eosinophilic esophagitis (EoE) patients will respond to treatment with topical corticosteroids (tCS) remains challenging, and it is unknown whether obesity impacts treatment response.
Aim
To determine whether treatment outcomes to tCS in EoE patients vary by body mass index (BMI).
Methods
This retrospective cohort s...
Background
Indirect consequences of COVID-19 in eosinophilic esophagitis (EoE) are not known.
Aim
To determine the impact of COVID-19-related endoscopy cancellations on outcomes in EoE patients.
Methods
In this retrospective cohort study, we assessed whether adult EoE patients who had routine endoscopy scheduled from mid-March 2020 to May 2020 (p...
Citations
... In this context, the study by Kiran and Dellon et al. published in this issue of Digestive Diseases and Sciences [7] affords valuable insights into these changes through analysis of a cohort of 1187 patients diagnosed with EoE over a 20-year period (2002-2021) at the University of North Carolina-Chapel Hill. The authors focused on changes over this timeframe according to 5-year intervals as well as on intervals based on the timing of international diagnostic guidelines. ...
... This may allow for a decreased need for upper endoscopies to monitor empirically chosen treatments or switching from one ineffective treatment to another option, depending on the complexity of the response outcomes assessed (37). Prior studies assessing clinical predictors of response have shown that nonresponse is associated with esophageal dilation (10,11,14), the so-called "extreme narrow caliber esophagus" (38), increased BMI (39), younger age (14,40), and minoritized racial groups (41). However, results have not yet been replicated, and these patient-based factors are not routinely considered when choosing treatments. ...
... There is the paradoxically named "EoE without eosinophilia," as well as lymphocytic esophagitis and a range of inflammatory EoE-like diseases, some of which can run in families, that do not quite meet the eosinophil-rich histopathologic features of EoE itself [28][29][30][31]. In addition to these masqueraders, there are patients who are asymptomatic but are found to have esophageal eosinophilia incidentally [32], and some who are symptomatic and have an exclusive mastocytic infiltration in the absence of eosinophils or abnormal endoscopic findings [33]. ...
Reference: Eosinophilic Esophagitis: What's in a Name?
... As per our previous work [7], we defined the inflammatory phenotype to include edema, exudates, or furrows without any rings, strictures, or narrowing, the fibrostenotic phenotype as rings, strictures, or narrowing without any inflammatory features, and the mixed phenotype as a combination of any of the inflammatory and fibrostenotic features. Second, we examined atopic EoE patients vs EoE patients without atopy vs those with multiple (defined as 2 or more) atopic conditions [36]. Atopic conditions included allergic rhinitis, asthma, food allergy, and eczema, as a documented diagnosis in the medical record. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/925376486309890-1597638355356_Q64/Walker-Redd.jpg)
... On endoscopy, patients with an inflammatory phenotype are more likely to be younger than those with mixed features or fibrostenotic disease and as such are less likely to present with symptoms of dysphagia or food impaction [7,10,11]. Patients with EoE are more likely to have atopic comorbidities [12,13], as well as non-atopic conditions, such as connective tissue diseases [14], inflammatory bowel disease [15], anxiety, and depression [16]. The differences in EoE presentation between children and adults are well described [6,17,18]. ...
... Moreover, determinants of response to treatment were identified from a limited number of variables, and did not include body mass index, which has been recently linked independently to poor response to EoE treatment with tC. 33 All possible viscous formulations of BUD or FP were grouped into only two categories (prepared by a pharmacist or home-made); variability in solvents T A B L E 5 Topical corticosteroids formulas are used to maintain EoE remission with dose reduction from that effective for inducing remission. and volumes potentially leading to variable effectiveness was not taken into account. ...
... [38,41,42] This model is supported by a number of studies showing higher rates of fibrostenosis with increasing symptom duration prior to diagnosis and by studies showing progression after diagnosis in untreated patients. [43][44][45][46][47][48][49] The high incidence of esophageal narrowing in pediatric case series from Saudi Arabia (13-28%) suggests that this progressive process may evolve rapidly in some children. An alternative explanation is that there are different phenotypes of EoE. ...
... More recently, a non-EoE esophagitis with marked mast cell infiltration has been observed and the entity of mast cell esophagitis has been proposed. This observation has been described in 87 patients and published in abstract form [83]. All of these patients presented with symptoms of esophageal dysfunction (mainly dysphagia and heartburn but also chest pain) but had otherwise normal endoscopy and histology. ...
