Clinical Reviews in Allergy & Immunology

, Volume 55, Issue 1, pp 88–98 | Cite as

Monoclonal Antibodies for Treatment of Eosinophilic Esophagitis

  • Mahsa Eskian
  • MirHojjat Khorasanizadeh
  • Amal H. Assa’ad
  • Nima RezaeiEmail author


Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus affecting both children and adults, with debilitating and progressive symptoms. EoE has shown an explosive epidemiological rise in the past few decades. Many patients experience a poor level of disease control despite maximal use of available guideline-based therapies, which seriously hampers their quality of life. Diet restrictions and systemic and topical corticosteroids are the current mainstays of EoE therapy, but are associated with significant efficacy, treatment compliance, and safety issues such as oral or esophageal candidiasis, growth retardation, osteopenia, osteoporosis, glucose intolerance, and cataract formation. As EoE is a chronic inflammatory disease, immune cells and cytokines are responsible for the inflammatory response and symptoms. Monoclonal antibodies specifically targeting these pathophysiologic effectors offer more potent relief of histologic and clinical disease features while keeping off-target adverse effects to a minimum. Herein, we have reviewed the current evidence regarding efficacy and safety of monoclonal antibodies including mepolizumab (anti-IL-5), reslizumab (anti-IL-5), QAX576 (anti-IL-13), omalizumab (anti-immunoglobulin-E), and infliximab (anti-TNF-α) in treatment of EoE. Our review indicates that although the use of monoclonal antibodies for EoE treatment is safe with limited and reversible adverse events, however, it is not yet possible to reach a final verdict on the efficacy of mAbs in EoE. Future well-designed studies are needed to clarify the exact role of mAbs in EoE.


Eosinophilic esophagitis Biological therapy Monoclonal antibody Mepolizumab Omalizumab Reslizumab IL-5 



Eosinophilic esophagitis




United States


T helper type 1/2


Transforming growth factor


Fibroblast growth factor






High-power field


c-c chemokine receptor type 3


Factor interacting with PAPOLA and CPSF1


Platelet-derived growth factor receptor alpha


Food and Drug Administration


Confidence interval


Mayo Dysphagia Questionnaire


Chemokine (C-X-C motif) ligand


Dehydrogenase/reductase SDR family member 9


Carboxypeptidase A3




Eosinophil-associated gastrointestinal disorder


Tumor necrosis factor




Monoclonal antibody


Compliance with Ethical Standards

No human or animals participants were included in this study.

Conflict of Interest

The authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Molecular Immunology Research Center, Children’s Medical CenterTehran University of Medical SciencesTehranIran
  2. 2.Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN)TehranIran
  3. 3.Division of Allergy and ImmunologyCincinnati Children’s Medical CenterCincinnatiUSA
  4. 4.Research Center for Immunodeficiencies, Children’s Medical CenterTehran University of Medical SciencesTehranIran
  5. 5.Department of Immunology, School of MedicineTehran University of Medical SciencesTehranIran
  6. 6.Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN)BostonUSA

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