The immune system’s job is to protect our bodies from harm. However, sometimes the immune system malfunctions in various ways and causes disease instead of protecting us from it. Eosinophilic esophagitis (EoE) is a chronic immune and allergic condition that involves inflammation in the esophagus, the tube through which we swallow food down into the stomach.

If you or your child are living with EoE, learning more about the immune system can help you better understand the condition and communicate with your doctor more effectively. Keep reading to learn about whether EoE is an autoimmune condition or whether it makes you immunocompromised.

What Does ’Immunocompromised’ Mean?

If your immune system doesn’t respond strongly enough to harmful substances and fails to protect you, you’re considered to be immunocompromised. In people who are immunocompromised, disease can develop when the immune system is underactive, and harmful bacteria and viruses can invade and cause infection. Depending on what part of your immune system is underactive, you may be more likely to develop different types of infections.

EoE results from an overactive, not an underactive, immune system. EoE is not considered to be a form of immunodeficiency.

Some people are born with a primary immunodeficiency disorder that makes them immunocompromised from birth. You may also become immunocompromised if you’re:

• Living with untreated HIV
• Living with a blood cancer such as leukemia or lymphoma
• Receiving chemotherapy, radiation therapy, or targeted therapy as a treatment for cancer
• Taking immunosuppressant drugs to treat an autoimmune condition or to prevent rejection of a transplanted organ

EoE results from an overactive, not an underactive, immune system. EoE is not considered to be a form of immunodeficiency.

EoE Is Immune-Mediated

EoE is an immune-mediated disease. Immune-mediated diseases result from immune system activity or involve the immune response. In immune-mediated diseases, the parts of the immune system are overactive and cause inflammation that can damage the body’s tissues. Different types of immune-mediated diseases may involve various parts of the immune system that overreact to different triggers.

What Does ‘Autoimmune’ Mean?

Autoimmune conditions are one type of immune-mediated disease. Autoimmunity develops when the immune system mistakenly recognizes normal, healthy cells or tissues as being harmful. Researchers think autoimmune diseases may develop when the immune system becomes overactive after an infection or injury and begins attacking the body. Inheriting certain genes from parents, smoking, taking certain medications, and being overweight can all increase the risk of developing an autoimmune disease.

Some examples of autoimmune diseases include:

• Multiple sclerosis
• Rheumatoid arthritis
• Lupus
• Crohn’s disease and ulcerative colitis
• Psoriasis and psoriatic arthritis
• Type 1 diabetes
• Graves’ disease and Hashimoto’s thyroiditis

EoE is usually considered to be related to allergies, not autoimmunity. However, some research has found a higher risk for autoimmune conditions among people with EoE. If you have concerns about your risk for autoimmune disease, speak to your health care provider about risk factors.

EoE Is an Allergic Condition

Allergies are another type of immune-mediated condition. In allergic conditions, the immune system overreacts to foreign substances that are harmless for most people. A substance that triggers an allergic response is known as an allergen.

EoE is generally considered to be an allergic condition. Most people with EoE have one or more other allergic diseases such as:

• Food allergies
• Asthma
• Atopic dermatitis (the most common form of eczema)
• Allergic rhinitis, also known as hay fever or seasonal allergies

In EoE, white blood cells called eosinophils gather in the inner lining of the esophagus and release chemicals that lead to long-term inflammation and damage. Inflammation and damage cause EoE symptoms such as difficulty swallowing, cough, heartburn that doesn’t respond to treatment, and abdominal pain. High levels of eosinophils are a typical sign of an allergic disorder.

EoE is generally considered to be an allergic condition, not an autoimmune condition. Most people with EoE have one or more other allergic diseases such as asthma, eczema, or food allergies.

Identifying and avoiding allergens — substances that trigger allergic responses — can help improve EoE symptoms. For instance, people with EoE may carefully remove all food allergens from their diet.

Read more about elimination diets for EoE.

Medications that target the inflammatory process in the esophagus such as dupilumab or budesonide oral suspension can also be used to treat EoE.

EoE involves an overactive immune system causing inflammation in the esophagus. It’s important to understand that EoE is not an autoimmune disease and doesn’t make you immunocompromised. Instead, it’s an immune-mediated condition where the body’s immune response goes into overdrive. Understanding the immune system’s role in EoE can make managing the condition easier and improve communication with your doctors.

Talk With Others Who Understand

On myEoEcenter, the site for people with eosinophilic esophagitis and their loved ones, people come together to gain a new understanding of EoE and share their stories with others who understand life with EoE.

Do allergies or autoimmune disorders run in your family? How do you feel EoE affects your immune system? Share your experience in the comments below.