Part of the Eosinophilic Esophagitis Playbook series |
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.
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.
Some people are born with a primary immunodeficiency disorder that makes them immunocompromised from birth. You may also become immunocompromised if you’re:
EoE results from an overactive, not an underactive, immune system. EoE is not considered to be a form of immunodeficiency.
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 Are Immune-Mediated, Autoimmune, and Allergic Conditions? | ||
In immune-mediated inflammatory diseases, the immune system is overactive and responds inappropriately to harmless substances by producing inflammation and damage. There are two main types of immune-mediated conditions, allergic conditions (also called hypersensitivities) and autoimmune conditions. Here are the differences. | ||
Allergic Conditions | Autoimmune Conditions | |
What types of substances trigger the immune system reaction? | Substances from outside the body such as pollen, food, metal, dust mite feces, plant oils, medications, or animal dander | Substances inside the body, such as myelin that insulates nerves, tissue that lines the inside of joints, the skin, and parts of normal cells and tissues |
Which parts of the immune system are involved? |
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Example conditions | Asthma, seasonal allergies (hay fever), food allergies, contact (skin) allergies, and eosinophilic esophagitis | Multiple sclerosis, rheumatoid arthritis, lupus, Crohn’s disease, type 1 diabetes, ankylosing spondylitis, and psoriasis |
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:
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.
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:
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.
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.
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.
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Jacqueline
Great questions. Hope a medical provider knowledgeable on thr topic answers your question on here so we all learn. My daughter was dx with EoE at age 3, she stopped being treated went off her SFED and meds) at age 14 because her allergist at the time said that she had “outgrown” EoE since her allergy IGE tests came back clean and her endoscopy showed 0 eosinophils. She is now 24, and in a major crisis. Her esophagus was at 7 mm. The one thing I kept noticing in thise 10 yrs is that she had a constant cough. She’d go to the allergist who would give her medication for awhile and when the trestment would stop in a few weeks the cough would return. I now believe it was the EoE flare up causing this cough for sure. This takes me to another important issue… not all doctors understand how to treat this condition. It is super important to find Drs who treat EoE.
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