Effect of topical swallowed steroids on the bacterial and fungal esophageal microbiota in eosinophilic esophagitis.

Characterization of the esophageal microbiota in EoE subjects relative to non-EoE controls was performed by comparison of steroid-naïve subjects with active or inactive EoE to non-EoE controls. We aimed to characterize the bacterial and fungal communities in the esophageal mucosa of children with EoE and non-EoE controls and examine the effects of TSS on the microbiota in children with EoE. Eosinophilic esophagitis (EoE) is a chronic inflammatory disease characterized by an eosinophil-predominant inflammation of the esophageal mucosa.1 We have previously characterized bacterial communities of the human esophagus in healthy children and adults.2 Our data and work from others suggest that the normal esophageal bacterial microbiota is dominated by I Firmicutes i species.2-4 Active inflammation in EoE is associated with bacterial dysbiosis, specifically with an increase in members of the I Proteobacteria i .2,3 However, while some have described the role of bacteria in atopic gastrointestinal diseases,5 little is known about the role of fungi in allergic esophageal inflammation or the role of topical swallowed steroids (TSS) in disease-associated dysbiosis. [Extracted from the article]