Patients with eosinophilic esophagitis (EoE) often describe the condition as painful, disruptive and frightening. The rare chronic disease causes inflammation of the esophagus, leading to abdominal pain, difficulty swallowing, vomiting and, in some cases, food getting stuck in the throat.
Now, a University of Cincinnati College of Medicine researcher has received new funding to expand her investigations into the underlying causes of EoE and potential new treatments.
Simin Zhang, MD, an allergist and research assistant professor in the Division of Rheumatology, Allergy and Immunology in the Department of Internal Medicine, has been awarded a three-year, $300,000 grant from the American Academy of Allergy, Asthma & Immunology. Her research focuses on the roles of mast cells – or allergic immune cells – and their interactions with fibroblasts, the structural cells which can both repair and damage tissue.
Mast cells are a key part of the allergic immune response, but we don’t fully understand their role in eosinophilic esophagitis. We are investigating how mast cells interact with fibroblasts in the esophagus and whether interrupting that interaction could prevent inflammation and tissue damage.”
Simin Zhang, MD, allergist and research assistant professor, Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, University of Cincinnati
Understanding a complex disease
The esophagus is the muscular tube that carries food from the mouth to the stomach. In EoE, unusually high numbers of white blood cells called eosinophils build up in the esophageal tissue, causing irritation and injury. Over time, this can result in scarring and narrowing of the esophagus, a condition known as stricturing, which can make eating painful and increase the risk of food becoming lodged, sometimes requiring endoscopic removal or dilation of the esophagus.
Unlike some food allergies that trigger immediate, life-threatening anaphylaxis, EoE causes a slower, more prolonged immune response. Many patients with EoE also live with other allergic conditions such as anaphylactic food allergies, asthma, hay fever and eczema. Physicians often describe this pattern as part of the “atopic march” in which allergic diseases emerge and overlap throughout a patient’s life.
While the exact cause of EoE remains unknown, having a personal or family history of allergies appears to raise the risk. The condition affects both children and adults, often requiring lifelong management.
A collaborative approach
In addition to her role at UC, Zhang holds a dual appointment at Cincinnati Children’s Hospital Medical Center, where she conducts research and provides clinical care through the Cincinnati Center for Eosinophilic Disorders (CCED), a facility that is internationally recognized for advancing both treatment and research for EoE and related conditions.
Zhang’s work bridges laboratory discovery and patient care. “Our research has the potential to identify new ways of treating a disease that affects quality of life for both children and adults,” she said.
She added that she is motivated by the challenges her patients face every day. “Many people with EoE struggle just to eat a meal without fear,” said Zhang. “Our goal is to uncover the mechanisms driving the disease and ultimately improve therapies so that patients can live more comfortably.”