Blog

A team of researchers from Tel Aviv University say they have made a breakthrough in the treatment of a serious food allergy-related disease, eosinophilic esophagitis (EoE).

This chronic condition, which has been identified only since the early ’90s, is now considered a major cause of digestive system illness, and currently affects one in 2,500 individuals in the Western world.

The new study found that blocking a specific protein called TSLP might stop the disease from developing.

“Using unique mouse models we completely neutralized the TSLP protein and blocked the damage caused by the disease,” lead researcher Prof. Ariel Munitz, of Tel Aviv University’s Gray Faculty of Medical and Health Sciences, told The Times of Israel.

“By studying the disease in depth, we can understand the involvement of various immune system components that may serve as targets for future treatment for this disease, and for other allergic disorders as well.”

Participating in the research were PhD student Anish Dsilva, Dr. Chen Varol of Ichilov Hospital, Prof. Marc Rothenberg of Cincinnati Children’s Hospital and the pharmaceutical company AstraZeneca. The findings were published earlier this year in Allergy, a leading journal in clinical immunology.

Raising awareness about EoE

“EoE is a type of food allergy that has increased in the past few decades and we’re raising awareness about it,” Munitz explained.

The poorly understood disease affects the esophagus, the tube that carries food and water from the mouth to the stomach. Sufferers have chronic inflammation caused by the body’s abnormal immune response to certain foods, “mainly milk, eggs, wheat, nuts, fish and more,” Munitz said.

The disease is characterized by an accumulation of a type of white blood cell, eosinophils, that is not typically present in a healthy esophagus.

EoE causes difficulty swallowing because food gets stuck in the esophagus. Adults may experience chest and abdominal pain. In children, there are growth delays and lack of weight gain. Current treatments require restrictive diets, and in severe cases, patients rely on essential amino acid formulas.

The first-ever World Eosinophilic Esophagitis Day was May 22, 2025. According to the organizers’ website, it was launched to “shine a light” on EoE, an “under-diagnosed immune condition,” with patient organizations from around the world including the United States, Australia, Italy, Austria, Serbia and Spain.

Why is there an increase in EoE?

Munitz links the rise of EoE to three factors.

“We’re eating different kind of foods, processed foods, and we’re living in industrialized areas, urban areas, where there is pollution and we’re breathing diesel exhaust that can induce multiple allergies,” he said. “There is also evidence that some of the things we use, even toothpaste, can induce changes to a cell type in our body.”

The second factor, he said, is a “definitely a genetic predisposition, a genetic component.” In the past, the disease was often under-diagnosed and confused with other conditions such as acid reflux disease.

Finally, there is the inability of the body’s immune system to modulate or restrain itself.

“Our immune system has been trained over millions of years of evolution to kill and attack foreign substances in our body,” Munitz said. “But in order for this not to happen all the time, the immune system is restrained.”

When there are defects in the ability of our body to restrain itself, it will start to attack substances like food.

“Why would our immune system react against food? Why does it identify food particles as foreign substances?” Munitz asked. “When you unleash this immune response, you will get a very robust disease.”

Two proteins involved in EoE

There are two proteins in the body, TSLP and IL-33, that have been implicated as “important regulators of multiple allergic diseases,” Munitz said. “But what is their role in EoE?”

One of the first things that the researchers did was to establish a model for this disease in mice where TSLP is blocked or neutralized. This model was developed during previous research in 2022.

“In humans, you can’t test the involvement of a protein unless you block it, and nobody will go and block TSLP as part of an experimental plan, ” he said.

The scientists used genetic engineering combined with antibodies that are responsible for defending cells from pathogens, which are the organisms that cause disease. In this way, the researchers examined disease development in mice that lacked either IL-33, TSLP or the ability to respond to TSLP.

The results were clear. Without IL-33, the disease continued almost as before.

“However, without TSLP, symptoms improved so much that EoE didn’t develop at all,” Munitz said. “Advanced genetic and computer analyses confirmed that TSLP is a key regulator of the disease.”

There are now multiple clinical trials that are trying to target TSLP in various allergic diseases, including EoE.

“So if our hypotheses are correct, we predict that the clinical trials will be beneficial for these patients,” he said.

He added that they usually work on pathways that are present in both mice and humans. This way, he said, “we can translate these findings from the bench to bedside, from the lab into the clinic.”

“The world of medicine is moving more and more towards specific targets using biological drugs,” he said. “We need a much larger arsenal of tools for personalized medicine to treat individual patients.”

In the future, his team wants to “slowly, slowly go upstream in understanding the process of these allergic diseases.”

“We know that TSLP is causing the disease. But what causes the secretion of TSLP? That’s what we’re working on now.”

Impact of BDS on Israeli research

Munitz said his research is gaining a lot of respect from peers in the US and in Europe.

However, people working at an institution in Belgium refused to send the lab reagents for their study because they didn’t want to deal with Israel.

“If it happened only once over the last year, it’s one time too many,” he said. “I am concerned about it, but we got the reagents from a different place, and we improvised, and we didn’t let that stop us.”

“We are very determined to continue and promote global health,” Munitz said. “That’s part of our strength, this innovation and determination.”