A groundbreaking study from Tel Aviv University has identified Thymic Stromal Lymphopoietin (TSLP) as a pivotal factor in the development of Eosinophilic Esophagitis (EoE), a chronic inflammatory condition of the esophagus. This discovery opens promising new avenues for targeted therapeutic interventions for EoE, a disease characterized by an abnormal immune response to food allergens that leads to inflammation and a buildup of eosinophils in the esophageal lining. Symptoms can include difficulty swallowing, chest and abdominal pain, and in children, growth delays. The prevalence of EoE has seen a notable increase globally over the past decade, with estimates suggesting it affects approximately 1 in 2,500 individuals. In Israel, studies indicated a steep rise in incidence and prevalence, with the rate of eosinophilic gastrointestinal disorders tripling between 2014 and 2021.
The research, conducted at Tel Aviv University's Gray Faculty of Medical and Health Sciences in collaboration with institutions including Ichilov Hospital and Cincinnati Children's Hospital, identified TSLP as a cytokine secreted by epithelial cells in response to allergens. High levels of TSLP were found in the esophagus of EoE patients, where it activates immune cells and drives inflammation. Experimental models demonstrated that neutralizing TSLP significantly reduced esophageal eosinophilia, a key diagnostic marker for EoE, aligning with genetic studies linking EoE susceptibility to variants in the TSLP gene. The research was supported by grants from the Israel Science Foundation, the US-Israel Binational Science Foundation, and the Azrieli Foundation Canada-Israel, and published in the journal Allergy. Professor Ariel Munitz of Tel Aviv University, who led the study with doctoral student Anish Dsilva, highlighted the potential of targeting TSLP, stating, "Our study offers real hope for a therapy that addresses the disease at its source." This advancement is occurring alongside progress in managing EoE, with therapies like dupilumab showing considerable efficacy and new treatments such as etrasimod demonstrating well-tolerated improvements. These findings are expected to be a focal point at upcoming scientific gatherings, such as the 2025 AAAAI/WAO Joint Congress.