For people with eosinophilic esophagitis (EoE), eating everyday foods like milk, eggs, wheat, nuts or fish can lead to pain, difficulty swallowing and even poor growth in children. Because there is no cure, the standard treatment is to cut out the foods that trigger inflammation, sometimes all common allergens at once, and rely on specialized formulas or carefully planned meals.
While effective for reducing symptoms, these restrictive diets can be hard to maintain. They often limit variety, increase food costs and make it more challenging to get enough essential nutrients, especially for children and teens who are still growing.
A new study from Tel Aviv University, published in Allergy, offers hope for a different approach. Researchers identified a protein called TSLP as a central trigger for the inflammation that drives EoE. In experiments, removing or neutralizing TSLP prevented the condition from developing and greatly reduced symptoms when it was present.
“Current treatments rely on restrictive diets,” said study leader Prof. Ariel Munitz. “Our findings point to a new potential target for therapy.”
If future treatments can target TSLP effectively, patients might be able to manage the condition without such extreme dietary restrictions, making it easier to maintain variety and meet nutritional needs.
EoE is a chronic immune-driven inflammation of the esophagus caused by an abnormal reaction to certain foods. It is part of a family of allergic conditions that can include asthma, eczema and seasonal allergies. Over time, the inflammation can cause narrowing of the esophagus, making it difficult or painful to swallow.
The research team found that while another protein, IL-33, had little impact on the course of the disease, blocking TSLP dramatically improved outcomes in their models. They achieved this both by removing the protein entirely and by using an antibody to neutralize it. Pharmaceutical companies are already developing antibody-based drugs that target TSLP for other conditions, which could speed the path toward testing them for EoE.
If these treatments prove effective in people, they could reduce or eliminate the need for extreme dietary restrictions, helping patients maintain more balanced and enjoyable eating patterns. This could also make it easier to meet nutritional needs without relying heavily on supplements or formula-based nutrition.
While the findings are promising, the research is still in the experimental stage. Clinical trials will be needed to confirm whether blocking TSLP is safe and effective for people with EoE. For now, the study offers a new direction in the search for better treatments, one that could transform how this increasingly common condition is managed.
This research was supported by the US–Israel Binational Science Foundation, the Israel Science Foundation, the Israel Cancer Research Fund, the Israel Cancer Association, the Cancer Biology Research Center at Tel Aviv University, the Azrieli Foundation Canada–Israel and sponsored research grants from AstraZeneca.