Abstract
Eosinophilic esophagitis (EoE) is a chronic, food antigen-driven, type 2 immune-mediated disease of the esophagus characterized by eosinophil-predominant mucosal inflammation, epithelial remodeling and subepithelial fibrosis. Although patient biopsies have established the EoE transcriptome and identified key cellular and molecular mediators, biopsy-based research is inherently correlative and cannot resolve causal disease mechanisms, temporal disease progression or the functional hierarchy of immune cell interactions. Thus, animal models are indispensable tools for addressing these limitations. In this Review, we examine the landscape of experimental EoE models. We assess the capacity of each model to recapitulate key disease features including lamina propria and intraepithelial eosinophilia, subepithelial fibrosis, basal cell hyperplasia, epithelial barrier dysfunction and angiogenesis. We further map these models to human EoE transcriptomic overlap and disease endotype relevance. Across this analysis, we highlight mechanistic insights that were obtained from these models including the eosinophil-independence of IL-13-driven esophageal remodeling, the respective roles of thymic stromal lymphopoietin and IL-33, the critical role of epithelial-expressed IL-13Rα1. We further highlight the profibrotic functions of amphiregulin-producing T helper 2 cells and CSF1-dependent macrophages. We discuss the anatomical, genetic and functional limitations of current models and outline directions for the next generation of EoE preclinical systems.
Keywords
References
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© The Author(s) 2026. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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