Esophageal Remodeling in Eosinophilic Esophagitis

The normal esophagus is composed of layers from the lumen to the adventitia. The non-keratinized stratified squamous epithelium abuts the lumen while the subepithelial regions contain the underlying lamina propria, muscularis mucosa, submucosa, and muscularis propria. The esophageal epithelium contains regenerative cells in the basal zone, which usually comprises 15% of the total epithelial height while projections of lamina propria, known as the vascular papillae, extend to approximately one third of the thickness of the squamous epithelium. In the normal esophagus, the LP comprises non-fibrotic, reticular collagen filaments and the epithelium is devoid of eosinophilic infiltration. Therefore, epithelial eosinophilia indicates a pathologic condition.