2 research outputs found
One-Hour Esophageal String Test: A Nonendoscopic Minimally Invasive Test That Accurately Detects Disease Activity in Eosinophilic Esophagitis
OBJECTIVES: Eosinophilic esophagitis (EoE), a chronic food allergic disease, lacks sensitive and specific peripheral
biomarkers. We hypothesized that levels of EoE-related biomarkers captured using a 1-hour minimally
invasive Esophageal String Test (EST) would correlate with mucosal eosinophil counts and tissue
concentrations of these same biomarkers. We aimed to determine whether a 1-hour EST accurately
distinguishes active from inactive EoE or a normal esophagus.
METHODS: In a prospective, multisite study, children and adults (ages 7–55 years) undergoing a clinically
indicated esophagogastroduodenoscopy performed an EST with an esophageal dwell time of 1 hour.
Subjects were divided into 3 groups: active EoE, inactive EoE, and normal esophageal mucosa.
Eosinophil-associated protein levels were compared between EST effluents and esophageal biopsy
extracts. Statistical modeling was performed to select biomarkers that best correlated with and
predicted eosinophilic inflammation.
RESULTS: One hundred thirty-four subjects (74 children, 60 adults) with active EoE (n 5 62), inactive EoE
(n 5 37), and patient controls with a normal esophagus (n 5 35) completed the study. EST-captured
eosinophil-associated biomarkers correlated significantly with peak eosinophils/high-power field,
endoscopic visual scoring, and the same proteins extracted from mucosal biopsies. Statistical
modeling, using combined eotaxin-3 and major basic protein-1 concentrations, led to the development
of EoE scores that distinguished subjects with active EoE from inactive EoE or normal esophagi. Eightyseven
percent of children, 95% of parents, and 92% of adults preferred the EST over endoscopy if it
provided similar information.
DISCUSSION: The 1-hour EST accurately distinguishes active from inactive EoE in children and adults and may
facilitate monitoring of disease activity in a safe and minimally invasive fashion
Recommended from our members
Advancing patient care through the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR)
Recent advances in rare disease research are accelerated by the work of consortia that have been supported by the National Institutes of Health. Development of such consortia rely on multidisciplinary relationships and engagement with patient advocacy groups, as well as the National Institutes of Health and industry and academic partners. In this rostrum we present the development of such a process that focuses on eosinophilic gastrointestinal diseases. Principal investigators, patient advocacy groups, research assistants, and trainees work together to perform natural history studies that promote clinical trial readiness tools, conduct clinical trials, train a new generation of investigators, and perform innovative pilot studies