Evan Dellon, MD, Shares Key Findings from Research Published in the Red Journal, “Utility of a Noninvasive Serum Biomarker Panel for Diagnosis and Monitoring of Eosinophilic Esophagitis: A Prospective Study.”
ACG: Explain the genesis of your research and what prompted this study.
Dr. Dellon: Eosinophilic esophagitis (EoE) is currently diagnosed after endoscopy and biopsy. There are currently no known blood-based non-invasive biomarkers for either diagnosis or monitoring or EoE. Because the endoscopy and biopsy are costly and invasive procedures, it would be very valuable to have a blood test for EoE. Several preliminary studies had suggested that inflammatory factors related to EoE pathogenesis might be elevated in the blood, but these had not been examined on a larger scale.
ACG: Explain the key findings and significance of your findings for physicians.
Dr. Dellon: This was a prospective study of EoE cases and non-EoE controls who underwent endoscopy for reflux of dysphagia. Baseline samples from the cases and controls were obtained and compared to assess the diagnostic utility of a panel of serum biomarkers. Then, the EoE cases were treated and follow-up specimens were obtained and compared to the baseline values to assess the utility of the same panel for monitoring of EoE treatment response.
The key findings were that none of the 14 serum biomarkers examined, which were a range of proinflammatory cytokines, eosinophil chemokines, and eosinophil granules, had utility for either diagnosis or monitoring of EoE. Levels were similar between cases and controls at baseline, and were similar in cases before and after treatment. No differences were seen after stratifying by treatment response or by the presence of concomitant allergic diseases
ACG: What do patients need to know?
Dr. Dellon: For the time being, the factors assessed in the study, though known to be related to EoE pathogenesis and elevated in esophageal tissue, are not elevated in the blood. Therefore, these factors cannot currently be used for a blood test for EoE disease activity.
ACG: How does this research advance our knowledge of EoE and what does it mean for the future identification of biomarkers for EoE?
Dr. Dellon: While this study had a negative result, it is important as it highlights that the traditional set of Th2-related cytokines should not be pursured for non-invasive blood-based testing for EoE at this time. For the future, novel biomarkers that are both elevated in the esophageal tissue but are also stable enough and in high enough concentrations in the blood, must be identified.
About Dr. Dellon
Dr. Dellon is an Associate Professor of Medicine and an Adjunct Associate Professor of Epidemiology at University of North Carolina at Chapel Hill School of Medicine, Division of Gastroenterology and Hepatology Center for Esophageal Diseases and Swallowing