Exploring potential noninvasive biomarkers in eosinophilic esophagitis in children

Girish Subbarao, Marc Rosenman, Lyo Ohnuki, Ann Georgelas, Miriam Davis, Joseph F. Fitzgerald, Jean Molleston, Joseph Croffie, Marian Pfefferkorn, Mark R. Corkins, Joel R. Lim, Steven Steiner, Elizabeth Schaefer, Gerald J. Gleich, Sandeep Gupta

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND AIMS: Eosinophilic esophagitis (EE) continues to present clinical challenges, including a need for noninvasive tools to manage the disease. To identify a marker able to assess disease status in lieu of repeated endoscopies, we examined 3 noninvasive biomarkers, serum interleukin (IL)-5, serum eosinophil-derived neurotoxin (EDN), and stool EDN, and examined possible correlations of these with disease phenotype and activity (symptoms and histology) in a longitudinal study of children with EE. SUBJECTS AND METHODS: Children with EE were studied for up to 24 weeks (12 weeks on 1 of 2 corticosteroid therapies and 12 weeks off therapy). Twenty children with normal esophagogastroduodenoscopies with biopsies were enrolled as controls. Serum IL-5, serum EDN, and stool EDN were measured at weeks 0, 4, 12, 18, and 24 in children with EE, and at baseline alone for controls. Primary and secondary statistical analyses (excluding and including outlier values of the biomarkers, respectively) were performed. RESULTS: Sixty subjects with EE (46 [75%] boys, mean age 7.5±4.4 years) and 20 normal controls (10 [50%] boys, mean age 6.7±4.1 years) were included. Significant changes in serum EDN (significant decrease from baseline to week 4, and then rebound from week 4 to week 12) occurred. Serum EDN levels were stable after week 12. Serum IL-5 and stool EDN levels in subjects with EE were not statistically different from those of the control subjects when each time point for the cases was compared with the controls' 1-time measurement. CONCLUSIONS: Serum EDN levels were significantly higher in subjects with EE than in controls, and the results suggest a possible role, after additional future studies, for serum EDN in establishing EE diagnosis, assessing response to therapy, and/or monitoring for relapse or quiescence.

Original languageEnglish
Pages (from-to)651-658
Number of pages8
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume53
Issue number6
DOIs
StatePublished - Dec 2011

Fingerprint

Eosinophil-Derived Neurotoxin
Eosinophilic Esophagitis
Biomarkers
Serum
Interleukin-5
Digestive System Endoscopy
Endoscopy
Longitudinal Studies
Histology
Adrenal Cortex Hormones
Therapeutics

Keywords

  • biomarkers
  • eosinophilic esophagitis
  • pediatrics

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Exploring potential noninvasive biomarkers in eosinophilic esophagitis in children. / Subbarao, Girish; Rosenman, Marc; Ohnuki, Lyo; Georgelas, Ann; Davis, Miriam; Fitzgerald, Joseph F.; Molleston, Jean; Croffie, Joseph; Pfefferkorn, Marian; Corkins, Mark R.; Lim, Joel R.; Steiner, Steven; Schaefer, Elizabeth; Gleich, Gerald J.; Gupta, Sandeep.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 53, No. 6, 12.2011, p. 651-658.

Research output: Contribution to journalArticle

Subbarao, Girish ; Rosenman, Marc ; Ohnuki, Lyo ; Georgelas, Ann ; Davis, Miriam ; Fitzgerald, Joseph F. ; Molleston, Jean ; Croffie, Joseph ; Pfefferkorn, Marian ; Corkins, Mark R. ; Lim, Joel R. ; Steiner, Steven ; Schaefer, Elizabeth ; Gleich, Gerald J. ; Gupta, Sandeep. / Exploring potential noninvasive biomarkers in eosinophilic esophagitis in children. In: Journal of Pediatric Gastroenterology and Nutrition. 2011 ; Vol. 53, No. 6. pp. 651-658.
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abstract = "BACKGROUND AND AIMS: Eosinophilic esophagitis (EE) continues to present clinical challenges, including a need for noninvasive tools to manage the disease. To identify a marker able to assess disease status in lieu of repeated endoscopies, we examined 3 noninvasive biomarkers, serum interleukin (IL)-5, serum eosinophil-derived neurotoxin (EDN), and stool EDN, and examined possible correlations of these with disease phenotype and activity (symptoms and histology) in a longitudinal study of children with EE. SUBJECTS AND METHODS: Children with EE were studied for up to 24 weeks (12 weeks on 1 of 2 corticosteroid therapies and 12 weeks off therapy). Twenty children with normal esophagogastroduodenoscopies with biopsies were enrolled as controls. Serum IL-5, serum EDN, and stool EDN were measured at weeks 0, 4, 12, 18, and 24 in children with EE, and at baseline alone for controls. Primary and secondary statistical analyses (excluding and including outlier values of the biomarkers, respectively) were performed. RESULTS: Sixty subjects with EE (46 [75{\%}] boys, mean age 7.5±4.4 years) and 20 normal controls (10 [50{\%}] boys, mean age 6.7±4.1 years) were included. Significant changes in serum EDN (significant decrease from baseline to week 4, and then rebound from week 4 to week 12) occurred. Serum EDN levels were stable after week 12. Serum IL-5 and stool EDN levels in subjects with EE were not statistically different from those of the control subjects when each time point for the cases was compared with the controls' 1-time measurement. CONCLUSIONS: Serum EDN levels were significantly higher in subjects with EE than in controls, and the results suggest a possible role, after additional future studies, for serum EDN in establishing EE diagnosis, assessing response to therapy, and/or monitoring for relapse or quiescence.",
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AU - Subbarao, Girish

AU - Rosenman, Marc

AU - Ohnuki, Lyo

AU - Georgelas, Ann

AU - Davis, Miriam

AU - Fitzgerald, Joseph F.

AU - Molleston, Jean

AU - Croffie, Joseph

AU - Pfefferkorn, Marian

AU - Corkins, Mark R.

AU - Lim, Joel R.

AU - Steiner, Steven

AU - Schaefer, Elizabeth

AU - Gleich, Gerald J.

AU - Gupta, Sandeep

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