Researchers at the Cincinnati Center for Eosinophilic Disorders at Cincinnati Children’s have identified a potential marker of disease activity for eosinophilic esophagitis (EoE). The discovery has the potential to spare patients the discomfort and risk of endoscopic procedures to assess whether their disease is active.

Disease activity of EoE is currently monitored using peak esophageal eosinophil count, which requires invasive endoscopy to collect esophageal tissue biopsies for assessment. People with EoE, a lifelong disease, must have continued monitoring of disease activity, even after effective treatment with restricted diets or steroids. Treatment changes, such as reintroducing a single food, require additional endoscopic exams to assess for disease flare-ups.

Prior research has demonstrated that testing the blood of EoE patients is not a clinically useful indication of active disease, because eosinophil levels in blood do not correlate well with levels in the esophagus. This led the researchers to investigate a precursor cell to eosinophils, a lineage-committed eosinophil progenitor (EoP), as a potential marker. They found elevated EoP levels in the blood of pediatric patients with active EoE disease, suggesting the existence of a blood-based marker that may correlate with disease activity. The study, considered a pilot, included 14 patients, and results were published in the Journal of Allergy and Clinical Immunology (May 16, 2016).

“These results are very promising, but additional research is needed to validate the EoP-based marker before its routine use in clinic,” says study author Vincent Mukkada, MD, a pediatric gastroenterologist at Cincinnati Children’s. “The next step is to create a systematic study to measure biomarkers in the same patient over time. This would help us to determine whether those biomarkers correlate with disease activity at baseline and after steroid- or diet-based therapy. If such a marker exists, the implications for patients would be significant, with the potential to reduce discomfort, costs and side effects.”

The Cincinnati Center for Eosinophilic Disorders at Cincinnati Children’s is the central site for the Registry for Eosinophilic Gastrointestinal Disorders (REGID), the first national epidemiological registry for eosinophilic disorders. The center’s extensive research program includes more than a dozen basic, clinical and translational studies to better understand the causes of eosinophilic disorders, identify more effective diagnostic tests and treatment protocols, and develop a cure for the disease.