118 Identification of a Novel Germ-Line Variant in an Uncharacterized Gene, FBE-1, and Its Putative Role in Familial Barrett's Esophagus

Abstract

Background and Aim: An early event in the pathogenesis of eosinophilic esophagitis (EoE) is food antigen penetration of esophageal epithelium, but the precise relationship of eosinophilia, dilated intercellular spaces (DIS) and decreased barrier function is unclear. The aim of this study was to determine the correlation and accuracy of site-specific mucosal impedance (MI) measurement of ion flux with esophageal histology in distinguishing active from inactive EoE. Methods: In this study, 10 patients each with active and inactive EoE underwent MI measurement and mucosal biopsies at four esophageal sites (2, 5,10,15cm above the Zline). MI was compared to 10 control patients without esophageal symptoms. Data were analyzed by comparing MI values, Eos/HPF and DIS grade in the three groups at each level examined. Results: The esophageal MI values (ohms) were significantly lower in active when compared to inactive and control patients (1909 vs. 4349 and 5530 ohms, resp., p<.001). (Table) Four active patients had biopsies with eos< 15/HPF with lower DIS grade. There were significant and inverse correlations between MI and eos/HPF as well as DIS (rs=.584 and -.531, respectively, p<.001). Furthermore, MI cut off of 2300 ohms demonstrated 90% sensitivity and 91% specificity for diagnosis of active EoE and 89% and 82% for high grade DIS. Conclusions: In EoE, eosinophil eosinophilia and DIS correlate to MI measured ionic conductance and by inference barrier function. Endoscopic MI measurement in the esophagus is a promising, safe and easy to perform means to assess disease activity in diseases such as EoE. Impedance measurements in EoE patients and controls