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Abstract
The pathogenesis of eosinophilic esophagitis (EoE) involves Th2-mediated eosinophil recruitment and degranulation into the esophagus. However, measuring serum Th2 cytokines, eosinophils, and eosinophil-derived products does not reliably distinguish EoE from control populations. Non-invasive methods to diagnose EoE are lacking. We evaluated the diagnostic value of a novel candidate biomarker of EoE: 15(S)-hydroxyeicosatetraenoic acid (HETE). We used immunoassay to measure 15(S)-HETE and cytokine profiles in patients undergoing endoscopy with known or suspected EoE. 31 subjects were enrolled, 16 with EoE, and 15 with an alternate diagnosis. 15(S)-HETE was elevated in the EoE group compared to non-EoE group. The sensitivity and specificity of 15(S)-HETE to be used as a non-invasive marker is 50% and 80%, respectively. 15(S)-HETE may aid in the diagnosis of EoE.
Highlights
Diagnosis of eosinophilic esophagitis (EoE) in all age groups is complicated by clinical and histologic overlap with other gastrointestinal conditions, gastroesophageal reflux disease (GERD)
A total of 16 EoE patients and 15 non-EoE patients were enrolled in the study
There was a male predominance in EoE patients (73.68%)
Summary
Diagnosis of EoE in all age groups is complicated by clinical and histologic overlap with other gastrointestinal conditions, gastroesophageal reflux disease (GERD). Distinguishing these disorders is invasive, expensive, and time-consuming. A subset of EoE patients have increased peripheral absolute eosinophilia counts (AEC), compared to controls[3,4], though AEC alone does not reliably differentiate these populations. Th2 cytokines such as IL-5 and IL-13 are increased in the plasma of EoE subjects compared to controls[5,6,7,8]. ALOX15 is up-regulated in esophageal mucosal biopsies of EoE patients compared to GERD patients and healthy controls[9,10,11]. We hypothesized that (1) 15(S)-HETE would be elevated in the sera of EoE patients compared to those without EoE; (2) that 15(S)-HETE, in combination with peripheral eosinophil count and Th2 cytokines typically found in EoE, reliably distinguish EoE from other conditions
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