The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis
Autor: | Mark A. Lovell, Amir F. Kagalwalla, Sophie Fillon, Caleb J. Kelly, Sergei I. Ochkur, Mark A. Kwatia, Shauna Schroeder, Vince Mukkada, Dan Atkins, Joanne C. Masterson, Katie Amsden, Wendy Moore, Cheryl A. Protheroe, Preeth Alumkal, Brian T. Maybruck, Lindsay Hosford, James J. Lee, Zachary D. Robinson, David Fleischer, Hector Melin-Aldana, Steven J. Ackerman, Kelley E. Capocelli, Zhaoxing Pan, Glenn T. Furuta |
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Rok vydání: | 2012 |
Předmět: |
Pathology
oesophagitis Biopsy Eosinophil Gastroenterology 0302 clinical medicine childhood nutrition oesophageal lesions Child 0303 health sciences Eosinophil cationic protein biology medicine.diagnostic_test respiratory system Eosinophil Granule Proteins 3. Good health medicine.anatomical_structure oesophageal reflux oesophageal disease Gastroesophageal Reflux breast milk 030211 gastroenterology & hepatology epithelial barrier Lysophospholipase Eosinophil peroxidase Mucositis medicine.medical_specialty Adolescent Sensitivity and Specificity enterotest string test Specimen Handling Diagnosis Differential 03 medical and health sciences Young Adult Esophagus Internal medicine medicine Humans Eosinophilic esophagitis 030304 developmental biology High-power field Glycoproteins Mucous Membrane business.industry Eosinophilic Esophagitis medicine.disease allergy Oesophagus oesophageal strictures pediatric inflammation biology.protein oesophageal disorders gastrointestinal tract business Biomarkers |
Zdroj: | Gut |
ISSN: | 1468-3288 |
Popis: | Objective Eosinophil predominant inflammation characterises histological features of eosinophilic oesophagitis (EoE). Endoscopy with biopsy is currently the only method to assess oesophageal mucosal inflammation in EoE. We hypothesised that measurements of luminal eosinophil-derived proteins would correlate with oesophageal mucosal inflammation in children with EoE. Design The Enterotest diagnostic device was used to develop an oesophageal string test (EST) as a minimally invasive clinical device. EST samples and oesophageal mucosal biopsies were obtained from children undergoing upper endoscopy for clinically defined indications. Eosinophil-derived proteins including eosinophil secondary granule proteins (major basic protein-1, eosinophil-derived neurotoxin, eosinophil cationic protein, eosinophil peroxidase) and Charcot–Leyden crystal protein/galectin-10 were measured by ELISA in luminal effluents eluted from ESTs and extracts of mucosal biopsies. Results ESTs were performed in 41 children with active EoE (n=14), EoE in remission (n=8), gastro-oesophageal reflux disease (n=4) and controls with normal oesophagus (n=15). EST measurement of eosinophil-derived protein biomarkers significantly distinguished between children with active EoE, treated EoE in remission, gastro-oesophageal reflux disease and normal oesophagus. Levels of luminal eosinophil-derived proteins in EST samples significantly correlated with peak and mean oesophageal eosinophils/high power field (HPF), eosinophil peroxidase indices and levels of the same eosinophil-derived proteins in extracts of oesophageal biopsies. Conclusions The presence of eosinophil-derived proteins in luminal secretions is reflective of mucosal inflammation in children with EoE. The EST is a novel, minimally invasive device for measuring oesophageal eosinophilic inflammation in children with EoE. |
Databáze: | OpenAIRE |
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