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
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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