Performance Analysis of Non-invasive Biomarkers in the Treatment of Eosinophilic Oesophagitis

Emilio Narváez-Fernández, Margarita Tomás-Perez. EMJ Allergy Immunol. 2024;9[1]:63-69. 

Abstract

Introduction: Eosinophilic oesophagitis (EoE) is an emerging disease of the oesophagus. However, so far there are no fully validated biomarkers for diagnosis and monitoring. Moreover, research focuses on parameters that are not very useful and accessible for routine clinical practice. Thus, endoscopy remains the main method of follow-up in this population.

Methods: The team analysed the levels of total Ig E, absolute eosinophil count (AEC), eosinophil cationic protein, and immunoglobulin G4 in a cohort of 399 adult patients with EoE (without other oesophageal pathologies). After controlling for confounding factors, they compared patients with active EoE and those in remission (responders).

Comparison of markers by treatment group.

Results: It was observed that, in responders, the AEC was lower (p=0.014). Furthermore, in corticosteroid-controlled patients, total Ig E was lower (p=0.016); while in proton pump inhibitors, responders both absolute (p=0.007) and percentage (p=0.002) eosinophils were lower.

Conclusion: The team considers that AEC is probably the most accessible and useful marker for monitoring treatment response in EoE.

Key Points

1. Effective differentiation between active disease and remission in eosinophilic oesophagitis (EoE) is pivotal for guiding clinical management and enhancing outcomes for affected patients.

2. The study described is a prospective cohort study. In this type of study, the progression of variables (such as total IgE levels, eosinophil count, eosinophil cationic protein, and immuniglobin G4) is compared between patients with active EoE and those in remission over time to gain a better understanding of the disease and its clinical manifestations.

3. Total Ig E levels, eosinophil count, eosinophil cationic protein, and immuniglobin G4 are promising markers to distinguish between active and remission phases of EoE, offering potential for improved clinical monitoring and treatment management.

PDF