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Patient-Reported Outcomes and Blood-Based Parameters Identify Response to Treatment in Eosinophilic Esophagitis.

Authors
  • Lingblom, Christine1, 2
  • Albinsson, Sofie3
  • Johansson, Leif4
  • Larsson, Helen5
  • Wennerås, Christine1, 2
  • 1 Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10A, 413 46, Göteborg, Sweden. , (Sweden)
  • 2 Department of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Region Västra Götaland, Sweden. , (Sweden)
  • 3 Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10A, 413 46, Göteborg, Sweden. [email protected] , (Sweden)
  • 4 Department of ENT, Head and Neck Surgery, Skövde County Hospital, Skaraborgs Sjukhus, Lövängsvägen, 541 42, Skövde, Sweden. , (Sweden)
  • 5 Department of ENT, Head and Neck Surgery, NU Hospital Group, Lärketorpsvägen, 461 73, Trollhättan, Sweden. , (Sweden)
Type
Published Article
Journal
Digestive Diseases and Sciences
Publisher
Springer-Verlag
Publication Date
May 01, 2021
Volume
66
Issue
5
Pages
1556–1564
Identifiers
DOI: 10.1007/s10620-020-06368-2
PMID: 32495256
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Noninvasive methods to assess treatment response in eosinophilic esophagitis are needed. Our aim was to determine whether a blood-based biomarker panel centered on immune parameters could identify histologic response to treatment in eosinophilic esophagitis patients. A pilot study involving adult patients with active eosinophilic esophagitis recruited at two Ear, Nose, Throat clinics in Sweden was designed. The patients (n = 20) donated blood and esophageal biopsies and filled in three questionnaires before and after a 2-month course of topical corticosteroids. Blood samples were analyzed for absolute levels of granulocytes and T cells and the fractions of eosinophils expressing 10 different surface markers by flow cytometry. All data were analyzed by multivariate methods of pattern recognition. Multivariate modeling revealed that a combination of 13 immune parameters and 10 patient-reported outcome scores were required to create a model capable of separating responders (n = 15) from non-responders (n = 5). Questions regarding symptoms of esophageal dysfunction and capacity to eat certain foods from two of the questionnaires were discriminatory in the multivariate model, as were absolute counts of T cells, eosinophils, and eosinophil expression of activation markers and cell adhesion molecules. A combination of blood-based immune parameters and directed questions may prove helpful to monitor response to treatment, perhaps reducing the need for repeat endoscopies in eosinophilic esophagitis patients in the future.

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