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    The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis


    Furuta, Glenn T. and Kagalwalla, Amir F. and Lee, James J. and Alumkal, Preeth and Maybruck, Brian T. and Fillon, Sophie A. and Masterson, Joanne C. and Ochkur, Sergei I. and Protheroe, Cheryl and Moore, Wendy and Pan, Zhaoxing and Amsden, Katie and Robinson, Zachary and Capocelli, K.E. and Mukkada, Vince and Atkins, Dan and Fleischer, David and Hosford, Lindsay and Kwatia, Mark A. and Schroeder, Shauna and Kelly, Caleb and Lovell, Mark and Melin-Aldana, Hector and Ackerman, Steven J. (2013) The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis. Gut, 62 (10). pp. 1395-1405. ISSN 1468-3288

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    Abstract

    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 eosinophilderived 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.

    Item Type: Article
    Keywords: oesophageal string test; novel; minimally invasive; mucosal inflammation; eosinophilic oesophagitis;
    Academic Unit: Faculty of Science and Engineering > Biology
    Item ID: 12488
    Identification Number: https://doi.org/10.1136/gutjnl-2012-303171
    Depositing User: Joanne Masterson
    Date Deposited: 27 Feb 2020 14:20
    Journal or Publication Title: Gut
    Publisher: BMJ Publishing Group
    Refereed: Yes
    URI:

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