Minimally-invasive biomarker studies in eosinophilic esophagitis: a systematic review

Publication date: Available online 10 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Brittany T. Hines, Matthew A. Rank, Benjamin L. Wright, Lisa A. Marks, John B. Hagan, Alex Straumann, Matthew Greenhawt, Evan S. Dellon
BackgroundEosinophilic esophagitis (EoE) is a chronic, inflammatory disease of the esophagus which currently requires repeated endoscopic biopsies for diagnosis and monitoring as no reliable non-invasive markers have been identified.ObjectiveTo identify promising minimally-invasive EoE biomarkers and remaining gaps in biomarker validation.MethodsWe performed a systematic review of EMBASE, Ovid Medline, PubMed, and Web of Science from inception to June 6, 2017. Studies were included if subjects met the 2007 consensus criteria for EoE diagnosis, a minimally-invasive biomarker was assessed, and the study included at least 1 control for comparison.ResultsThe search identified 2094 studies, with 234 reviewed at full text level, and 49 included in the analysis (20 adult, 19 pediatric, 7 pediatric and adult, and 3 not stated). The majority (26 of 49) were published after 2014. Thirty-five studies included normal controls, 9 analyzed atopic controls, and 29 compared samples from subjects with active and inactive EoE. Minimally-invasive biomarkers were obtained from peripheral blood (n=41 studies), sponge/string samples (3), oral/throat swab secretions (2), breath condensate (2), stool (2), and urine (2). The most commonly reported biomarkers were peripheral blood eosinophils (16), blood and string eosinophil granule proteins (14), and eosinophil surface or intracellular markers (12). EoE biomarkers distinguished active EoE from normal controls in 23 studies, atopic controls in 2 studies, and inactive EoE controls in 20 studies.ConclusionSeveral promising minimally-invasive biomarkers for EoE have emerged; however, few are able to differentiate EoE from other atopic diseases.



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