A Better Way to Diagnose EoE…”in a Galaxy Far, Far Away!”
The gold standard for diagnosing eosinophilic esophagitis (EoE) at this time is symptoms and multiple tissue biopsies of the esophagus (food tube) showing eosinophils obtained by the gastroenterologist during the endoscopy procedure. However, diagnosing EoE is not always that straightforward. It can be difficult to distinguish reflux esophagitis (RE) which is the result of gastroesophageal reflux disease (GERD) or heartburn as it may also contain some eosinophils like EoE. The eosinophils in EoE can be patchy while the eosinophils in RE are believed to be more distributed in a continuum (with more near the stomach and less in the upper esophagus). The interaction between EoE and RE is complex and not fully understood.
- Investigators from Boston, MA evaluated a new method using genes to help differentiate EoE from RE in esophageal biopsies from patients with EoE and RE compared to healthy adults. They used an eosinophil transcriptome utilizing 10 genes and found it was highly sensitive (94% of the time a positive test correlated with having EoE) and quite specific. Importantly, there were no “false positive” test findings in the patients with RE. In other words, none of the RE patients had a positive test. The lab test uses a high-throughput digital mRNA expression platform. Source: Lexmond WS, et al. Accuracy of digital mRNA profiling of esophageal biopsies as a novel diagnostic approach to eosinophilic esophagitis. Clinical Experimental Allergy. 2015; 45:1317-1327 or go to Clin Exp Allergy
Why would this test be helpful?
- The sooner a correct diagnosis is made, the sooner specific treatment for EoE or RE can begin and potentially prevent complications.
Why is this test not readily available?
- The high-throughput digital mRNA expression platform is not available at a cost for routine testing. With improved technology, this test may be available to physicians in the future in a “galaxy far, far away!”
At Family Allergy & Asthma Care of Montana, we care for individuals with eosinophilic esophagitis (EoE) today, tomorrow and beyond! As new technology becomes available in the future, we will keep our patients informed.