Posted on Jun 14, 2018, 9 p.m.
Three distinct subtypes of eosinophilic esophagitis have been discovered which may provide framework for developing precision medicines to treat the often debilitating disorder, as published in The Lancet Gastroenterology & Hepatology.
Researchers have found that each of the three endotype groups, EoEe1, EoEe2, and EoEe3, are associated with different clinical features and molecular pathways. Molecular profiling provided advantage over traditional microscopic analysis. Deep molecular profiling was conducted using biopsy tissues taken from adult and pediatric patients undergoing endoscopy to evaluate for presence of EoE.
Analysis for various molecular and structural features was conducted on biopsies from 185 patients, findings of identified endotypes were consistent across adult and pediatric patients and were independent of the number of eosinophils in each sample; identified endotypes ranged from severe to mild.
While eosinophils are a normal cellular component of blood, when produced in excess eosinophils can cause a variety of eosinophilic disorders involving chronic inflammation resulting in tissue damage, often within the gastrointestinal system which includes the esophagus, such as EoE.
Altered genes have been identified within each of the three Eoe endotypes, giving insight into distinct disease mechanisms allowing consideration of personalized treatment approaches, which is an important leap forwards for allergy and gastroenterology fields. New therapies including a new class of anti-eosinophil drugs and anti-inflammatory biological agents blocking specific components of allergic inflammation is wonderful news for worldwide allergy sufferers, as it brings the field a step closer to personalized precision therapy.
Materials provided by Cincinnati Children's Hospital Medical Center.
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Tetsuo Shoda, Ting Wen, Seema S Aceves, J Pablo Abonia, Dan Atkins, Peter A Bonis, Julie M Caldwell, Kelley E Capocelli, Christina L Carpenter, Margaret H Collins, Evan S Dellon, Michael D Eby, Nirmala Gonsalves, Sandeep K Gupta, Gary W Falk, Ikuo Hirano, Paul Menard-Katcher, Jonathan T Kuhl, Jeffrey P Krischer, John Leung, Vincent A Mukkada, Jonathan M Spergel, Michael P Trimarchi, Guang-Yu Yang, Nives Zimmermann, Glenn T Furuta, Marc E Rothenberg. Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: a cross-sectional study. The Lancet Gastroenterology & Hepatology, 2018; DOI: 10.1016/S2468-1253(18)30096-7