title: Exploring potential noninvasive biomarkers in eosinophilic esophagitis in children.
abstract: OBJECTIVE
  Eosinophilic esophagitis (EE) continues to present clinical challenges, including a need for noninvasive tools to manage the disease. To identify a marker able to assess disease status in lieu of repeated endoscopies, we examined 3 noninvasive biomarkers, serum interleukin (IL)-5, serum eosinophil-derived neurotoxin (EDN), and stool EDN, and examined possible correlations of these with disease phenotype and activity (symptoms and histology) in a longitudinal study of children with EE.
  
  
  METHODS
  Children with EE were studied for up to 24 weeks (12 weeks on 1 of 2 corticosteroid therapies and 12 weeks off therapy). Twenty children with normal esophagogastroduodenoscopies with biopsies were enrolled as controls. Serum IL-5, serum EDN, and stool EDN were measured at weeks 0, 4, 12, 18, and 24 in children with EE, and at baseline alone for controls. Primary and secondary statistical analyses (excluding and including outlier values of the biomarkers, respectively) were performed.
  
  
  RESULTS
  Sixty subjects with EE (46 [75%] boys, mean age 7.5 ± 4.4 years) and 20 normal controls (10 [50%] boys, mean age 6.7 ± 4.1 years) were included. Significant changes in serum EDN (significant decrease from baseline to week 4, and then rebound from week 4 to week 12) occurred. Serum EDN levels were stable after week 12. Serum IL-5 and stool EDN levels in subjects with EE were not statistically different from those of the control subjects when each time point for the cases was compared with the controls' 1-time measurement.
  
  
  CONCLUSIONS
  Serum EDN levels were significantly higher in subjects with EE than in controls, and the results suggest a possible role, after additional future studies, for serum EDN in establishing EE diagnosis, assessing response to therapy, and/or monitoring for relapse or quiescence.
authors.affiliation: Division of Pediatric Gastroenterology/Hepatology/Nutrition, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors.forename: Girish
authors.initials: G
authors.lastname: Subbarao
authors.forename: Marc B
authors.initials: MB
authors.lastname: Rosenman
authors.forename: Lyo
authors.initials: L
authors.lastname: Ohnuki
authors.forename: Ann
authors.initials: A
authors.lastname: Georgelas
authors.forename: Miriam
authors.initials: M
authors.lastname: Davis
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Fitzgerald
authors.forename: Jean P
authors.initials: JP
authors.lastname: Molleston
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Croffie
authors.forename: Marian D
authors.initials: MD
authors.lastname: Pfefferkorn
authors.forename: Mark R
authors.initials: MR
authors.lastname: Corkins
authors.forename: Joel R
authors.initials: JR
authors.lastname: Lim
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Steiner
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Schaefer
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Gleich
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Gupta
mesh_terms: D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System / Q000379:methods; D047208:Eosinophil-Derived Neurotoxin / Q000097:blood; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000503:physiopathology*; D004804:Eosinophils / Q000378:metabolism; D005260:Female; D006801:Humans; D015848:Interleukin-5 / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D010641:Phenotype; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D015848:Interleukin-5; D047208:Eosinophil-Derived Neurotoxin