Comparison of eotaxin‐3 biomarker in patients with eosinophilic oesophagitis, proton pump inhibitor‐responsive oesophageal eosinophilia and gastro‐oesophageal reflux disease

• Published in: Alimentary pharmacology & therapeutics Vol. 42; no. 2; pp. 231 - 238
• Main Authors: Moawad, F. J., Wells, J. M., Johnson, R. L., Reinhardt, B. J., Maydonovitch, C. L., Baker, T. P.
• Format: Journal Article
• Language: English
• Published: England 01.07.2015
• Subjects: Adult; Biomarkers; Chemokine CCL26; Chemokines, CC - immunology; Diagnosis, Differential; Eosinophilic Esophagitis - diagnosis; Eosinophilic Esophagitis - drug therapy; Eosinophilic Esophagitis - pathology; Female; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - pathology; Humans; Immunohistochemistry; Male; Middle Aged; Proton Pump Inhibitors - therapeutic use; Retrospective Studies
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.13258

Summary Background Proton pump inhibitor‐responsive oesophageal eosinophilia (PPI‐REE) is a recently described entity which resembles oeosinophilic oesophagitis (EoE), yet responds to acid suppressive treatment. Aim To determine whether EoE shares similar staining features with PPI‐REE or with gastro‐oesophageal reflux disease (GERD). Methods This retrospective study consisted of patients with an established diagnosis of EoE, PPI‐REE, or GERD identified from a database during a 1‐year period. Immunohistochemistry (IHC) analysis was performed specifically targeting eotaxin‐3 antibodies. All sections were qualitatively (intensity) and quantitatively (percentage of cells stained) assessed independently by two blinded pathologists. Results The cohort consisted of three groups of patients: EoE (n = 22), PPI‐REE (n = 23) and GERD (n = 23) for a total of 68 patients. Study demographics included mean age 39 (14) years, 75% male and 77% Caucasian. There was a significant difference in the eotaxin‐3 staining among EoE, PPI‐REE and GERD groups [mean score (s.d.): 1.2 (1.2), 0.8 (1.0), 0.3 (0.7), P = 0.006]. Staining scores of EoE patients were significantly higher compared with GERD (P = 0.002) and a trend towards significance was seen between EoE and PPI‐REE (P = 0.054). There was also a significant difference in EoE staining intensity score among the three groups (P = 0.006). Intensity scores of EoE were significantly higher compared with GERD [1.0 (0.9) vs. 0.22 (0.52), P < 0.001]. There was no significant difference between EoE and PPI‐REE groups [1.0 (0.0) vs. 0.52 (0.75) P = 0.094]. Conclusions A difference in eotaxin‐3 staining was seen in the three groups of patients with oesophageal eosinophilia. Eotaxin‐3 can distinguish EoE from GERD, but not from proton pump inhibitor responsive‐oesophageal eosinophilia.