Biomarkers of T2-inflammation in the diagnosis and monitoring of eosinophilic esophagitis in children



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Abstract

BACKGROUND: Eosinophilic esophagitis is an immune-mediated disease associated with activation of T2-inflammation in esophageal tissues. Monitoring eosinophilic esophagitis activity in children requires invasive diagnostic methods using general anesthesia. The study of T2-inflammatory biomarkers is currently not a generally accepted diagnostic method, but may be an informative and more accessible way to monitor eosinophilic esophagitis in children over time.

AIMS: Comparative assessment of serum markers of T2-inflammation in children with eosinophilic esophagitis and other T2-associated diseases and determination of the potential of these biomarkers for monitoring the course of eosinophilic esophagitis.

MATERIALS AND METHODS: A cross-sectional, single-center comparative study included patients with eosinophilic esophagitis and other T2-associated diseases without eosinophilic esophagitis aged under 18 years. All patients underwent clinical and laboratory tests, esophagogastroduodenoscopy with morphological examination of esophageal mucosa biopsy specimens. EoE activity was assessed using the I-SEE index. The concentrations of cytokines involved in the T2-type immune response were determined in blood serum using enzyme immunoassay.

RESULTS: The study included 80 patients: 40 patients with eosinophilic esophagitis, the comparison group included 40 children with other T2-associated diseases without eosinophilic esophagitis. Male patients were statistically significantly more common in the eosinophilic esophagitis group (p=0.004). IgE- and non-IgE-mediated food allergy were statistically significantly more common in patients with eosinophilic esophagitis (p=0.003 and p=0.002, respectively). The levels of IL-4 and IL-13 were statistically significantly higher in the comparison group (p<0.001). However, after dividing patients with eosinophilic esophagitis into subgroups by the degree of disease activity, in patients with low eosinophilic esophagitis activity, the level of IL-4, IL-13 and eotaxin-3 was statistically significantly lower (p<0.001). The level of eosinophil peroxidase was statistically significantly higher than in the comparison group and in patients with higher eosinophilic esophagitis activity and (p=0.045 and p=0.030, respectively). All patients with EoE complicated by esophageal stenosis had 15 or more points on I-SEE. The level of IL-33 in patients with esophageal stenosis was statistically significantly higher than in patients without stenosis (p<0.001).

CONCLUSIONS: Biomarkers of T2-inflammation demonstrated statistical significance in relation to the activity and severity of eosinophilic esophagitis. The obtained results highlight the high potential of using these biomarkers as a minimally invasive method for dynamic monitoring of disease activity, opening up new possibilities for a personalized approach to the treatment of eosinophilic esophagitis in children.

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About the authors

Svetlana Svyatoslavovan Vyazankina

National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health

Email: svsvpav@mail.ru
ORCID iD: 0000-0002-6945-1104
SPIN-code: 5222-7651

- Junior Researcher, Laboratory of Clinical Immunology and Nutrition

- Allergist-Immunologist, Department of Dermatology and Allergology, Research Institute of Pediatric Dermatology

Россия, 119991, Moscow, Lomonosovsky Prospect, 2, Building 1

Svetlana G. Makarova

National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health

Email: sm27@yandex.ru
ORCID iD: 0000-0002-3056-403X
SPIN-code: 2094-2840

MD, Dr. Sci. (Med.), Professor

Россия, 119991, Moscow, Lomonosovsky Prospect, 2, Building 1

Maxim M. Lokhmatov

National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health

Email: lokhmatov@mail.ru
ORCID iD: 0000-0002-8305-7592
SPIN-code: 4738-3410

MD, PhD, head of the endoscopic research department

Россия, 119991, Moscow, Lomonosovsky Prospect, 2, Building 1

Nikolay N. Murashkin

National Medical Research Center for Children’s Health; The First Sechenov Moscow State Medical University (Sechenov University); Central State Medical Academy of Department of Presidential Affairs

Email: m_nn2001@mail.ru
ORCID iD: 0000-0003-2252-8570
SPIN-code: 5906-9724

MD, Dr. Sci. (Med.), Professor

Россия, Moscow; Moscow; Moscow

Tatyana N. Budkina

National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health

Email: tatyana-budkina@mail.ru
ORCID iD: 0000-0002-7379-7298
SPIN-code: 3845-2759

PhD, Endoscopist, Endoscopic Research Department

Россия, 119991, Moscow, Lomonosovsky Prospect, 2, Building 1

Elena L. Semikina

National Medical Research Center for Children’s Health

Email: semikinaelena@yandex.ru
ORCID iD: 0000-0001-8923-4652
SPIN-code: 3647-4967

MD, Dr. Sci. (Med.)

Россия, Moscow

Marina A. Snovskaya

National Medical Research Center for Children’s Health

Email: snows@inbox.ru
ORCID iD: 0000-0002-5263-6743
SPIN-code: 9899-1095

MD, Cand. Sci. (Med.), Leading Research Associate

Россия, Moscow

Olga V. Kurbatova

National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health

Email: putintseva@mail.ru
ORCID iD: 0000-0002-9213-5281
SPIN-code: 5227-3102

MD, PhD

Россия, 119991, Moscow, Lomonosovsky Prospect, 2, Building 1

Anastasia A. Zhuzhula

Federal State Autonomous Institution "National Medical Research Center for Children's Health" of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: anas-zh@inbox.ru
ORCID iD: 0000-0002-6292-7229
SPIN-code: 8783-9571
Россия, Russia, Moscow, Lomonosovsky Prospekt, 2, building 1

Andrei P. Fisenko

National Medical Research Center for Children’s Health

Email: director@nczd.ru
ORCID iD: 0000-0001-8586-7946
SPIN-code: 4397-6291

MD, Dr. Sci. (Med.), Professor

Россия, 2, b. 1, Lomonosovsky prospekt, Moscow, 119991

Oksana A. Ereshko

National Medical Research Center for Children’s Health

Email: ksenya2005@inbox.ru
ORCID iD: 0000-0002-1650-652X
SPIN-code: 3893-9946

MD, Cand. Sci. (Med.)

Россия, 2 b. 1, Lomonosovsky prospekt, Moscow, 119991

Valeriya M. Ivanova

National Medical Research Center for Children’s Health

Email: valeriak06120@mail.ru
ORCID iD: 0009-0003-4166-062X
SPIN-code: 9085-3568
2 b. 1, Lomonosovsky prospekt, Moscow, 119991

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