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Show CHAPTER 4 PROTEIN BIOMARKERS IN ESOPHAGEAL SECRETIONS ARE A FEASIBLE LOWCOST AND NONINVASIVE DIAGNOSTIC MODALITY FOR EOSINOPHILIC ESOPHAGITIS Noninvasive diagnostic biomarkers are needed for EoE. In this collaboration with Dr. Kathryn Peterson in the Department of Gastroenterology, we reanalyzed RNA-seq data from Chapter 4 in order to discover gene expression biomarkers for EoE that encode secreted protein products. In theory, these proteins could be detected in esophageal luminal secretions and serve as noninvasive diagnostic markers for EoE. The feasibility of the approach and utility of these markers were then assessed in a small validation study. 4.1 Introduction Eosinophilic esophagitis (EoE) is a chronic inflammatory condition governed by a form of non-IgE hypersensitivity. Recent literature shows rapidly rising EoE incidence among children and adults, with striking population-based rates reported in Utah [1]. While EoE symptoms often improve with treatment, disease activity may persist, and can contribute to esophageal fibrostenosis [2]. Noninvasive biomarkers to track EoE activity in response to treatment are not currently applied in clinical practice. Therefore, patients are committed to frequent endoscopy with biopsy. Endoscopy requires sedation, carries a procedural risk, and is the key driver of the estimated $1.4 billion in annual EoE-attributable healthcare costs in the US [3]. The onus of endoscopy likely leads to substantial nonadherence with recommended EoE disease surveillance. Diagnostic and tracking modalities for EoE that are less expensive and less |
