An Increasing Trend of Eosinophilic Esophagitis in Korea and the Clinical Implication of the Biomarkers to Determine Disease Activity and Treatment Response in Eosinophilic Esophagitis
Journal of Neurogastroenterology and Motility
;
: 525-533, 2019.
Article
in English
| WPRIM
| ID: wpr-765971
ABSTRACT
BACKGROUND/AIMS:
The epidemiology and pathogenesis of eosinophilic esophagitis (EoE) remain unclear in Asian countries. We investigated clinicopathological characteristics and diagnostic trends of EoE, and evaluated 3 tissue biomarkers for correlation with disease activity and treatment response in Korean patients with EoE.METHODS:
We retrospectively reviewed 25 271 esophageal biopsies performed during upper endoscopies between 2006 and 2017. We diagnosed EoE based on ≥ 15 eosinophils/high-power field (HPF) and, symptoms of esophageal dysfunction. We performed immunohistochemical analysis for tryptase, eosinophilic derived neurotoxin (EDN), and eotaxin-3.RESULTS:
We diagnosed EoE in 72 patients (53 men and 19 women; mean age, 46.2 years) with presenting symptoms of, dysphagia (15.3%), epigastric pain (31.9%), and heartburn (30.6%). The diagnostic rate of EoE considerably increased between 2006 and 2017, from 0.29 diagnoses to 7.99 diagnoses per 1000 esophageal biopsies (P < 0.001). The mean peak eosinophil count (PEC) was 56.0 (± 77.8)/HPF. Whereas the EDN (rho = 0.667, P < 0.001) and eotaxin-3 levels (rho = 0.465, P < 0.001) correlated with PEC, tryptase and PEC were weakly correlated (rho = 0.291, P = 0.013). EDN (rho = 0.279, P = 0.017), and tryptase (rho = 0.279, P = 0.033) correlated with the inflammatory score of Eosinophilic Esophagitis Endoscopic Reference Score. Immunohistochemical analysis and changes in tryptase, EDN, and eotaxin-3 levels were associated with histologic and endoscopic improvements.CONCLUSIONS:
EoE incidence considerably increased during the 12-year period, regardless of endoscopic esophageal biopsy rate. Tryptase, EDN, and eotaxin-3 levels in esophageal biopsy specimens could be promising biomarkers for disease activity, symptom, and endoscopic response in Korea.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Biopsy
/
Biomarkers
/
Deglutition Disorders
/
Epidemiology
/
Incidence
/
Retrospective Studies
/
Asian People
/
Diagnosis
/
Endoscopy
/
Eosinophils
Type of study:
Diagnostic study
/
Incidence study
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Journal of Neurogastroenterology and Motility
Year:
2019
Type:
Article
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