Principal Investigator: Joshua Wechsler, MD An allergic/immune condition, the inflammatory process of eosinophilic esophagitis (EoE) leads to chronic swallowing problems and food impaction. These symptoms develop when large numbers of white blood cells called eosinophils build up in the inner lining of the esophagus. EoE is on the rise in the United States, contributing to more than $1.4 billion in health care costs annually. Recently, EoE patients have been found to experience abrupt food-induced responses of the esophagus (FIRE). Symptoms occur immediately after the ingestion of foods that don’t typically trigger eosinophilic inflammation. Preliminary data from Dr. Ikuo Hirano of the Northwestern Medicine Digestive Health Center suggests these patients are sensitized to specific allergy-related antibodies directed at FIRE-associated foods. An antibody linked to food allergies, IgE typically involve mast cells—immune cells present within tissues such as the esophagus that are increased in patients with EoE. Dr. Wechsler’s study will examine esophageal biopsies to determine whether IgE is present on mast cells and whether increased IgE+ mast cells are increased in patients with FIRE when compared to those without FIRE...
Principal Investigator: Joshua Wechsler, MD Eosinophilic esophagitis (EoE) is an allergic inflammatory disease of the esophagus. Specific foods can trigger esophageal inflammation leading to pain, difficulty swallowing and malnutrition. Elimination diets remain a mainstay for identifying triggers since effective biomarkers or testing are currently nonexistent in this chronic disease. Previous work of Dr. Wechsler’s team revealed an immune response of white blood cells (T-cell receptors) in patients with active EoE who underwent rigorous dietary elimination and reintroduction regimens. Pursuing this promising line of research, Dr. Wechsler intends to examine esophageal biopsies for evidence of the specific immune response of white blood cells to specific foods. The investigators will use deep sequencing of the T-lymphocyte receptor to identify how frequently certain types of T-cells exist between adults with similar and unique food triggers. Findings from this study could open the door to building a digital library of T-cell receptors that identify specific foods and allow for more personalized...
Principal Investigator: Guang-Yu Yang, MD, PhD Most patients with Eosinophilic Esophagitis (EoE) experience an abnormal immune-mediated response to food antigens. Identifying unique biomarkers involved in the pathogenesis of allergic inflammation could significantly improve treatments. The conversion of cell membrane arachidonic acid to ω-6 prostaglandin and ω-6 leukotriene eicosanoids during the inflammatory cascade provides many potential drug targets to impede the inflammatory process in patients with EoE. ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) have opposing influences on inflammation. Currently, there is no study on PUFA metabolism and the role these PUFAs metabolites play in the pathogenesis of EoE. Dr. Yang’s study aims to determine the ω-3 and ω-6 PUFAs metabolites/eicosanoids profile in eosinophilic esophagitis using a liquid chromatography tandem mass spectrometry (LC-MS/MS)-based metabolomics approach and to identify the unique eicosanoids or biomarker/s for diagnosis, prognosis and monitoring the therapeutic effect on...
Principal Investigator: Ronak Vashi Patel, MD Imagine a piece of food becomes stuck in your throat while eating dinner. Unfortunately, for many patients with Eosinophilic Esophagitis (EoE), this is a symptom that occurs all too often. Dysphagia, or difficulty swallowing, is a gastroenterology “red flag” that often alerts physicians to initiate a work up to determine the cause. Typically, the first step calls for an upper endoscopy to visually assess inflammation and narrowing (strictures) that can be treated. Prior data suggests that visual evaluation is not perfect. Missed strictures can lead to additional testing and delay diagnosis. Other tools have become available to assist in measuring the esophageal diameter such as the Functional Lumen Imaging Probe (FLIP), a novel technology. Dr. Patel’s research project aims to determine how accurately physicians measure esophageal diameter as compared to FLIP in patients with EoE. Better understanding the accuracy of endoscopic assessment by both visual estimation and FLIP assessment will offer insight into which tools should be used in diagnostic and therapeutic treatment of esophageal...
