Ensayos clínicos

Eosinophilic esophagitis patients evaluated at Mayo Clinic will be the source of patients for this study.

Part 1:

20 children and 20 adult eosinophilic esophagitis patients will be retrospectively reviewed for the following:

1. Patient demographics including age, sex, race

2. EoE patient symptoms: dysphagia, food impaction, atopy (asthma, allergic rhinitis, eczema, IgE-mediated food allergies)

3. Mast cell symptoms: flushing, pruritus, urticaria, abdominal cramping with diarrhea

4. Comorbid mast cell disorder diagnosis

5. If performed: Baseline tryptase and 24 hour urine studies: beta-prostaglandin, N-methylhistamine, and leukotriene E4

6. Concurrent medications which histamine mediators: antihistamines, montelukast, aspirin

7. EoE Rx (Concurrent medications which influence esophageal eosinophilia): PPI, steroids, elimination diet

8. Endoscopic findings (rings, furrows)

Esophageal biopsies will further be analyzed based on tryptase staining for mast cells and then low and peak mast cells/HPF will be identified for the esophageal biopsies. Also, peak eosinophils/HPF will be identified in the esophageal biopsies with H&E staining.

Part 2:

The group with higher mast cells/HPF will be the cohort for Part 2 of the study.

At least 20 eosinophilic esophagitis patients will be prospectively reviewed for the following:

1. Patient demographics including age, sex, race

2. EoE patient symptoms: dysphagia, food impaction, atopy (asthma, allergic rhinitis, eczema, IgE-mediated food allergies)

3. Mast cell symptoms: flushing, pruritus, urticaria, abdominal cramping with diarrhea

4. Comorbid mast cell disorder diagnosis

5. Baseline tryptase and 24 hour urine studies: beta-prostaglandin, N-methylhistamine, and leukotriene E4

6. Concurrent medications which histamine mediators: antihistamines, montelukast, aspirin

7. EoE Rx (Concurrent medications which influence esophageal eosinophilia): PPI, steroids, elimination diet

8. Endoscopic findings (rings, furrows)

Esophageal biopsies will further be analyzed based on tryptase staining for mast cells and then low and peak mast cells/HPF will be identified for the esophageal biopsies. Peak eosinophils/HPF will be identified in the esophageal biopsies with H&E staining.

We aim to see if there is an elevated histamine release (via serum tryptase and 24 hour urine N-methyl histamine, beta-prostaglandin, and leukotriene E4) in EoE patients and further correlated with density of tryptase staining on esophageal biopsies.