Eosinophilic Oesophagitis (EoE) is a condition that causes inflammation and scarring of the oesophagus, the tube that connects the mouth to the stomach. EoE can lead to difficulty swallowing, food getting stuck, and chest pain. An allergic reaction to certain foods or environmental factors usually triggers EoE.

The diagnosis and treatment of EoE require repeated endoscopies, which are invasive procedures that involve inserting a camera into the oesophagus and taking tissue samples. Endoscopies can be uncomfortable, expensive, and risky for patients. Therefore, there is a need for alternative methods that can monitor EoE without endoscopies.


A recent study published in BMC Gastroenterology explored the potential of blood tests to measure the levels of specific proteins that reflect the changes in the oesophagal tissue due to EoE in adults. These proteins are fragments of collagen, which is a major component of the tissue structure, and calprotectin and vimentin, which are markers of inflammation and cell activation.


The study involved 29 adult (over 18) patients with EoE who underwent a dietary elimination trial for six weeks. The patients avoided gluten, milk, soy, and eggs, which are common allergens that can trigger EoE. The researchers measured the levels of 12 different protein fragments in the patients' blood before and after the diet. They also compared the blood levels of these proteins with those of healthy controls.


The results showed that patients with EoE had higher levels of most protein fragments than healthy controls, indicating more tissue damage and inflammation in their oesophagus. The levels of some protein fragments also correlated with the severity of EoE symptoms, endoscopic findings, and histological features.

For example, patients with more fibrosis (scarring) in their oesophagus had higher levels of protein fragments related to collagen formation and cross-linking. Patients who achieved histological remission (reduction of eosinophils in the tissue) after the diet had lower levels of protein fragments related to collagen degradation. 

Patients who had no symptoms of food impaction (food getting stuck) after the diet had higher levels of protein fragments related to collagen breakdown.


The study suggests that blood tests can provide useful information about tissue remodelling and disease activity in EoE patients. Blood tests can also help monitor the response to dietary or other treatments for EoE. 

However, more studies are needed to validate the accuracy and reliability of these blood tests and to establish their clinical utility in EoE management.

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TSLP: A Pathway to Non-Invasive Blood Tests and Targeted Treatments