Ekaterina Safroneeva1, Zhaoxing Pan2, Eileen King3, Lisa J Martin4, Margaret H Collins5, Guang-Yu Yang6, Kelley E Capocelli7, Nicoleta C Arva8, J Pablo Abonia9, Dan Atkins10, Peter A Bonis11, Evan S Dellon12, Gary W Falk13, Nirmala Gonsalves14, Sandeep K Gupta15, Ikuo Hirano14, John Leung11, Paul A Menard-Katcher16, Vincent A Mukkada17, Alain M Schoepfer18, Jonathan M Spergel19, Barry K Wershil20, Marc E Rothenberg9, Seema S Aceves21, Glenn T Furuta22. 1. Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. Electronic address: ekaterina.safroneeva@ispm.unibe.ch. 2. Pediatric Gastroenterology, Pediatric Allergy and Immunology, Aurora, Colorado. 3. Division of Biostatistics and Epidemiology, Cincinnati, Ohio. 4. Division of Human Genetics, Cincinnati, Ohio. 5. Division of Pathology and Laboratory Medicine, Cincinnati, Ohio. 6. Division of Pathology, Chicago, Illinois. 7. Division of Pathology, Aurora, Colorado. 8. Department of Pathology and Laboratory Medicine, Chicago, Illinois. 9. Division of Allergy and Immunology, Department of Pediatrics, Cincinnati, Ohio. 10. Section of Allergy, Immunology, Aurora, Colorado. 11. Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts. 12. Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill School of Medicine, Chapel Hill, North Carolina. 13. Division of Gastroenterology, Philadelphia, Pennsylvania. 14. Division of Gastroenterology and Hepatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois. 15. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Riley Hospital for Children/Indiana University School of Medicine, Indianapolis, Indiana. 16. Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado. 17. Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio. 18. Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. 19. Department of Allergy and Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. 20. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. 21. Division of Allergy Immunology, University of California, San Diego, Rady Children's Hospital, San Diego, California. 22. Digestive Health Institute, Children's Hospital Colorado, Gastrointestinal Eosinophilic Diseases Program, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Aurora, Colorado.
Abstract
BACKGROUND & AIMS: Esophageal dilation improves dysphagia but not inflammation in eosinophilic esophagitis (EoE) patients. We investigated if dilation modifies the association between symptoms and peak esophageal eosinophils per high-power field (eos/hpf). METHODS: Adults enrolled in a multisite prospective Consortium of Gastrointestinal Eosinophilic Disease Researchers Outcome Measures for Eosinophilic Gastrointestinal Diseases Across Ages observational study (NCT02523118) completed the symptom-based EoE activity index (EEsAI) patient-reported outcome instrument and underwent endoscopy with biopsy specimens. Patients were stratified based on dilation status as absent, performed 1 year or less before endoscopy, and performed more than 1 year before endoscopy. Assessments included Spearman correlations of the relationship between symptoms and eos/hpf and linear regression with EEsAI as the outcome, eos/hpf as predictor, and interaction for dilation and eos/hpf. RESULTS: Among 100 patients (n = 61 males; median age, 37 y), 15 and 40 patients underwent dilation 1 year or less and more than 1 year before index endoscopy, respectively. In nondilated patients, the association between eos/hpf and symptoms was moderate (ρ = 0.49; P < .001); for a 10-eos/hpf increase, the predicted EEsAI increased by 2.69 (P = .002). In patients dilated 1 or less and more than 1 year before index endoscopy, this association was abolished (ρ = -0.38; P = .157 for ≤1 y and ρ = 0.02; P = .883 >1 y); for a 10-eos/hpf increase, the predicted EEsAI changed by -1.64 (P = .183) and 0.78 (P = .494), respectively. Dilation modified the association between symptoms and eos/hpf (P = .005 and P = .187 for interaction terms of eos/hpf and dilation 1 or less years before and more than 1 year before index endoscopy, respectively). CONCLUSIONS: In nondilated EoE adults, eos/hpf correlate modestly with symptoms; this correlation was no longer appreciated in dilated patients, and the dilation effects lasted longer than 1 year. Dilation status should be considered in studies evaluating EoE treatment and for clinical follow-up evaluation.
BACKGROUND & AIMS: Esophageal dilation improves dysphagia but not inflammation in eosinophilic esophagitis (EoE) patients. We investigated if dilation modifies the association between symptoms and peak esophageal eosinophils per high-power field (eos/hpf). METHODS: Adults enrolled in a multisite prospective Consortium of Gastrointestinal Eosinophilic Disease Researchers Outcome Measures for Eosinophilic Gastrointestinal Diseases Across Ages observational study (NCT02523118) completed the symptom-based EoE activity index (EEsAI) patient-reported outcome instrument and underwent endoscopy with biopsy specimens. Patients were stratified based on dilation status as absent, performed 1 year or less before endoscopy, and performed more than 1 year before endoscopy. Assessments included Spearman correlations of the relationship between symptoms and eos/hpf and linear regression with EEsAI as the outcome, eos/hpf as predictor, and interaction for dilation and eos/hpf. RESULTS: Among 100 patients (n = 61 males; median age, 37 y), 15 and 40 patients underwent dilation 1 year or less and more than 1 year before index endoscopy, respectively. In nondilated patients, the association between eos/hpf and symptoms was moderate (ρ = 0.49; P < .001); for a 10-eos/hpf increase, the predicted EEsAI increased by 2.69 (P = .002). In patients dilated 1 or less and more than 1 year before index endoscopy, this association was abolished (ρ = -0.38; P = .157 for ≤1 y and ρ = 0.02; P = .883 >1 y); for a 10-eos/hpf increase, the predicted EEsAI changed by -1.64 (P = .183) and 0.78 (P = .494), respectively. Dilation modified the association between symptoms and eos/hpf (P = .005 and P = .187 for interaction terms of eos/hpf and dilation 1 or less years before and more than 1 year before index endoscopy, respectively). CONCLUSIONS: In nondilated EoE adults, eos/hpf correlate modestly with symptoms; this correlation was no longer appreciated in dilated patients, and the dilation effects lasted longer than 1 year. Dilation status should be considered in studies evaluating EoE treatment and for clinical follow-up evaluation.
Authors: Alfredo J Lucendo; Stephan Miehlke; Christoph Schlag; Michael Vieth; Ulrike von Arnim; Javier Molina-Infante; Dirk Hartmann; Albert Jan Bredenoord; Constanza Ciriza de Los Rios; Stefan Schubert; Stefan Brückner; Ahmed Madisch; Jamal Hayat; Jan Tack; Stephen Attwood; Ralph Mueller; Roland Greinwald; Alain Schoepfer; Alex Straumann Journal: Gastroenterology Date: 2019-03-26 Impact factor: 22.682
Authors: Ikuo Hirano; Evan S Dellon; Jennifer D Hamilton; Margaret H Collins; Kathryn Peterson; Mirna Chehade; Alain M Schoepfer; Ekaterina Safroneeva; Marc E Rothenberg; Gary W Falk; Yehudith Assouline-Dayan; Qiong Zhao; Zhen Chen; Brian N Swanson; Gianluca Pirozzi; Leda Mannent; Neil M H Graham; Bolanle Akinlade; Neil Stahl; George D Yancopoulos; Allen Radin Journal: Gastroenterology Date: 2019-10-05 Impact factor: 22.682
Authors: Sandeep K Gupta; Gary W Falk; Seema S Aceves; Mirna Chehade; Margaret H Collins; Evan S Dellon; Nirmala Gonsalves; Ikuo Hirano; Vincent A Mukkuda; Kathryn A Peterson; Jonathan Spergel; Guang-Yu Yang; Glenn T Furuta; Marc E Rothenberg Journal: Gastroenterology Date: 2018-11-17 Impact factor: 22.682
Authors: Alain M Schoepfer; Alex Straumann; Radoslaw Panczak; Michael Coslovsky; Claudia E Kuehni; Elisabeth Maurer; Nadine A Haas; Yvonne Romero; Ikuo Hirano; Jeffrey A Alexander; Nirmala Gonsalves; Glenn T Furuta; Evan S Dellon; John Leung; Margaret H Collins; Christian Bussmann; Peter Netzer; Sandeep K Gupta; Seema S Aceves; Mirna Chehade; Fouad J Moawad; Felicity T Enders; Kathleen J Yost; Tiffany H Taft; Emily Kern; Marcel Zwahlen; Ekaterina Safroneeva Journal: Gastroenterology Date: 2014-08-23 Impact factor: 22.682
Authors: Ekaterina Safroneeva; Alex Straumann; Michael Coslovsky; Marcel Zwahlen; Claudia E Kuehni; Radoslaw Panczak; Nadine A Haas; Jeffrey A Alexander; Evan S Dellon; Nirmala Gonsalves; Ikuo Hirano; John Leung; Christian Bussmann; Margaret H Collins; Robert O Newbury; Giovanni De Petris; Thomas C Smyrk; John T Woosley; Pu Yan; Guang-Yu Yang; Yvonne Romero; David A Katzka; Glenn T Furuta; Sandeep K Gupta; Seema S Aceves; Mirna Chehade; Jonathan M Spergel; Alain M Schoepfer Journal: Gastroenterology Date: 2015-11-14 Impact factor: 22.682
Authors: Ikuo Hirano; Edmond S Chan; Matthew A Rank; Rajiv N Sharaf; Neil H Stollman; David R Stukus; Kenneth Wang; Matthew Greenhawt; Yngve T Falck-Ytter Journal: Gastroenterology Date: 2020-05 Impact factor: 33.883
Authors: Ekaterina Safroneeva; Cary C Cotton; Alain M Schoepfer; Marcel Zwahlen; John T Woosley; Evan S Dellon Journal: Am J Gastroenterol Date: 2020-12 Impact factor: 12.045
Authors: Evan S Dellon; Paneez Khoury; Amanda B Muir; Chris A Liacouras; Ekaterina Safroneeva; Dan Atkins; Margaret H Collins; Nirmala Gonsalves; Gary W Falk; Jonathan M Spergel; Ikuo Hirano; Mirna Chehade; Alain M Schoepfer; Calies Menard-Katcher; David A Katzka; Peter A Bonis; Albert J Bredenoord; Bob Geng; Elizabeth T Jensen; Robert D Pesek; Paul Feuerstadt; Sandeep K Gupta; Alfredo J Lucendo; Robert M Genta; Girish Hiremath; Emily C McGowan; Fouad J Moawad; Kathryn A Peterson; Marc E Rothenberg; Alex Straumann; Glenn T Furuta; Seema S Aceves Journal: J Allergy Clin Immunol Date: 2022-05-20 Impact factor: 14.290
Authors: Evan S Dellon; Paneez Khoury; Amanda B Muir; Chris A Liacouras; Ekaterina Safroneeva; Dan Atkins; Margaret H Collins; Nirmala Gonsalves; Gary W Falk; Jonathan M Spergel; Ikuo Hirano; Mirna Chehade; Alain M Schoepfer; Calies Menard-Katcher; David A Katzka; Peter A Bonis; Albert J Bredenoord; Bob Geng; Elizabeth T Jensen; Robert D Pesek; Paul Feuerstadt; Sandeep K Gupta; Alfredo J Lucendo; Robert M Genta; Girish Hiremath; Emily C McGowan; Fouad J Moawad; Kathryn A Peterson; Marc E Rothenberg; Alex Straumann; Glenn T Furuta; Seema S Aceves Journal: Gastroenterology Date: 2022-05-20 Impact factor: 33.883