The following is a summary of “Plasma Biomarkers and Fractional Exhaled Nitric Oxide in the Diagnosis of Eosinophilic Esophagitis,” published in the  January 2023 issue of Gastroenterology and Nutrition by Josyabhatla, et al.

Endoscopy with biopsies were necessary for the diagnosis and management of eosinophilic esophagitis (EoE), a chronic condition. For a study, researchers sought to come up with a list of non-invasive indicators that may be used to spot people who had active EoE.

They included 128 kids aged 5 to 18 who were scheduled for endoscopies due to suspected esophageal or peptic illness. Fractionated exhaled nitric oxide (FeNO) was assessed on the endoscopy day, and blood was drawn to measure plasma amino acids, plasma polyamines, and peripheral absolute eosinophil count (AEC). Based on esophageal eosinophilia and a history of EoE, patients were divided into control groups (n = 91), EoE in remission groups (n = 16), and active groups (n = 21).

The difference in AEC between the groups under comparison was not statistically significant (P = 0.056). Citrulline (CIT), β-alanine (β-ALA), and cysteine (CYS) plasma amino acids were all greater in active EoE compared to controls (P< 0.05). In active EoE compared to controls, the polyamine spermine was decreased (P< 0.05). The area under the curve (AUC) for the receiver operator characteristic (ROC) curve used to evaluate the predictive power of a composite score comprised of FeNO, β-ALA, CYS, and spermine was 0.90 (95% CI: 0.80-0.96) when separating active EoE from controls and 0.87 (95% CI: 0.74-1.00) when separating active EoE from EoE in remission.

To distinguish active EoE patients from controls, a panel of FeNO, two plasma amino acids (β-ALA, CYS), and the polyamine spermine can be employed.