One of the most pressing unmet clinical needs in the pediatric eosinophilic esophagitis (EoE) population is a minimally invasive biomarker to monitor disease activity. Researchers wanted to see if circulating eosinophil progenitors (EoPs) might be utilized as a biomarker to identify juvenile EoE patients. Peripheral blood samples, symptom history, and laboratory data were gathered from pediatric patients having endoscopy for assessment of EoE on dietary treatment at Cincinnati Children’s Hospital in prospective observational research. Flow cytometry was used to determine the EoP level in peripheral blood. The study comprised 34 children with both active and passive EoE. EoP levels in the peripheral blood were three times greater in individuals with active EoE than in those with inactive EoE. The absolute eosinophil count in the blood did not differentiate between active and inactive EoE. A cut-off EoP level of 17 correctly diagnosed active illness in 79% of patients, with 94.4 % specificity and 62.5 % sensitivity. The use of antihistamines reduced the EoP level required to detect active EoE.

According to the findings, blood EoP levels might be utilized as a biomarker to detect active EoE illness in individuals undertaking dietary trials, thus reducing the need for recurrent endoscopies. Larger prospective studies are required to explore the effects of antihistamines and ingested steroids on EoP mobilization into the peripheral circulation, as well as longitudinal studies to evaluate the assay’s performance in individual patients over time.