Eosinophilic esophagitis (EoE) is a chronic esophageal illness characterized by eosinophilic inflammation. Proton-pump inhibitors (PPI) cause illness remission, although no predictors of PPI response have been discovered. As a result, a biomarker that distinguishes between PPI responders (PPI-R) and nonresponders (PPI-NR) must be discovered. The goals were to find any molecular biomarkers that could predict PPI response and to investigate molecular remission following PPI treatment. This prospective study included 39 healthy children and 43 pediatric EoE patients from two hospitals who were given esomeprazole for 8 to 12 weeks. Patients were categorized as PPI-R or PPI-NR after treatment. Biopsies were obtained, and RNA, microRNAs, and proteins were extracted and quantified using qPCR and Western blot (WB). MiRNAs were also examined in serum. Researchers discovered numerous esophageal miRNAs with distinct expression levels in PPI-R and PPI-NR youngsters that can be utilized to differentiate them. However, no effective serum miRNAs were discovered. Furthermore, these miRNAs were shown to be dysregulated in responder patients both before and after PPI treatment. They found that PPI-R had a substantial drop in eotaxin-3, IL-5, IL-13, periostin, and major basic protein levels and a large rise in filaggrin levels following PPI therapy in this kid group.

Since esophageal miRNA levels can distinguish between PPI-R and PPI-NR at baseline, as well as before and after therapy in PPI-R, they might be utilized as biomarkers. Furthermore, after PPI treatment, they found clinical and esophageal molecular restoration in PPI-R patients.

Reference: https://journals.lww.com/jpgn/Fulltext/2020/12000/Proton_pump_Inhibitor_Response_Prediction_Using.14.aspx