Posttreatment Gene Scores Support Histologic and Endoscopic Response Thresholds in Eosinophilic Esophagitis

Abstract

INTRODUCTION: The correlation between clinical and molecular treatment response thresholds in eosinophilic esophagitis (EoE) is not well understood. METHODS:We evaluated posttreatment EoE diagnostic panel gene expression profiles across histologic and endoscopic thresholds (EREFS) in a prospective adult EoE cohort. RESULTS:We observed a strong inverse correlation between posttreatment gene score and eosinophil count (R 5 20.66; P < 0.001); biopsies with <15 eos/hpf had higher gene scores ( ‡425) vs those with ‡15 eos/hpf. Findings for EREFS were similar; EREFS £2 was associated with EoE diagnostic panel scores ‡395. DISCUSSION:Molecular signatures support the use of posttreatment response thresholds <15 eos/hpf and EREFS £2 in clinical practice and trials.