Pilot Project

Mirna Chehade
Mirna Chehade, M.D.
Assistant Professor Pediatrics
Assistant Professor Medicine, Gastroenterology
Mount Sinai School of Medicine

Microarray-Based Approach to Develop Non-Invasive Biomarkers in Eosinophilic Esophagitis

Eosinophilic esophagitis (EE) is a chronic inflammatory disease of the esophagus caused by multiple food allergies. Its diagnosis is made by endoscopy and esophageal biopsies demonstrating eosinophilic infiltration of the esophageal mucosa. Children with active, untreated, EE suffer from a variety of upper gastrointestinal symptoms including abdominal pain, gastroesophageal reflux symptoms, dysphagia, recurrent esophageal food impactions, and even growth failure. To date, no FDA approved therapies exist for patients with EE. Treatment mainly consists of dietary avoidance of allergenic foods. Since food allergens in EE are not adequately identified using standard techniques, diets are either very restrictive, or empirically chosen for all children with EE. Dietary expansions following disease remission are equally difficult due to the lack of means for identification of safe foods to re-introduce. As a result, children with EE end up with multiple food eliminations and challenges, the follow-up of which is always done by a combination of clinical and histological assessment, looking for esophageal eosinophilia upon endoscopy and esophageal biopsies. These multiple procedures are invasive and carry a psychological burden on children with EE and their families. To date, no noninvasive biomarkers to monitor disease activity have been found. Our aim is to use a gene-microarray approach to identify an EE-specific signature, which can itself be used to reflect disease activity, or lead us to identify novel biomarkers for the disease, hence replacing endoscopies and biopsies needed for management of children with EE. Our approach will also enhance our understanding of the pathogenesis of EE, therefore allowing new avenues in hypothesis-driven research, with the ultimate goal of finding targeted therapies for children suffering from EE.