BioEvocs - Testing the “poo sniffer” in children and young with EoE
Research type
Research Study
Full title
BioEvocs - Faecal volatile organic compounds in children with eosinophilic oesophagitis (EoE): potential as non-invasive biomarkers
IRAS ID
320020
Contact name
Marcus KH Auth
Contact email
Sponsor organisation
Alder Hey Children's NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Eosinophilic oesophagitis (EoE) is a new disease attributed to food-related immune reactions, leading to activation of eosinophils (a subtype of white blood cells) to food proteins, eosinophil migration into the oesophagus and inability to swallow fluids and food. Although EoE is continuously rising , professionals and carers misinterpret or under-estimate the signs as no biomarker exists to indicate if a patient has EoE.
Until now, evaluation depends on repeated upper endoscopies (OGD) under general anaesthetic with multiple oesophageal biopsies. There is growing evidence that environment factors profoundly modify the composition of gut bacteria, and that these changes have a knock-on effect on how food proteins are tolerated by the human digestive tract and immune system.
Currently, treatment can be dietetic, which requires empirical elimination of several common food types (dairy, wheat, soya, egg, nuts and fish), with uncertainty about to which food types the individual with EoE reacts and which long-term elimination is required. Alternatively, topically applied steroid slurries are successful but associated with side effects on longer term and anti-acid medicines (PPI) work in only a small proportion of patients.
To offer a non-invasive test, we have established a laboratory test of the gut metabolome. It detects soluble compounds from food fermentation (faecal organic volatile compounds, VOCs) and analyses chemical reactions of gut bacteria (gut microbiome). We will correlate the ‘poo sniffer’ faecal test sample with validated EoE activity scores and environmental and medical questionnaires.
We will demonstrate the feasibility to collect stool samples from 60 children with EoE (before and after modifications of their treatment), other forms of oesophageal disease and healthy gut controls, to analyse faecal VOCs during active disease or in remission, in order to understand the effects of medical and dietetic treatment in EoE.
REC name
North West - Haydock Research Ethics Committee
REC reference
22/NW/0341
Date of REC Opinion
14 Feb 2023
REC opinion
Further Information Favourable Opinion