Eosinophilic Oesophagitis Assessment with String Testing (EoEAST)
Research type
Research Study
Full title
Eosinophil associated proteins and microbiome profiling in adults with eosinophilic oesophagitis at a single UK tertiary centre
IRAS ID
303427
Contact name
Joseph Cooney
Contact email
Sponsor organisation
St George's University Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 6 months, 17 days
Research summary
Eosinophilic oesophagitis (EoE) is an inflammatory condition of the oesophagus (food pipe) that can lead to difficulty swallowing and to food to getting stuck (Park 2014) and has become increasingly common over the past 40 years (Dellon 2019).
EoE is triggered by a protein in the diet but alterations to the types of bacteria (microbiome) in the oesophagus may also be involved (Harris 2015). EoE is diagnosed with gastroscopy (a thin camera test via the mouth) where 6 tiny samples (biopsies) are taken (Lucendo 2017). Treatment is either with removing food groups from the diet or medications including steroids (budesonide) or a proton pump inhibitor (PPI, omeprazole). The aim is to improve symptoms and to stop scar tissue forming that can cause food to get stuck.
Patients with EoE will need to undergo many gastroscopies over their life, which even with sedation can be a daunting experience (BSG 2017). There has been research into less invasive tests and two previous studies (Furuta 2013, Ackerman 2019) have shown that a thin swallowed string may be able to detect substances (biomarkers) that indicate how severe the EoE is. These studies were small and it is not known how the biomarkers change with different treatments or how well they relate to symptoms and findings with endoscopy.
In this study we will ask adults with EoE to swallow a thin string made of rayon for 30 minutes, with one end taped to the cheek, which we will analyse for biomarkers and bacteria, on the same day as their routine gastroscopy and a symptom survey. We will also take an extra 2 biopsies to analyse the nerves which may explain why some patients have more symptoms than others. With these findings we may understand better how to monitor and treat EoE in future, in less invasive ways.
REC name
North of Scotland Research Ethics Committee 1
REC reference
22/NS/0100
Date of REC Opinion
30 Jul 2022
REC opinion
Favourable Opinion