Noninvasive Biomarkers in Eosinophilic Esophagitis: Current Perspectives

Eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus, diagnosed based on clinical symptoms and elevated eosinophil counts in esophageal mucosal biopsies. While endoscopic biopsy remains the gold standard for diagnosing and monitoring this disease, the average child with EoE receives at minimum yearly endoscopy. There are risks and high costs associated with repeated procedures. Studies have been developed to evaluate less invasive methods for disease diagnosis and surveillance. We will be reviewing the current literature on noninvasive biomarkers in eosinophilic esophagitis, including specific levels of markers in blood, urine, stool, and saliva samples, as well as the esophageal string test. To date, there are no consensus statements recommending the use of noninvasive biomarkers in symptomatic patients or in asymptomatic patients. Only the esophageal string test has been formally accepted as a potential alternative to endoscopic surveillance by the American Society for Gastrointestinal Endoscopy Consensus Conference. Further studies need to be conducted to validate the use of biomarkers in diagnosing and monitoring this disease.