Odetola Segun, Feulefack Joseph, Sergi Consolato M
Department of Pathology, Dorset County Hospital, Dorchester, UK.
Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.
Transl Pediatr. 2024 Mar 27;13(3):474-483. doi: 10.21037/tp-23-478. Epub 2024 Mar 20.
Eosinophilic esophagitis is a chronic inflammatory disorder, often relapsing. There is an increasing need to develop new alternative diagnostic and monitoring methods on a critical basis, which will provide samples through none or minimally invasive procedures. This study aims to identify and document the types and roles of potential biomarkers in eosinophilic esophagitis released by eosinophils as well as the potential relationship to the peak eosinophilic count and the degree of degranulation of eosinophils (DGE/DGE + NDGE: degranulated eosinophils/degranulated eosinophils and non-degranulated eosinophils).
This is the first in-depth systematic review study using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) parameters involving a literature search of academic databases (PubMed, Scopus, Medline, Google Scholar, and Cochrane Database, 2011-2022) targeting specifically the eosinophilic counts and ratio, and the eosinophilic degranulation products as potential biomarkers. Data were extracted from ten selected studies and presented on a spreadsheet.
The studies show the ability to detect eosinophilic and non-eosinophilic degranulation products, and absolute eosinophilic count in samples, including blood and urine, thereby serving as potential surrogates in making the diagnosis or monitoring disease progression in the future. There is an obvious paucity of studies that correlate potential biomarkers to the degree of degranulation of eosinophils.
A few minimally invasive methods and biomarkers may be suggested as alternative tools in diagnosing and monitoring eosinophilic esophagitis. While there is no consensus on the clinical usefulness of these biomarkers, our critical evaluation may suggest that the eosinophilic degranulation ratio (DGE/DGE + NDGE: degranulated eosinophils/degranulated eosinophils and non-degranulated eosinophils) in the esophagus may be critical for evaluating properly these biomarkers. An increasing trend may culminate in the potential clinical use of these biomarkers evaluated not only with the peak eosinophilic count, but also with the degranulation score upon regulatory bodies' approval to monitor eosinophilic esophagitis in the future. We strongly advocate for the necessity to score the esophageal biopsies with both a peak eosinophilic count and a score of the degranulated eosinophils.
嗜酸性粒细胞性食管炎是一种慢性炎症性疾病，常反复发作。迫切需要在关键基础上开发新的替代诊断和监测方法，这些方法将通过无创或微创程序提供样本。本研究旨在识别和记录嗜酸性粒细胞释放的嗜酸性粒细胞性食管炎潜在生物标志物的类型和作用，以及与嗜酸性粒细胞峰值计数和嗜酸性粒细胞脱颗粒程度（DGE/DGE + NDGE：脱颗粒嗜酸性粒细胞/脱颗粒嗜酸性粒细胞和未脱颗粒嗜酸性粒细胞）的潜在关系。
这是第一项使用PRISMA（系统评价和Meta分析的首选报告项目）参数进行的深入系统评价研究，涉及对学术数据库（PubMed、Scopus、Medline、谷歌学术和Cochrane数据库，2011 - 2022年）进行文献检索，专门针对嗜酸性粒细胞计数和比例以及嗜酸性粒细胞脱颗粒产物作为潜在生物标志物。从十项选定的研究中提取数据并呈现在电子表格上。
研究表明能够检测样本（包括血液和尿液）中的嗜酸性粒细胞和非嗜酸性粒细胞脱颗粒产物以及绝对嗜酸性粒细胞计数，从而在未来作为潜在替代指标用于诊断或监测疾病进展。将潜在生物标志物与嗜酸性粒细胞脱颗粒程度相关联的研究明显匮乏。
可以提出一些微创方法和生物标志物作为诊断和监测嗜酸性粒细胞性食管炎的替代工具。虽然这些生物标志物的临床实用性尚无共识，但我们的批判性评估可能表明食管中的嗜酸性粒细胞脱颗粒率（DGE/DGE + NDGE：脱颗粒嗜酸性粒细胞/脱颗粒嗜酸性粒细胞和未脱颗粒嗜酸性粒细胞）对于正确评估这些生物标志物可能至关重要。未来，这些生物标志物的潜在临床应用可能不仅取决于嗜酸性粒细胞峰值计数，还取决于监管机构批准后的脱颗粒评分，这一趋势可能会不断增加。我们强烈主张有必要对食管活检标本同时进行嗜酸性粒细胞峰值计数和脱颗粒嗜酸性粒细胞评分。
