Two large trials, DREAM and MENSA have found IL-5 therapy with mepolizumab to lower risk of exacerbation in patients with asthma with an eosinophilic phenotype.
The current standard for diagnosis of Eosinophilic Esophagitis (EoE) is endoscopy with esophageal biopsy to determine the eosinophil count. A non-invasive biomarker of eosinophil activation would be helpful in management. A recent study investigated urinary 3-bromotyrosine (3-BT) measurements as a possible biomarker.
An assay called the Eosinophil Quantitated Urine Kinetic was developed. In the EoE patients, median urinary 3-BT level was 93 times higher than the nonatopic (nonallergic) group and 13 times higher than the atopic (allergic) group. Subjects with urine 3-BT level greater than 20pg/400mg of creatinine were 4.8 times more likely to have EoE compared to atopic controls. An atopic disease flare was not associated with any difference in urinary 3-BT.
Urinary 3-BT is an exciting assay that may assist allergists for the diagnosis of EoE.
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