The Minimally Invasive 1-Hour Esophageal String Test Monitors Therapeutic Changes in Mucosal Inflammation in Eosinophilic Esophagitis

Am J Gastroenterol. 2025 Jan 1;120(1):254-258. doi: 10.14309/ajg.0000000000003192. Epub 2024 Nov 6.

Abstract

Introduction: Endoscopy, standard-of-care for monitoring eosinophilic esophagitis (EoE), assesses mucosal inflammation. The Esophageal String Test (EST), a minimally invasive swallowed capsule and immunoassays, quantifies EoE inflammation. We determined whether the EST/EoEScore can monitor disease in patients undergoing treatment.

Methods: Thirty-three samples from 14 patients with EoE (7 children, 7 adults) who underwent repeat endoscopies and ESTs were studied. Biopsies were analyzed for peak eosinophil counts; ESTs were analyzed for EoEScores.

Results: Eosinophil counts and EoEScores significantly correlated during treatment, distinguishing patients with active EoE from treatment-associated remissions for 93.9% of ESTs performed.

Discussion: The EST can be used to longitudinally monitor responses to treatment in EoE.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Eosinophilic Esophagitis* / diagnosis
  • Eosinophilic Esophagitis* / pathology
  • Eosinophils
  • Esophageal Mucosa / diagnostic imaging
  • Esophageal Mucosa / pathology
  • Esophagoscopy / methods
  • Esophagus / pathology
  • Female
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Young Adult