EoP –Biomarker or Balderdash?

One of the categories in the game of balderdash is abbreviations.  Someone with extra time on their hands should invent a medical version with obscure acronyms as one of the categories.

An acronym that I recently discovered, EoP, which stands for eosinophil progenitor came to my attention from Dr. Benjamin Enav and Dr. Oral Alpan. they suggested two articles (both letters to the editor) related to EoP as a biomarker for eosinophilic esophagitis:

  • DW Morris et al. J Allergy Clin Immunol 2016;138: 915-8.
  • JT Schwartz et al. J Allergy Clin Immunol 2019; 143: 1221-3.

Both of these articles came from researchers at the Cincinnati Children’s Hospital.  In the first, the authors studied 31 children (17 with active eosinophilic esophagitis [EoE], and 14 with inactive EoE).  Key findings:

  • With a cutoff of 15.5 EoPs/mL, there were none of the 17 patients with active EoE below this threshold and 8 of 14 (57%) with inactive EoE were below this threshold.
  • At this cutoff, this pilot study predicted active EoE with a sensitivity of 100%, specificity of 57%, positive predictive value of 74% and negative predictive value of 100%.

The second study, also with 31 children, showed that the peripheral blood EoP levels were significantly increased in patients with active disease and correlated with the
EoEHSS (EoE histologic scoring system) composite ratio.

My take: These studies show that a blood level of EoP is a promising biomarker which could help avoid endoscopy in those with low levels of EoP.

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