Eosinophilic oesophagitis (EoE) is a chronic clinicopathologic allergic gastrointestinal disorder, with increasing prevalence. Although immense efforts have been invested in understanding this emerging disease, to date there is a limit to treatment options, treatment effectiveness and no cure. Additionally, to date there have been no investigations specifically examining Irish EoE patients, who are regularly diagnosed at Our Lady’s Children’s Hospital Crumlin.
Currently the main treatment available to EoE patients is steroids. It is estimated that up to 60% of Irish patients return following treatment and are deemed by their doctors to still have active disease, despite high-dose topical steroid therapy. There are currently no other medicines besides steroids available and medically approved for treating EoE. Recent Swiss studies determined a low 16.1% complete remission rate in low-dose swallowed topical corticosteroid maintenance treatment, while estimates from around the world are between 25-40% of other populations studied also don’t respond optimally to high-dose topical steroid treatment. The consequences of ineffectively treated disease are continuing symptoms, eventual oesophageal narrowing and sometimes the need for surgical removal of foods ‘impacted’ in the oesophagus. Eventually food avoidance behaviours and significant quality of life impacts for children with EoE and their families have been well documented.
Through this project we will address this problem from a mechanistic (understanding how) and predictive biomarker (who is more liable to be) approach and develop research strategies benefitting patients who are steroid non-/poorly-responsive. These will be attractive avenues to target clinically, therapeutically and for the patients themselves.
