Correlation of ALOX15 expression with eosinophilic or reflux esophagitis in a cohort of pediatric patients with esophageal eosinophilia

Andres Matoso, Danisha Allen, Michael Herzlinger, Jason Ferreira, Sonja Chen, Shaolei Lu, Valeria Fabre, Renee Monahan, Dongfang Yang, Lelia Noble, Shamlal Mangray, Murray B. Resnick

Research output: Contribution to journalArticle

Abstract

The differential diagnosis between eosinophilic esophagitis (EoE) and gastroesophageal reflux disease (GERD) is often challenging. We recently showed that the ALOX15 protein is expressed in 95% of esophageal biopsies from patients with a definitive diagnosis of EoE. Here we correlated ALOX15 expression with the clinical classification of EoE or GERD in a cohort of consecutive pediatric patients (n = 62) with at least 1 esophageal biopsy containing at least 15 eosinophils per high-power field (eos/HPF). The patients were categorized into the following groups: (1) at least 15 eos/HPF in the distal esophagus only (n = 24), (2) at least 15 eos/HPF in the proximal esophagus only (n = 5), and (3) at least 15 eos/HPF in the distal and proximal biopsies (n = 33). Control groups included patients with GERD with biopsies containing 6 to 15 eos/HPF (n = 9), patients with GERD with 5 eos/HPF or less (n = 15), patients with candida esophagitis (n = 15), and patients with normal biopsies (n = 15). ALOX15 was positive in 90.5% of patients with EoE (13/16 in group 1, 4/4 in group 2, 31/33 in group 3) versus 44% of patients with GERD (4/8 in group 1, 0/1 in group 2, and 0/0 in group 3), 2 of 9 (22%) of patients with 6 to 15 eos/HPF, and was negative in all patients with GERD with biopsies containing 5 eos/HPF or less, all patients with candida esophagitis, and all normal controls. In conclusion, ALOX15 is a sensitive marker of EoE; however, subpopulations of patients with GERD with >5 eos/HPF also express ALOX15. Positive ALOX15 expression is more prevalent in EoE than in GERD and may prove to be a useful diagnostic marker in patients with discrepant biopsy findings between the proximal and distal esophagus.

Original languageEnglish (US)
Pages (from-to)1205-1212
Number of pages8
JournalHuman pathology
Volume45
Issue number6
DOIs
StatePublished - Jun 2014

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Keywords

  • ALOX15
  • Biomarker
  • Eosinophilic esophagitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Matoso, A., Allen, D., Herzlinger, M., Ferreira, J., Chen, S., Lu, S., Fabre, V., Monahan, R., Yang, D., Noble, L., Mangray, S., & Resnick, M. B. (2014). Correlation of ALOX15 expression with eosinophilic or reflux esophagitis in a cohort of pediatric patients with esophageal eosinophilia. Human pathology, 45(6), 1205-1212. https://doi.org/10.1016/j.humpath.2014.01.021