Eosinophilic esophagitis program
The eosinophilic esophagitis (EoE) program is a multi- disciplinary program devoted to the comprehensive care and research of children diagnosed with eosinophilic esophagitis. Located at our Outpatient Center in Lincoln Park, the program serves the growing number of children who suffer from EoE.
Patients are seen by a dedicated, multi-disciplinary team that includes pediatric gastroenterologists, a pediatric allergist, a registered dietitian, a pediatric nurse practitioner, and registered nurses. The EoE care team provides state of the art diagnostic testing including upper endoscopy,
allergy blood testing, skin prick testing, as well as several novel experimental non-invasive or minimally-invasive tests. The treatments offered are individualized to the specific needs of the patients. The treatments include different diets, and drugs. The dietary options include elemental diet, standard or empiric elimination diet and directed elimination diet, the later based on results of allergy testing. The drug treatment options include oral steroids and swallowed steroids.
The members of the EoE program include:
- Amir Kagalwalla, MD - Co-director
- Barry Wershil, MD - Co-director, Head, Gastroenterology, Hepatology and Nutrition
- Melanie Makhija, MD - Program allergist
- Maria Manuel-Rubio, APN - Program nurse practitioner
- Sally Ritz, RD - Program dietician
- Ronda Shaykin, RN - Program nurse clinician
- Emily Whalen, RN - Program nurse clinician
- Patricia Reamer, RN - Program nurse clinician
- Bernadette Czyz, RN - Program nurse clinician
- Katie Amsden - Clinical research coordinator
Members of the EoE program are currently participating in translational research to advance understanding of this complex disease.
Clinical research
The EoE program has an active and growing research component and members of the EoE program participate in both clinical and laboratory research to advance understanding of this complex disease. In addition to participation in clinical trials, the members of EoE team are collaborating with other institutions to advance basic and clinical research in this area. The eosinophilic esophagitis program is participating in the following studies at the present time:
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Potential non-invasive biomarkers as a surrogate to repeated histologic evaluation to assess esophageal inflammation.
Currently the only way doctors can diagnose the damage of EoE is by performing an endoscopy with biopsy. We have special laboratory tests that may help us understand the causes of esophageal diseases. Tissues, blood and urine obtained during this study will be used to better understand why these diseases happen. We hope to find out how the esophagus changes and what is causing this to happen.
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Evaluation of esophageal inflammation (the "string test")
More here about the string test.
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Eosinophilic Esophagitis Database Project
This study aims to collect and analyze data from EoE patients seen at Children's Memorial Hospital (CMH) for a period of six years to better understand the etiology, pathogenesis and clinical presentation of EoE. With this information, we hope to better define its association with other atopic conditions including reactive airway disease, seasonal allergies and atopic dermatitis. The database will allow clinicians to better evaluate the effectiveness of therapeutic strategies used to treat patients with EoE. -
Efficacy of drug (anti-IL5) for patients with eosinophilic esophagitis
Some patients do not respond to the standard treatment methods for EoE, researchers are looking at new drug treatment options for these patients. The purpose of this study is to assess how well the drug, reslizumab, works in improving the clinical signs and symptoms of eosinophilic esophagitis.
* Clinical trial participation is offered to CMH patients who meet appropriate criteria and are interested Laboratory research
Dr. Wershil and his lab staff are involved in a variety of research projects related to eosinophilic esophagitis. Dr. Wershil's research interests include the role of mast cells in GI inflammation and homeostasis. This work involves the use of mouse models to investigate mast cells and mast cell mediators in a variety of inflammatory reactions, including allergic, neurogenic, and immune inflammation. The lab is also interested in studying the pathogenesis of eosinophilic esophagitis, and specifically the mediators that influence the pathology of the esophagus by using immunohistochemistry and the molecular biology method.
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Understanding the mechanism of remodeling in EoE
This research project involves studying the natural history and inflammation in the esophagus of patients with eosinophilic esophagitis (EoE).