Eosinophilic Colitis Distinct Disease From EGIDs and IBD

Eosinophilic colitis (EoC), or colonic eosinophilia, was established as a distinct disease rather than a colonic manifestation of eosinophilic gastrointestinal diseases (EGIDs) or inflammatory bowel disease (IBD), according to findings of a recent study.

The investigators conducted colonic molecular profiles of 61 patients enrolled across sites associated with the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). The patients were separated into 2 cohorts, those with EoC (n = 27) and a control, including patients without conditions (“normal” or NL, n = 20), or Crohn disease (CD, n = 14).

According to the authors, “EoC was diagnosed as colonic eosinophilia (ascending ≥100, descending ≥85, sigmoid ≥65 eosinophils/high-power field) with related symptoms.” Colon biopsies underwent RNA sequencing and “associations between gene expression and histologic features were analyzed with Spearman correlation; operational pathways and cellular constituents were computationally derived,” the authors wrote.

The authors wrote that they identified “987 differentially expressed genes (EoC transcriptome) between EoC and NL (>1.5-fold change, P < .05). Colonic eosinophil count correlated with 31% of EoC transcriptome,” with minimal transcriptomic overlap between EoC and other EGIDs.  “EoC transcriptome–based scores were reversible with disease remission and differentiated EoC from IBD, even after controlling for colonic eosinophil levels (P < .0001).”

With this study, the researchers established EoC transcriptomic profiles, identified mechanistic pathways, and integrated findings with parallel IBD and EGID data. These findings will provide a basis for improved diagnosis and treatment.

—Allison Casey

Reference:
Shoda T, Collins MH, Rochman M. Evaluating eosinophilic colitis as a unique disease using colonic molecular profiles: A multi-site study. Gastroenterology. Published online January 24, 2022. DOI: https://doi.org/10.1053/j.gastro.2022.01.022