Evidence map›Paper›PMID 31567192›Full record

ArticleThe American journal of gastroenterology2019

One-Hour Esophageal String Test: A Nonendoscopic Minimally Invasive Test That Accurately Detects Disease Activity in Eosinophilic Esophagitis.

Steven J Ackerman, Amir F Kagalwalla, Ikuo Hirano, Nirmala Gonsalves, Paul Menard Katcher, Sandeep Gupta, Joshua B Wechsler, Milica Grozdanovic, Zhaoxing Pan, Joanne C Masterson and 16 more

Registry-linked trialOpen access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02008903 (Phase 2 Study of Esophageal String Test in Diagnosing Eosinophilic Esophagitis), which is not on this map. Cited by 51 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 3 pooled it
9.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02008903 active not recruitingnot on this map

Phase 2 Study of Esophageal String Test in Diagnosing Eosinophilic Esophagitis

TypeobservationalSponsorUniversity of Colorado, DenverRan2009 to 2027Enrolled440ConditionsEosinophilic Esophagitis
3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 95 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Shifting the scope: Moving toward less invasive diagnosis and monitoring of eosinophilic esophagitis.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2026
    Review
  8. Review
  9. Emerging Tissue and Blood Biomarkers for Eosinophilic Esophagitis.Gastroenterology clinics of North America · 2026
    Review
  10. Review
  11. Review
  12. Review
  13. Review
  14. Review
  15. Review
  16. Review
  17. Clinical monitoring of eosinophilic esophagitis using the esophageal string test.The journal of allergy and clinical immunology. In practice · 2025
    Article
  18. Implementation of the esophageal string test in clinical practice and research.The Journal of allergy and clinical immunology · 2025
    Article
  19. The Dynamic Evolution of Eosinophilic Esophagitis.Diagnostics (Basel, Switzerland) · 2025
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors at 7 institutions in 2 countries.

Steven J AckermanDepartments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Amir F KagalwallaDepartment of Pediatrics, Lurie Children's Hospital and Northwestern University, Chicago, Illinois, USA.
Ikuo HiranoDepartment of Medicine, Section of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Nirmala GonsalvesDepartment of Medicine, Section of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Paul Menard KatcherDepartment of Medicine, Section of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Sandeep GuptaDepartment of Pediatrics, Section of Pediatric Gastroenterology, Children's Hospital of Illinois, University of Illinois, Peoria, Chicago, Illinois, USA.
Joshua B WechslerDepartment of Pediatrics, Lurie Children's Hospital and Northwestern University, Chicago, Illinois, USA.
Milica GrozdanovicDepartments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Zhaoxing PanDepartment of Pediatrics, Gastrointestinal Eosinophilic Diseases Program.
Joanne C MastersonDepartment of Pediatrics, Gastrointestinal Eosinophilic Diseases Program.
Jian DuDepartments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Robert J FantusDepartments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Preeth AlumkalDepartments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
James J LeeDepartment of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA.
Sergei OchkurDepartment of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA.
Faria AhmedMucosal Inflammation Program, University of Colorado School of Medicine, Aurora, Colorado, USA.
Kelley CapocelliDepartment of Pathology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Hector Melin-AldanaDepartment of Pathology, Lurie Children's Hospital and Northwestern University, Chicago, Illinois USA.
Kathryn BietteDepartment of Pediatrics, Gastrointestinal Eosinophilic Diseases Program.
Allison DubnerDepartment of Medicine, Section of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Katie AmsdenDepartment of Pediatrics, Lurie Children's Hospital and Northwestern University, Chicago, Illinois, USA.
Kaitlin KeeleyDepartment of Pediatrics, Lurie Children's Hospital and Northwestern University, Chicago, Illinois, USA.
Maureen SulkowskiDepartment of Pediatrics, Lurie Children's Hospital and Northwestern University, Chicago, Illinois, USA.
Angelika ZalewskiDepartment of Medicine, Section of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Dan AtkinsDepartment of Pediatrics, Gastrointestinal Eosinophilic Diseases Program.
Glenn T FurutaDepartment of Pediatrics, Gastrointestinal Eosinophilic Diseases Program.
University of Colorado Denver · USLurie Children's Hospital · USUniversity of Illinois Chicago · USNorthwestern University · USChildren's Hospital Colorado · USMayo Clinic in Arizona · USChildren's Hospital of Illinois · US

Funding

Phase 2 Study of Esophageal String Test in Diagnosing Eosinophilic EsophagitisR01FD004086 · FDA · UNIVERSITY OF COLORADO DENVER · PI ACKERMAN, STEVEN JULES, FURUTA, GLENN T · 2013 to 2018
$1.6M
FDA HHS R01 FD004086
6 · The paper itself

Abstract

objectivesEosinophilic esophagitis (EoE), a chronic food allergic disease, lacks sensitive and specific peripheral biomarkers. We hypothesized that levels of EoE-related biomarkers captured using a 1-hour minimally invasive Esophageal String Test (EST) would correlate with mucosal eosinophil counts and tissue concentrations of these same biomarkers. We aimed to determine whether a 1-hour EST accurately distinguishes active from inactive EoE or a normal esophagus.

methodsIn a prospective, multisite study, children and adults (ages 7-55 years) undergoing a clinically indicated esophagogastroduodenoscopy performed an EST with an esophageal dwell time of 1 hour. Subjects were divided into 3 groups: active EoE, inactive EoE, and normal esophageal mucosa. Eosinophil-associated protein levels were compared between EST effluents and esophageal biopsy extracts. Statistical modeling was performed to select biomarkers that best correlated with and predicted eosinophilic inflammation.

resultsOne hundred thirty-four subjects (74 children, 60 adults) with active EoE (n = 62), inactive EoE (n = 37), and patient controls with a normal esophagus (n = 35) completed the study. EST-captured eosinophil-associated biomarkers correlated significantly with peak eosinophils/high-power field, endoscopic visual scoring, and the same proteins extracted from mucosal biopsies. Statistical modeling, using combined eotaxin-3 and major basic protein-1 concentrations, led to the development of EoE scores that distinguished subjects with active EoE from inactive EoE or normal esophagi. Eighty-seven percent of children, 95% of parents, and 92% of adults preferred the EST over endoscopy if it provided similar information. DISCUSSION: The 1-hour EST accurately distinguishes active from inactive EoE in children and adults and may facilitate monitoring of disease activity in a safe and minimally invasive fashion.

Indexed as

EosinophilsAdolescentAdultBiomarkersBiopsyChemokine CCL24Chemokine CCL26ChildEndoscopy, Digestive SystemEosinophilic EsophagitisEsophageal MucosaEsophagusFeasibility StudiesFemaleHumansLeukocyte CountBiomarkersCCL24 protein, humanCCL26 protein, humanChemokine CCL24Chemokine CCL26

Identifiers

PMID31567192
PMCPMC6784776
OpenAlexW2976359726

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.