Mo1679 Development and Validation of a Novel Ultra-Mobile Ambulatory Total Parenteral Nutrition Model

G A A b st ra ct s previously have described the presence of cytokines in saliva which also are present in blood and esophageal tissue and have been suggested as playing a fundamental role in the pathogenesis of EoE. However, the usefulness of these salivary cytokines in discriminating between patients with/without EoE and their potential correlation with esophageal eosinophilia have not been examined. Methods In this cross−sectional study, we collected saliva using oral swabs (OS; Salimetrics Oral Swab®, Salimetrics LLC, PA) at the time of upper gastrointestinal endoscopy in sixteen children being evaluated for gastroesophageal and/or dyspeptic symptoms. Children with oral lesions, neurodevelopmental disorders, inflammatory bowel disease, or celiac disease were excluded. Six children were diagnosed with EoE and ten children had no evidence of EoE and were considered Controls (Table). Esophageal histology was compared between groups. Salivary cytokines: IL−4, IL−5, and IL−13 were measured on a high sensitivity human multiplex platform, and eotaxin 3 (Eo3) and thymic stromal lymphopoietin (TSLP) by sandwich ELISA technique. Differences between groups were evaluated using the Wilcoxon rank sum test. Spearman's correlation was performed to examine potential associations between salivary cytokines and esophageal eosinophils per high powered field (eos/hpf). Results See Table. Age and sex were comparable between groups. Median salivary IL−5 and IL−4 concentrations were significantly greater in patients with EoE than in Controls. In contrast, there were no differences between groups in median IL−13, Eo3, or TSLP concentrations although values were numerically higher in patients with EoE. Salivary IL−4 and IL−5 were positively correlated with eos/hpf in the distal esophagus (Spearman's ρ=0.53; P=0.03 and ρ=0.56; P=0.02, respectively). In contrast, IL−13, Eo3, and TSLP did not correlate with histologic findings. Conclusions Our preliminary data suggest that salivary cytokines, specifically IL−4 and IL−5 have the potential to distinguish children with vs without EoE. Salivary concentrations of these cytokines appear to reflect esophageal eosinophilic infiltration in EoE. Confirmation of our findings in a larger sample with additional types of disease controls may simplify management and reduce the cost of caring for children with EoE. Table: Summary of results