QuBIE: Quantitative Biomarker Identification for Non-Endoscopic Prediction and Monitoring of Treatment Response in Eosinophilic Oesophagitis

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Eosinophilic oesophagitis (EoE) is a disease of the oesophagus ("food pipe") affecting tens of thousands of adults and children across the UK. Related to asthma, allergies and other chronic inflammatory conditions, this disease has been on the rise in the last decade. However, it can often take years and even several trips to A&E due to food getting stuck in the oesophagus before a diagnosis is made. Treatments are available, but not all patients respond to treatment and the only way to check response is an invasive endoscopy. Finding the right treatment can take multiple endoscopies in a single year, and even after one is found a patient will need regular endoscopies throughout their life.This project aims to improve patient care in EoE in two ways: by decreasing the need for endoscopy through use of the minimally-invasive capsule sponge testing to collect cells from the oesophagus, and providing a personalised predictive test for therapy response.Our capsule sponge test has already been used by more than 15,000 patients across the UK as part of an early cancer detection programme, decreasing the need for endoscopies in patients who are at the lowest risk and ensuring patients who need care are identified more quickly. Instead of an hours-long endoscopy in a hospital setting, the capsule sponge test can be performed in an office-based setting by a nurse in less than 10 minutes.We have partnered with three NHS Trusts who have used our early detection test in cancer and further believe that this is the best approach for non-endoscopic EoE testing. Patients who are known to have EoE will be recruited and offered both an endoscopy and a capsule sponge test. The resulting information will be clinically validated diagnoses alongside biomarker measurements, providing a clear readout on personalised EoE management.Our expertise in biomarker development with input from the top clinical experts in EoE across the UK will enable us to provide a non-endoscopic biomarker test for patients that will be robust, less invasive, provide greater information to clinicians, and enable patients to better manage their disease.