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| Name | Class |
|---|---|
| Seattle Children's Hospital | OTHER |
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This study aims to introduce a new dietary therapy for Eosinophilic Esophagitis (EoE) patients by using partial enteral nutrition (PEN) to enhance remission rates and explore how this approach affects immune function, gut microbiota, and environmental toxin exposures.
The purpose of this research project is to offer patients diagnosed with Eosinophilic Esophagitis (EoE) a novel dietary therapy approach which models that of evidence-based dietary therapy used in Crohn's disease and the principles of dietary antigen elimination currently successfully implemented in EoE patients. The study proposes using partial enteral nutrition (PEN) to improve remission rates in EoE patients and investigate the mechanism by which these effects immune dysregulation, microbiota shifts, and through assessment of changes in environmental toxin exposure.
Objectives 1: Determine clinical and endoscopic remission rates, adherence, nutrition, and anthropometric measures in EoE patients prior to and three months after PEN with dairy elimination.
Objectives 2: Investigate immune profiles in EoE patients prior to and three months after PEN with dairy elimination.
Objectives 3: Investigate the microbiota in EoE patients prior to and three months after PEN with dairy elimination.
Objectives 4: Investigate environmental contaminants prior to and three months after PEN with dairy elimination.
It is hypothesized favorable shifts in the microbiota, immune system, and environmental contaminants will be present following three months of PEN in the EoE patient population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | 12 participants will be control subjects without diagnosis of EoE | |
| Dairy Free | Experimental | 12 subjects will be enrolled in the dairy free diet group. |
|
| Dairy free + Partial Enteral Nutrition (PEN) diet | Experimental | 12 subjects will be enrolled in the diary free and 50% PEN diet |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Partial enteral nutrition (PEN) with dairy elimination | Other | Patients in the PEN with dairy elimination group will receive 50% calories from Kate Farms Standard 1.2 formula and 50% dairy free regular diet. |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility of PEN assessed by 3-day diet record | Feasibility and adherence of PEN in EoE patients will be evaluated using 3-day diet records collected at 2 weeks post initiation of the study and at 3 months. | 3 months |
| Tolerability of PEN in EoE patients will be assessed by stool quality evaluated using the Bristol Stool Chart. | Bristol stool chart will be used to assess stool quality at 2 weeks and at month 3. | 3 months |
| Clinical and endoscopic remission rates assessed by mucosal eosinophilia and Eosinophilic Esophagitis Histology Scoring System (EoE-HSS) from GI tissue biopsies | For baseline and three-month tissue collection, GI tissue biopsies will be obtained at the time of clinical endoscopy assess mucosal eosinophilia and EoE-HSS. | 3 months |
| Immune profiles assessed by blood markers | Immune profiles in EoE patients will be assessed by blood markers using CBC with differential, comprehensive metabolic panel, C-Reactive Protein, and Erythrocyte Sedimentation Rate before and after PEN and dairy elimination. | 3 months |
| Microbiota shifts in EoE patients | Microbiota shifts will be assessed from stool metabolomics, urine metabolomics, oral swab microbiome, and esophageal brushing of EoE before and after PEN and dairy free diets. | 3 months |
| Environmental contaminants assessed by blood serum levels | Environmental contaminants assessed by CBC with differential before and after PEN with dairy elimination. |
| Measure | Description | Time Frame |
|---|---|---|
| Nutritional status assessed by 3-day diet record and blood collection | Nutrition status of EoE will be assessed by the collection a 3-day diet record, vitamin D, vitamin B12, iron, total iron binding capacity, and ferritin at baseline and 3 months. | 3 months |
| Growth and development assessed by anthropometric measure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Danny Gagucas | Contact | 206-987-1062 | Danny.Gagucas@seattlechildrens.org |
| Name | Affiliation | Role |
|---|---|---|
| Michael Pickens, DO | Seattle Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seattle Children's Hospital | Recruiting | Seattle | Washington | 98105 | United States |
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| ID | Term |
|---|---|
| D057765 | Eosinophilic Esophagitis |
| ID | Term |
|---|---|
| D004941 | Esophagitis |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| C058388 | penclomedine |
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| Dairy elimination alone | Other | Participants in this group will be on a dairy-free regular diet alone. |
|
| 3 months |
Z-scores for height and weight will be collected at baseline and at 3 months. |
| 3 months |
| D005759 |
| Gastroenteritis |
| D004802 | Eosinophilia |
| D007960 | Leukocyte Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |