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Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: a cross-sectional study

Overview of attention for article published in The Lancet Gastroenterology & Hepatology, May 2018
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  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#15 of 1,650)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

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58 news outlets
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14 X users
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6 Facebook pages

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137 Dimensions

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Title
Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: a cross-sectional study
Published in
The Lancet Gastroenterology & Hepatology, May 2018
DOI 10.1016/s2468-1253(18)30096-7
Pubmed ID
Authors

Tetsuo Shoda, Ting Wen, Seema S Aceves, J Pablo Abonia, Dan Atkins, Peter A Bonis, Julie M Caldwell, Kelley E Capocelli, Christina L Carpenter, Margaret H Collins, Evan S Dellon, Michael D Eby, Nirmala Gonsalves, Sandeep K Gupta, Gary W Falk, Ikuo Hirano, Paul Menard-Katcher, Jonathan T Kuhl, Jeffrey P Krischer, John Leung, Vincent A Mukkada, Jonathan M Spergel, Michael P Trimarchi, Guang-Yu Yang, Nives Zimmermann, Glenn T Furuta, Marc E Rothenberg, Consortium of Eosinophilic Gastrointestinal Disease Researchers

Abstract

Eosinophilic oesophagitis is understood in terms of quantifiable histological, endoscopic, and molecular features. Data are scant for inter-relations of these features and their potential to identify distinct disease endotypes. We aimed to identify clinical-pathological correlations between endoscopic and histological disease variables by transcription profiling of the oesophagus of patients with eosinophilic oesophagitis of varying severity and disease activity states. We did a cross-sectional study across ten hospital sites in the USA associated with the Consortium of Eosinophilic Gastrointestinal Disease Researchers. We analysed oesophageal biopsy specimens taken from paediatric and adult patients with eosinophilic oesophagitis (discovery cohort), using the eosinophilic oesophagitis diagnostic panel (EDP), a set of 96 informative transcripts. Histological and endoscopic features were assessed by quantification of oesophageal eosinophils and use of the eosinophilic oesophagitis histology scoring system (HSS) and the eosinophilic oesophagitis endoscopic reference score (EREFS). Associations among the various histological, endoscopic, and molecular features were analysed by Spearman correlation. Results were replicated in a biologically independent, single-centre, validation cohort of patients with active eosinophilic oesophagitis. The discovery cohort contained 185 samples and the validation cohort comprised 100 specimens. In the discovery cohort, EDP showed intersite consistency, significant correlation with oesophageal eosinophils (p<0·0001), and similar findings between paediatric and adult patients. Of eight HSS domains, basal zone hyperplasia correlated with the EDP (median Spearman ρ 0·47 [IQR 0·36-0·60]). Of five EREFS features, distal furrows correlated with the EDP (median Spearman ρ 0·42 [0·32-0·50]). By analysing active eosinophilic oesophagitis in the discovery cohort, the EDP identified three clusters associated with distinct endotypes (termed EoEe1-3) despite similar eosinophil levels. EoEe1 was associated with a normal-appearing oesophagus (risk ratio [RR] 3·27, 95% CI 1·04-10·27; p=0·0443), an inverse association with a history of oesophageal dilation (0·27, 0·09-0·82; p=0·0105) and showed relatively mild histological, endoscopic, and molecular changes. EoEe2 showed an inflammatory and steroid-refractory phenotype (RR 2·77, 95% CI 1·11-6·95; p=0·0376) and had the highest expression of inflammatory cytokines and steroid-responding genes. EoEe3 was associated with a narrow-calibre oesophagus (RR 7·98, 95% CI 1·84-34·64; p=0·0013) and adult onset (2·22, 1·19-4·12; p=0·0155), and showed the highest degree of endoscopic and histological severity and the lowest expression of epithelial differentiation genes. These endotypes were replicated in the validation cohort by clustering and with an eosinophilic oesophagitis endotype-prediction algorithm. Our new disease classification stratifies patients with eosinophilic oesophagitis into subgroups with potential clinical and therapeutic significance and provides a framework for a precision medicine approach to eosinophilic oesophagitis. National Institutes of Health.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 97 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 97 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 16 16%
Other 9 9%
Student > Master 9 9%
Student > Ph. D. Student 7 7%
Student > Postgraduate 5 5%
Other 22 23%
Unknown 29 30%
Readers by discipline Count As %
Medicine and Dentistry 34 35%
Biochemistry, Genetics and Molecular Biology 5 5%
Immunology and Microbiology 3 3%
Agricultural and Biological Sciences 3 3%
Engineering 3 3%
Other 13 13%
Unknown 36 37%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 458. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 September 2023.
All research outputs
#59,848
of 25,382,440 outputs
Outputs from The Lancet Gastroenterology & Hepatology
#15
of 1,650 outputs
Outputs of similar age
#1,383
of 338,967 outputs
Outputs of similar age from The Lancet Gastroenterology & Hepatology
#2
of 46 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,650 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 38.2. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 338,967 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.