(Overall) This renewal application aims to continue research on rare eosinophilic gastrointestinal diseases with a focus on eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC) through the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). CEGIR will promote highly collaborative, multi-site, patient-centric, translational, and clinical research with the intent of addressing unmet clinical trial readiness needs. CEGIR comprises clinical centers in Ohio (coordinating center), Colorado, Arkansas, California, Illinois, Maryland, Massachusetts, Minnesota, New York, North Carolina, Pennsylvania, Tennessee, Texas, and Utah. The CEGIR sites have been carefully chosen on the basis of their pre-existing record of collaboration and success with each other before and during the first cycle of CEGIR; diverse expertise in relevant clinical specialties including Gastroenterology, Allergy, Immunology, Nutrition, and Pathology; the ability to integrate pediatric and adult patients into a common consortium; well-established record of excellence in clinical and translational research involving this patient population; and excellent mentorship experience and capacity to impact early stage trainees? career development. CEGIR sites have proven access to an adequate number of patients with EoE, EG, EGE, and EC, as evidenced from completion of several controlled clinical trials involving these patients. Proactive patient advocacy groups (PAGs), including the American Partnership for Eosinophilic Disorders and the Campaign Urging Research for Eosinophilic Disease, partner synergistically in the context of CEGIR. Though still in a relatively early stage, CEGIR is demonstrating success via its collaborative interactions between investigators (at all stages of career development including newly established promising faculty who represent the next generation of thought leaders), highly engaged PAGs, and partnering institutions and has emerged into the leading research group focused on rare EoE, EG, EGE, and EC. Current and proposed CEGIR initiatives are developing clinical trial readiness for this set of rare diseases, such as the establishment of deeply phenotyped and genotyped patients who are ready to participate in research and emerging tools that quantify clinical states, endoscopic abnormalities, tissue pathology, and patient well-being. In this renewal application, investigators plan to study an already developed observational cohort of patients, providing a valuable opportunity for longitudinal analyses. Data emerging from this cohort has already substantiated the association of type 2 allergic immunity (e.g. IL-13) in the pathogenesis of EG, leading to a proposal, described herein, to examine the impact of a promising new anti-type 2 immunity therapeutic (dupilumab, anti-IL-4Ra). CEGIR includes transformative Pilot-Feasibility and Career Enhancement Cores based on collaboration across and outside of the RDCRN and which will collectively test novel hypotheses, particularly focused on enhancing clinical trial readiness and attracting early stage investigators for careers in rare disease research.

Public Health Relevance

(Overall) Eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, and eosinophilic colitis are challenging rare diseases that make it difficult to live normally or impossible for many suffering individuals to eat many or all foods. These diseases are relatively poorly understood compared with other forms of allergy and gastrointestinal inflammatory diseases, in part due to their rare nature and early stages of research. Herein, we propose to partner with researchers, patients, and other key groups to better understand, treat, educate, and optimize clinical trial readiness of these rare diseases.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZTR1)
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Minnicozzi, Michael
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Cincinnati Children's Hospital Medical Center
United States
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Durrani, Sandy R; Mukkada, Vincent A; Guilbert, Theresa W (2018) Eosinophilic Esophagitis: an Important Comorbid Condition of Asthma? Clin Rev Allergy Immunol 55:56-64
Rochman, Mark; Azouz, Nurit P; Rothenberg, Marc E (2018) Epithelial origin of eosinophilic esophagitis. J Allergy Clin Immunol 142:10-23
Philpott, Hamish; Dellon, Evan (2018) Histologic improvement after 6 weeks of dietary elimination for eosinophilic esophagitis may be insufficient to determine efficacy. Asia Pac Allergy 8:e20
Fahey, Lisa M; Chandramouleeswaran, Prasanna M; Guan, Shaobo et al. (2018) Food allergen triggers are increased in children with the TSLP risk allele and eosinophilic esophagitis. Clin Transl Gastroenterol 9:139
Wechsler, Joshua B; Bolton, Scott M; Amsden, Katie et al. (2018) Eosinophilic Esophagitis Reference Score Accurately Identifies Disease Activity and Treatment Effects in Children. Clin Gastroenterol Hepatol 16:1056-1063
Spergel, Jonathan M; Aceves, Seema S; Kliewer, Kara et al. (2018) New developments in patients with eosinophilic gastrointestinal diseases presented at the CEGIR/TIGERS Symposium at the 2018 American Academy of Allergy, Asthma & Immunology Meeting. J Allergy Clin Immunol 142:48-53
Pesek, Robert D; Gupta, Sandeep K (2018) Emerging drugs for eosinophilic esophagitis. Expert Opin Emerg Drugs 23:173-183
Schwartz, Justin T; Morris, David W; Collins, Margaret H et al. (2018) Eosinophil progenitor levels correlate with tissue pathology in pediatric eosinophilic esophagitis. J Allergy Clin Immunol :
Mark, Jacob; Fernando, Shahan D; Masterson, Joanne C et al. (2018) Clinical Implications of Pediatric Colonic Eosinophilia. J Pediatr Gastroenterol Nutr 66:760-766
Nguyen, N; Fernando, S D; Biette, K A et al. (2018) TGF-?1 alters esophageal epithelial barrier function by attenuation of claudin-7 in eosinophilic esophagitis. Mucosal Immunol 11:415-426

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