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Page 8 of 10 Lambert et al. J Transl Genet Genom 2018;2:11. I https://doi.org/10.20517/jtgg.2018.11

Table 3. Currently identified eosinophilic esophagitis endotypes
Clinical features Endotype 1 Endotype 2 Endotype 3
Endoscopic appearance Normal Inflammation Fibrostenotic
Steroid responsiveness Sensitive Refractory Mixed responses
Disease onset No age Predominance Pediatric Adult
Atopic status Atopic No clear association with atopy Non-atopic

Molecular profiling of esophageal biopsies from a recent cohort of nearly 200 adult and pediatric patients was correlated with other
clinical features of EoE in order to identify three clusters or distinct groups of disease. The three groups or endotypes range in severity
from mild (Endotype 1) to severe (Endotype 3) [42]

5p in EoE samples compared to control. Expression of miR-3613-5p and miR-4668-5p decreased in patients
following fluticasone treatment, suggesting these two miRNAs may be candidate biomarkers for surveilling
[40]
treatment response . Similarly, Swanson et al. profiled salivary miRNA in a pediatric cohort and dis-
[41]
covered 97 differentially expressed miRNAs, with miR-223 having the greatest level of expression. Here too,
Swanson et al. demonstrate the potential for identifying noninvasive miRNA biomarkers in saliva.
[41]
FUTURE PERSPECTIVES AND CONCLUSIONS
Our understanding of miRNA contributions to inflammation and the regulation of immune function has
improved but still remains underdeveloped. In particular, there are many unanswered questions regarding
the role of miRNAs in eosinophilic esophagitis. Recent work has defined three main disease endotypes [Table 3]
that associate with phenotypic and clinical features of EoE . These newly identified EoE endotypes have
[42]
not yet been correlated with miRNA expression. It stands to be seen whether miRNAs are differentially ex-
pressed between EoE endotypes and whether miRNAs can then be used to predict disease course and treat-
ment responsiveness for these subpopulations of disease. Similarly, the effects of dietary modification, acid
suppression, and emerging biologic therapies on miRNA profiles in EoE are also under investigation. Future
work that compares miRNA expression among growing cohorts of individuals with EoE may uncover dis-
tinct ‘miRNA fingerprints’ to guide effective and personalized treatment.

DECLARATIONS
Authors’ contributions
Literature research: Lambert KA, Jhaveri P
Manuscript writing and figures: Lambert KA
Manuscript editing: Jhaveri P, Jhaveri P
Manuscript revision: Lambert KA, Jhaveri P, Jhaveri P

Availability of data and materials
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Financial support and sponsorship
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Conflicts of interest
All authors declare that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.