Endoscopic Tool for Esophageal Delivery
Student Team: GI Joes
Nicolas Castro, Julius Chai, Nicholas Riccardelli, Anna Romanov, and Lee-Kai Sun
Anand, Jain, MD Emory University Hospital
Eosinophilic esophagitis (EoE) is an allergic disease of the esophagus characterized by the presence of eosinophils on biopsy. EoE is typically mediated by chronic exposure to allergens from six food groups: milk, wheat, nuts, egg, soy, seafood; however, conventional skin-based allergy tests, such as skin prick or patch tests, do not accurately identify food triggers associated with EoE. As a result, identification of the trigger allergen involves the elimination of the 6 food groups from the patient’s diet, reintroduction of each food group, and endoscopy following each introduction. Limited meal variety, cost of allergen-free foods, and number of endoscopies required to identify the food allergen can significantly impair patient quality of life. Market analysis estimated a cost of $6.4 billion annually for the treatment and management of eosinophilic esophagitis in the U.S. Therefore, there is a need for a device to accurately test for food allergens in EoE. Here, we designed an external endoscopic attachment to deliver up to 4 allergens to the esophageal wall. The device is tendon actuated and is predicted to safely present food allergens without esophageal injury. Through diffusion studies, allergen presentation is predicted to be localized to the device application area without causing an acute immune reaction. Following allergen presentation, the application areas may be sampled via biopsy during endoscopy. Together, this device may enable accurate, multiplexed identification of food allergens while eliminating the need for multiple endoscopies and improving the diagnostic process for EoE.
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