Eosinophilic esophagitis histology scoring system in patients before and following benralizumab treatment
| Patient ID . | Benralizumab status . | Esophagus location . | Peak eos/HPF . | *Grade score . | †Stage score . | EI grade . | EI stage . | BZH grade . | BZH stage . | EA grade . | EA stage . | ESL grade . | ESL stage . | DIS grade . | DIS stage . | SEA grade . | SEA stage . | DEC grade . | DEC stage . | LPF grade . | LPF stage . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Pre | Distal | 23 | 0.24 | 0.1 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 2 | Pre | Distal | 162 | 0.79 | 0.67 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 3 | 3 | 2 | 1 | 1 | 1 | 3 | 3 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 1 | 3 | |
| 3 | Pre | Proximal | 117 | 0.58 | 0.63 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 1 | 1 | 2 | 3 |
| Post | Proximal | 0 | 0.38 | 0.25 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 1 | |
| 4 | Pre | Esophagus | 30 | 0.29 | 0.38 | 2 | 3 | 1 | 2 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.33 | 0.21 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | |
| 5 | Pre | Distal | 252 | 0.52 | 0.52 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.38 | 0.38 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | |
| 6 | Pre | Proximal | 151 | 0.79 | 0.79 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 3 | 3 | 3 | 3 | 3 | 0 | 0 | 3 | 3 |
| Post | Proximal | 0 | 0.1 | 0.05 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 7 | Pre | Distal | 38 | 0.46 | 0.38 | 2 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 8 | Pre | Proximal | 184 | 0.48 | 0.52 | 3 | 3 | 3 | 3 | 1 | 2 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Proximal | 0 | 0.33 | 0.24 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 9 | Pre | Distal | 64 | 0.5 | 0.5 | 3 | 3 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 |
| Post | Distal | 3 | 0.29 | 0.29 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 10 | Post | Distal | 0 | 0.24 | 0.1 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 11 | Pre | Proximal | 132 | 0.54 | 0.54 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 2 | 3 | 3 | 0 | 0 | 0 | 0 | 2 | 1 |
| Post | Distal | 0 | 0.29 | 0.19 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | n/a | n/a |
| Patient ID . | Benralizumab status . | Esophagus location . | Peak eos/HPF . | *Grade score . | †Stage score . | EI grade . | EI stage . | BZH grade . | BZH stage . | EA grade . | EA stage . | ESL grade . | ESL stage . | DIS grade . | DIS stage . | SEA grade . | SEA stage . | DEC grade . | DEC stage . | LPF grade . | LPF stage . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Pre | Distal | 23 | 0.24 | 0.1 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 2 | Pre | Distal | 162 | 0.79 | 0.67 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 3 | 3 | 2 | 1 | 1 | 1 | 3 | 3 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 1 | 3 | |
| 3 | Pre | Proximal | 117 | 0.58 | 0.63 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 1 | 1 | 2 | 3 |
| Post | Proximal | 0 | 0.38 | 0.25 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 1 | |
| 4 | Pre | Esophagus | 30 | 0.29 | 0.38 | 2 | 3 | 1 | 2 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.33 | 0.21 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | |
| 5 | Pre | Distal | 252 | 0.52 | 0.52 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.38 | 0.38 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | |
| 6 | Pre | Proximal | 151 | 0.79 | 0.79 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 3 | 3 | 3 | 3 | 3 | 0 | 0 | 3 | 3 |
| Post | Proximal | 0 | 0.1 | 0.05 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 7 | Pre | Distal | 38 | 0.46 | 0.38 | 2 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 8 | Pre | Proximal | 184 | 0.48 | 0.52 | 3 | 3 | 3 | 3 | 1 | 2 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Proximal | 0 | 0.33 | 0.24 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 9 | Pre | Distal | 64 | 0.5 | 0.5 | 3 | 3 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 |
| Post | Distal | 3 | 0.29 | 0.29 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 10 | Post | Distal | 0 | 0.24 | 0.1 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 11 | Pre | Proximal | 132 | 0.54 | 0.54 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 2 | 3 | 3 | 0 | 0 | 0 | 0 | 2 | 1 |
| Post | Distal | 0 | 0.29 | 0.19 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | n/a | n/a |
Patients before (pre) and following (post) benralizumab treatment in tissue location with peak eosinophil counts and associated histology scores. Patient 1 had no tissue collected during follow-up due to complications during EGD. Patient 10 tissue was unavailable as EGD was completed outside of university system. To account for missing features, scores were normalized by dividing the observed total score by the maximal possible score for that biopsy (e.g. maximum score 21 for those missing lamina propria) to result in a ‘total score ratio’ that is designated as ‘composite score’ in the table.14
*Composite histology grade scoring is severity; scale 0 (normal) to 3 (severe).
†Composite histology stage scoring is extent; scale 0 (normal) to 3 (severe). BZH, basal zone hyperplasia; DIS, dilated intercellular spaces; DEC, dyskeratotic epithelial cells; EA, eosinophil abscess; ESL, eosinophil surface layering; eos/HPF, eosinophils/high power field; EI, esophageal inflammation; LPF, lamina propria fibrosis; n/a, not available; SEA, surface epithelial alteration.
Eosinophilic esophagitis histology scoring system in patients before and following benralizumab treatment
| Patient ID . | Benralizumab status . | Esophagus location . | Peak eos/HPF . | *Grade score . | †Stage score . | EI grade . | EI stage . | BZH grade . | BZH stage . | EA grade . | EA stage . | ESL grade . | ESL stage . | DIS grade . | DIS stage . | SEA grade . | SEA stage . | DEC grade . | DEC stage . | LPF grade . | LPF stage . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Pre | Distal | 23 | 0.24 | 0.1 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 2 | Pre | Distal | 162 | 0.79 | 0.67 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 3 | 3 | 2 | 1 | 1 | 1 | 3 | 3 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 1 | 3 | |
| 3 | Pre | Proximal | 117 | 0.58 | 0.63 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 1 | 1 | 2 | 3 |
| Post | Proximal | 0 | 0.38 | 0.25 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 1 | |
| 4 | Pre | Esophagus | 30 | 0.29 | 0.38 | 2 | 3 | 1 | 2 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.33 | 0.21 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | |
| 5 | Pre | Distal | 252 | 0.52 | 0.52 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.38 | 0.38 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | |
| 6 | Pre | Proximal | 151 | 0.79 | 0.79 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 3 | 3 | 3 | 3 | 3 | 0 | 0 | 3 | 3 |
| Post | Proximal | 0 | 0.1 | 0.05 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 7 | Pre | Distal | 38 | 0.46 | 0.38 | 2 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 8 | Pre | Proximal | 184 | 0.48 | 0.52 | 3 | 3 | 3 | 3 | 1 | 2 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Proximal | 0 | 0.33 | 0.24 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 9 | Pre | Distal | 64 | 0.5 | 0.5 | 3 | 3 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 |
| Post | Distal | 3 | 0.29 | 0.29 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 10 | Post | Distal | 0 | 0.24 | 0.1 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 11 | Pre | Proximal | 132 | 0.54 | 0.54 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 2 | 3 | 3 | 0 | 0 | 0 | 0 | 2 | 1 |
| Post | Distal | 0 | 0.29 | 0.19 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | n/a | n/a |
| Patient ID . | Benralizumab status . | Esophagus location . | Peak eos/HPF . | *Grade score . | †Stage score . | EI grade . | EI stage . | BZH grade . | BZH stage . | EA grade . | EA stage . | ESL grade . | ESL stage . | DIS grade . | DIS stage . | SEA grade . | SEA stage . | DEC grade . | DEC stage . | LPF grade . | LPF stage . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Pre | Distal | 23 | 0.24 | 0.1 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 2 | Pre | Distal | 162 | 0.79 | 0.67 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 3 | 3 | 2 | 1 | 1 | 1 | 3 | 3 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 1 | 3 | |
| 3 | Pre | Proximal | 117 | 0.58 | 0.63 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 1 | 1 | 2 | 3 |
| Post | Proximal | 0 | 0.38 | 0.25 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 1 | |
| 4 | Pre | Esophagus | 30 | 0.29 | 0.38 | 2 | 3 | 1 | 2 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.33 | 0.21 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | |
| 5 | Pre | Distal | 252 | 0.52 | 0.52 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Distal | 0 | 0.38 | 0.38 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | |
| 6 | Pre | Proximal | 151 | 0.79 | 0.79 | 3 | 3 | 3 | 3 | 3 | 1 | 1 | 3 | 3 | 3 | 3 | 3 | 0 | 0 | 3 | 3 |
| Post | Proximal | 0 | 0.1 | 0.05 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 7 | Pre | Distal | 38 | 0.46 | 0.38 | 2 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 2 |
| Post | Distal | 0 | 0.33 | 0.33 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 8 | Pre | Proximal | 184 | 0.48 | 0.52 | 3 | 3 | 3 | 3 | 1 | 2 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a |
| Post | Proximal | 0 | 0.33 | 0.24 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 1 | 1 | 0 | 0 | n/a | n/a | |
| 9 | Pre | Distal | 64 | 0.5 | 0.5 | 3 | 3 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 |
| Post | Distal | 3 | 0.29 | 0.29 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | 3 | 3 | 0 | 0 | 0 | 0 | n/a | n/a | |
| 10 | Post | Distal | 0 | 0.24 | 0.1 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 | n/a | n/a |
| 11 | Pre | Proximal | 132 | 0.54 | 0.54 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 2 | 3 | 3 | 0 | 0 | 0 | 0 | 2 | 1 |
| Post | Distal | 0 | 0.29 | 0.19 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | 3 | 2 | 0 | 0 | 0 | 0 | n/a | n/a |
Patients before (pre) and following (post) benralizumab treatment in tissue location with peak eosinophil counts and associated histology scores. Patient 1 had no tissue collected during follow-up due to complications during EGD. Patient 10 tissue was unavailable as EGD was completed outside of university system. To account for missing features, scores were normalized by dividing the observed total score by the maximal possible score for that biopsy (e.g. maximum score 21 for those missing lamina propria) to result in a ‘total score ratio’ that is designated as ‘composite score’ in the table.14
*Composite histology grade scoring is severity; scale 0 (normal) to 3 (severe).
†Composite histology stage scoring is extent; scale 0 (normal) to 3 (severe). BZH, basal zone hyperplasia; DIS, dilated intercellular spaces; DEC, dyskeratotic epithelial cells; EA, eosinophil abscess; ESL, eosinophil surface layering; eos/HPF, eosinophils/high power field; EI, esophageal inflammation; LPF, lamina propria fibrosis; n/a, not available; SEA, surface epithelial alteration.
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