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The Esophageal String Test as a Diagnostic Screening Tool for Eosinophilic Esophagitis Among Africans With Dysphagia in Mali and the United States

Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) • ClinicalTrials.gov ID: NCT07027826

Registry updated: 2026-10-20

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Description

Background: Eosinophilic esophagitis (EoE) is a disease that causes inflammation in the esophagus. The esophagus is the tube that moves food from the mouth to the stomach. Diagnosing EoE currently requires a specialized tool called an endoscope. The esophageal string test (EST) is another test; the EST collects fluid from the upper digestive tract. An EST is simpler and cheaper than an endoscopy. Researchers want to know if an EST can diagnose EoE. Objective: To test if the EST can diagnose EoE in people who have trouble swallowing. Eligibility: Adults aged 18 to 65 years with trouble swallowing. They must have been born in the African continent or their parents were born in Africa. Design: Participants will be screened. They will give blood, stool, urine, and skin swab samples. They will complete surveys about their medical history, diet, symptoms, and home environment. They will bring a sample of their drinking water for testing. Participants will have an EST. They will swallow a pill capsule that contains a nylon string. One end of the string will be taped to their cheek. The string will unravel down the esophagus and into the stomach. It will be pulled out after 1 hour. Fluids that soaked into the string will be tested. At a different visit, participants will have an endoscopic exam. An endoscope is a flexible tube that is inserted down the mouth; it can be used to take tissue samples from the esophagus, stomach, and small intestine. Participants will have a final visit in person, online, or by phone. They will take a survey and talk about their test results.

Interventions

Esophageal string test (Device)
The esophageal string test consists of a gelatin or cellulose capsule containing a nylon string. The capsule dissolves allowing the nylon string to absorb esophageal secretions which can be analyzed for various inflammatory mediators.

Eligibility criteria

* INCLUSION CRITERIA: In order to be eligible to participate in this study, an individual must meet all of the following criteria: 1. Able to provide informed consent. 2. Aged 18 to 65 years. 3. Born in the African continent or their parents were born in Africa, 4. Exhibiting symptoms of dysphagia and/or prior history of food impaction. 5. Undergoing clinically indicated endoscopy at the NIH Clinical Center (U.S.), Centre Hospitalier Universitaire Gabriel Tour(SqrRoot)(Copyright) (Mali), or other local clinics (Mali) and willing to provide research samples and data. EXCLUSION CRITERIA: An individual who meets any of the following criteria will be excluded from participation in this study: 1. Recent steroid use (systemic or swallowed/topical corticosteroid) within 4 weeks prior to endoscopy. 2. Recent use of dupilumab (Dupixent) within the last 6 months. 3. Recent use of other biologic medications (within either 6 months or 5 half-lives, whichever is longer). Examples of biologic medications include: 3a. mepolizumab (Nucala) 3b. reslizumab (Cinqair, Cinqaero) 3c. benralizumab (Fasenra) 3d. cendakimab 3e. tezepelumab (Tezspire) 3f. barzolvolimab 4\. Individuals suffering from a bleeding diathesis (e.g., hemophilia, severe thrombocytopenia). 5\. Current use of anticoagulant medications. 6\. Pregnancy. 7\. Treatment with another investigational drug or other investigational intervention within 6 months or 5 half-lives whichever is longer. 8\. Individuals with a known history of any of the following: 8a. eosinophilic esophagitis 8b. esophageal stricture unable to be passed with an upper endoscope 8c. esophageal cancer 8d. esophageal motility disorder (e.g., achalasia) 8e. esophageal varices 8f. esophageal or gastric surgery including fundoplication 8g. neurologic cause of dysphagia (e.g., stroke, Parkinson s disease, etc.) 8h. allergy to gelatin 8i. inability to swallow pills 9\. Any condition that, in the investigator s opinion, places the individual at undue risk by participating in the study. Co-enrollment guidelines: Co-enrollment in other trials is restricted, other than enrollment on observational studies. Consideration for co-enrollment in trials evaluating the use of a licensed medication will require the approval of the principal investigator in consultation with the medical monitor. Study staff should be notified of co-enrollment on any other protocol as it may require the approval of the principal investigator.

Conditions

Dysphagia Eosinophilic Esophagitis

Locations

National Institutes of Health Clinical Center — Bethesda, Maryland, United States
Gabriel Toure University Hospital Center — Bamako, Mali
Mali International Center for Excellence in Research — Bamako, Mali

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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