Component-Resolved Diagnostics Enhance Allergen Precision in EoE
A narrative review highlights the emerging role of component-resolved diagnostics (CRD) and molecular tools in improving dietary management strategies for eosinophilic esophagitis (EoE), while emphasizing the continued need for empiric elimination diets in clinical practice.
While dietary elimination remains a mainstay of therapy, current methods for identifying specific triggers are largely empiric and can lead to unnecessary food exclusions.
Across multiple observational and cohort studies, CRD has demonstrated improved sensitivity in identifying relevant allergen sensitizations compared with conventional testing. “Current evidence supports CRD as a promising adjunctive tool that enhances the precision of allergen identification,” the authors wrote.
However, the review also notes that remission rates achieved through CRD-guided diets remain comparable or slightly lower than those associated with empiric elimination, underscoring the need for further validation. “CRD is not yet ready to replace empiric dietary strategies,” the authors concluded.
The review also explores emerging omics-based technologies—including gene expression profiling and proteomic biomarkers—that may further refine patient endotyping. These molecular diagnostics offer a pathway to more personalized management but are not yet standardized for routine clinical use.
Looking ahead, the integration of CRD and omics data with dietitian-led nutritional assessments and biomarker monitoring may offer a more comprehensive, patient-centered approach. “Future research should focus on validating standardized CRD-guided algorithms and developing non-invasive diagnostic platforms,” the authors added.
Until such tools are fully validated, empiric elimination remains the cornerstone of dietary therapy in EoE, with CRD serving as an adjunct to support individualized care and potentially reduce unnecessary dietary restrictions.
Reference
Wawrzeńczyk A, Napiórkowska-Baran K, Szota M, Treichel P, Durślewicz J, Bartuzi Z. Dietary management of eosinophilic esophagitis in the era of molecular diagnostics: The role and limitations of component-resolved diagnostics-a narrative review. Nutrients. Published online November 17, 2025. doi:10.3390/nu17223588
