**AWARDS ISSUED PRIOR TO JANUARY 20, 2025, WERE FUNDED UNDER PREVIOUS ADMINISTRATIONS AND MAY NOT REFLECT THE PRIORITIES AND POLICIES OF THE CURRENT ADMINISTRATION.** EOSINOPHILIC ESOPHAGITIS (EOE) IS AN INCREASINGLY RECOGNIZED INFLAMMATORY DISEASE OF THE ESOPHAGUS RESULTING IN DIFFICULTY SWALLOWING, ESOPHAGEAL TISSUE CHANGES, AND RECURRENT FOOD IMPACTIONS. EOE AFFECTS ALL AGES, RACES, AND GENDERS AND IS INCREASING IN PREVALENCE. DESPITE FOODS BEING THE PRIMARY TRIGGER OF EOE, PATIENTS CONTINUE TO STRUGGLE TO MANAGE THEIR DISEASE DUE TO A LACK OF ACCURATE FOOD ALLERGY TESTING. INSTEAD, PATIENTS WILL UNDERGO CUMBERSOME AND TIME-CONSUMING ELIMINATION DIETS THAT REQUIRE MULTIPLE ENDOSCOPIES FOR DISEASE RESOLUTION. TWO-THIRDS OF EOE PATIENTS REPORT THAT THE CURRENT MANAGEMENT OF THE DISEASE IS UNAFFORDABLE. THIS RESEARCH IS RELEVANT TO PUBLIC HEALTH BECAUSE IT FOCUSES ON THE DEVELOPMENT OF A NEW AND ALTERNATIVE STRATEGY TO GUIDE ELIMINATION DIETS FOR THE MANAGEMENT OF EOE.SECRETIONS ALONG THE ENTIRE LENGTH OF THE ESOPHAGEAL SURFACE CONTAIN VALUABLE INFORMATION ON THE RESPONSE TO FOODS IN EOE, AS MEASURED BY FOOD-SPECIFIC ANTIBODIES. USING ESOPHAGEAL SECRETIONS FROM EOE PATIENTS, WE WILL OPTIMIZE THE DEVELOPMENT AND INTERPRETATION OF A TEST THAT WILL MEASURE THE FOOD-SPECIFIC ANTIBODIES TO TOP TRIGGER FOODS (WHEAT, DAIRY, EGG, AND SOY). TEST STANDARDS FOR INTERPOLATION, TEST FOOD PROTEINS AND THE FOOD-SPECIFIC ANTIBODY PROFILE IN ESOPHAGEAL SECRETIONS, SALIVA, AND SERUM WILL BE DETERMINED. WE WILL THEN TRIAL THE ACCURACY OF THIS FOOD-SPECIFIC ANTIBODY TEST TO PREDICT FOOD(S) TRIGGERING IN EOE. THE SIGNIFICANCE OF THE RESEARCH IS THE ADVANCEMENT OF A CUSTOM FOOD-SPECIFIC ANTIBODY TEST BY ESTABLISHING REASONABLE EMPIRICAL THRESHOLDS TO BE USED IN FUTURE CLINICAL TRIALS. ULTIMATELY, VALIDATING THE ACCURACY OF THIS FOOD-SPECIFIC ANTIBODY TEST TO IDENTIFY FOOD TRIGGERS IN EOE LEADS TO EFFICIENT, PERSONALIZED ELIMINATION DIETS AND REDUCES PATIENT COSTS AND THE BURDEN OF DISEASE MANAGEMENT. THIS PRECISION MEDICINE APPROACH WILL IMPROVE HEALTH AND QUALITY OF LIFE.