IL-18 stimulates iNKT cells and endothelial cells leading to induction of EoE cytokines IL-5 and IL-13.28 Finally, it has also been suggested that EoE in adults is likely an IgG4-associated disease and not an IgE-induced allergy based on failure of omalizumab (anti-IgE recombinant DNA-derived humanized IgG1k monoclonal antibody) to alter symptoms of EoE compared with placebo.29 Our study demonstrates that a single biomarker may not be sufficient to diagnose or monitor EoE and rather, a biomarker panel or network may be the way of the future. This evidence concerns the gene IL18 and allergic disease.