Correlation of Probe-Based Confocal Laser Endomicroscopy (pCLE) and Mucosal Integrity Testing (MIT) with Epithelial Barrier Function and Presence of Gastroesophageal Reflux Disease (GERD).

Autor: Mutha PR; Division of Gastroenterology, Hunter Holmes McGuire Richmond VA Medical Center, Gastroenterology # 111N, Richmond, VA, 23249, USA. Pritesh.Mutha@va.gov.; Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA. Pritesh.Mutha@va.gov., Fasullo M; Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA., Chu S; Division of Mathematics, General and Health Sciences, John Tyler Community College, Chester, VA, USA., Schubert ML; Division of Gastroenterology, Hunter Holmes McGuire Richmond VA Medical Center, Gastroenterology # 111N, Richmond, VA, 23249, USA.; Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA., Zfass A; Division of Gastroenterology, Hunter Holmes McGuire Richmond VA Medical Center, Gastroenterology # 111N, Richmond, VA, 23249, USA.; Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA., Cooper P; Division of Gastroenterology, Hunter Holmes McGuire Richmond VA Medical Center, Gastroenterology # 111N, Richmond, VA, 23249, USA., Gill M; Division of Gastroenterology, Hunter Holmes McGuire Richmond VA Medical Center, Gastroenterology # 111N, Richmond, VA, 23249, USA., Kang L; Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA., Vaezi M; Department of Gastroenterology and Hepatology, Vanderbilt University, Nashville, TN, USA., Wildhorn S; Diversatek Healthcare, Highlands Ranch, CO, USA., Slaughter C; Department of Biostatistics, Vanderbilt University, Nashville, TN, USA., Shah T; Division of Gastroenterology, Hunter Holmes McGuire Richmond VA Medical Center, Gastroenterology # 111N, Richmond, VA, 23249, USA.; Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2022 May; Vol. 67 (5), pp. 1773-1782. Date of Electronic Publication: 2021 May 03.
DOI: 10.1007/s10620-021-06980-w
Abstrakt: Introduction: Epithelial barrier function (EBF) disruption is a key mechanism underlying gastroesophageal reflux disease (GERD). Our aim was to assess whether two novel technologies, probe-based confocal laser endomicroscopy (pCLE) and mucosal integrity testing (MIT), could assess EBF.
Methods: We prospectively enrolled patients undergoing upper endoscopy for refractory GERD or non-GERD conditions. Patients underwent esophagogastroduodenoscopy, pCLE, MIT, esophageal biopsy at 2 cm and 6 cm above the esophagogastric junction, and wireless pH testing. To assess EBF in vitro, biopsies were mounted in a mini-Ussing chamber, 1 ml of fluorescein was instilled on the mucosal side, and concentration of fluorescein on the serosal side was measured at 3 h.
Results: We enrolled 54 subjects (28 GERD, 26 non-GERD based on Lyon consensus criteria). In vivo permeability assessed by pCLE did not differ significantly between GERD vs. non-GERD patients and did not correlate with in vitro permeability. Mean MIT at 2 cm was lower in GERD compared to non-GERD (1914 vs. 3727 ohms). MIT correlated inversely with in vitro permeability at 2 cm and at 6 cm. Using a predictive model that used slope and intercept of MIT at 2 cm and 6 cm, sensitivity and specificity of MIT at identifying GERD was 76% and 72%, respectively.
Conclusion: pCLE did not differentiate GERD vs non-GERD and did not correlate with EBF measured in vitro. MIT, on the other hand, may be more promising as it differentiated GERD vs non-GERD and correlated with EBF measured in vitro.
(© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)
Databáze: MEDLINE
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