Tabatabaei Nima, Kang Dongkyun, Wu Tao, Kim Minkyu, Carruth Robert W, Leung John, Sauk Jenny S, Shreffler Wayne, Yuan Qian, Katz Aubrey, Nishioka Norman S, Tearney Guillermo J
Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA ; School of Engineering, The University of Tokyo, Yayoi 2-11-16 Bunkyo, Tokyo 113-8656, Japan.
Biomed Opt Express. 2013 Dec 13;5(1):197-207. doi: 10.1364/BOE.5.000197.
Eosinophilic esophagitis (EoE) is an allergic condition that is characterized by eosinophils infiltrating the esophageal wall. The treatment of the disease may require multiple follow up sedated endoscopies and biopsies to confirm elimination of eosinophils. These procedures are expensive, time consuming, and may be difficult for patients to tolerate. Here we report on the development of a confocal microscopy capsule for diagnosis and monitoring of EoE. The swallowable capsule implements a high-speed fiber-based reflectance confocal microscopy technique termed Spectrally Encoded Confocal Microscopy (SECM). SECM scans the sample in one dimension without moving parts by using wavelength swept source illumination and a diffraction grating at the back plane of the objective lens. As the wavelength of the source is tuned, the SECM optics within the 7 x 30 mm capsule are rotated using a driveshaft enclosed in a 0.8 mm flexible tether. A single rotation of the optics covered a field of view of 22 mm x 223 µm. The lateral and axial resolutions of the device were measured to be 2.1 and 14 µm, respectively. Images of Acetic Acid stained swine esophagus obtained with the capsule ex vivo and in vivo clearly showed squamous epithelial nuclei, which are smaller and less reflective than eosinophils. Imaging of esophageal biopsies from EoE patients ex vivo demonstrated the capability of this technology to visualize individual eosinophils. Based on the results of this study, we believe that this capsule will be a simpler and more effective device for diagnosing EoE and monitoring the therapeutic response of this disease.
嗜酸性粒细胞性食管炎（EoE）是一种过敏性疾病，其特征是嗜酸性粒细胞浸润食管壁。该疾病的治疗可能需要多次后续的镇静内镜检查和活检，以确认嗜酸性粒细胞已消除。这些程序昂贵、耗时，且患者可能难以耐受。在此，我们报告一种用于诊断和监测EoE的共聚焦显微镜胶囊的研发情况。这种可吞咽胶囊采用了一种基于光纤的高速反射共聚焦显微镜技术，称为光谱编码共聚焦显微镜（SECM）。SECM通过使用扫频光源照明和物镜后平面的衍射光栅，在不移动部件的情况下对样本进行一维扫描。随着光源波长的调整，7×30毫米胶囊内的SECM光学元件通过包裹在0.8毫米柔性系绳中的驱动轴进行旋转。光学元件单次旋转覆盖的视野为22毫米×223微米。该设备的横向和轴向分辨率分别测量为2.1微米和14微米。用该胶囊在体外和体内获得的醋酸染色猪食管图像清楚地显示了鳞状上皮细胞核，其比嗜酸性粒细胞更小且反射性更低。对EoE患者食管活检样本进行的体外成像证明了该技术可视化单个嗜酸性粒细胞的能力。基于本研究结果，我们认为这种胶囊将是一种用于诊断EoE和监测该疾病治疗反应的更简单、更有效的设备。
