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Revisiting the Role of Esophageal Mucosal Dilated Intercellular Spaces in the Diagnosis and Pathophysiology of Heartburn.

作者信息

Gorgulu Volkan, Ergun Pelin, Kipcak Sezgi, Doganavsargil Basak, Sifrim Daniel, Bor Serhat

机构信息

Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey.

Department of Medical Biochemistry, Faculty of Medicine, Ege University, Izmir, Turkey.

出版信息

J Neurogastroenterol Motil. 2023 Oct 30;29(4):436-445. doi: 10.5056/jnm22142.


DOI:10.5056/jnm22142
PMID:37814434
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10577464/
Abstract

BACKGROUND/AIMS: Dilated intercellular spaces (DISs) facilitate the diffusion of noxious agents into the deep layers of the esophageal epithelium. The role of DIS in heartburn pathogenesis is still controversial. Therefore, we aim to reinvestigate DIS in an extensively evaluated group of patients and healthy controls (HCs). METHODS: We classified 149 subjects into the following groups: 15 HC, 58 mild erosive reflux disease (ERD), 17 severe ERD, 25 nonerosive reflux disease (NERD), 15 reflux hypersensitivity (RH), and 19 functional heartburn (FH). A total of 100 length measurements were performed for each patient's biopsy. RESULTS: The overall intercellular spaces (ISs) value of gastroesophageal reflux disease (GERD) patients was higher than that of HC ( = 0.020). In phenotypes, mild ERD (vs HC [ = 0.036], NERD [ = 0.004], RH [ = 0.014]) and severe ERD (vs HC [ = 0.002], NERD [ < 0.001], RH [ = 0.001], FH [ = 0.004]) showed significantly higher IS. There was no significant difference between the HC, NERD, RH, and FH groups. The 1.12 μm DIS cutoff value had 63.5% sensitivity and 66.7% specificity in the diagnosis of GERD. There was a weak correlation ( = 0.302) between the IS value and acid exposure time, and a weak correlation ( = -0.359) between the IS value and baseline impedance. A strong correlation was shown between acid exposure time and baseline impedance ( = -0.783). CONCLUSIONS: Since the IS length measurement had better discrimination power only in erosive groups, it is not feasible to use in daily routine to discriminate other nonerosive phenotypes and FH. The role of DIS in heartburn in nonerosive patients should be reconsidered.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2705/10577464/c9c14a78d2d2/jnm-29-4-436-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2705/10577464/8adee6cb3793/jnm-29-4-436-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2705/10577464/c9c14a78d2d2/jnm-29-4-436-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2705/10577464/8adee6cb3793/jnm-29-4-436-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2705/10577464/c9c14a78d2d2/jnm-29-4-436-f2.jpg

相似文献

[1]
Revisiting the Role of Esophageal Mucosal Dilated Intercellular Spaces in the Diagnosis and Pathophysiology of Heartburn.

J Neurogastroenterol Motil. 2023-10-30

[2]
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[3]
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本文引用的文献

[1]
Sample size determination and power analysis using the G*Power software.

J Educ Eval Health Prof. 2021

[2]
Mucosal pathogenesis in gastro-esophageal reflux disease.

Neurogastroenterol Motil. 2020-12

[3]
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Gut. 2020-10-9

[4]
Phenotypes of Gastroesophageal Reflux Disease: Where Rome, Lyon, and Montreal Meet.

Clin Gastroenterol Hepatol. 2020-4

[5]
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Ann Card Anaesth. 2019

[6]
Modern diagnosis of GERD: the Lyon Consensus.

Gut. 2018-2-3

[7]
Esophageal Baseline Impedance Reflects Mucosal Integrity and Predicts Symptomatic Outcome With Proton Pump Inhibitor Treatment.

J Neurogastroenterol Motil. 2018-1-30

[8]
Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease.

J Neurogastroenterol Motil. 2017-10-30

[9]
Reflux Hypersensitivity: A New Functional Esophageal Disorder.

J Neurogastroenterol Motil. 2017-10-30

[10]
Superficial Esophageal Mucosal Afferent Nerves May Contribute to Reflux Hypersensitivity in Nonerosive Reflux Disease.

Gastroenterology. 2017-7-20

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