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Dilated intercellular spaces as a marker of oesophageal damage: comparative results in gastro-oesophageal reflux disease with or without bile reflux.
Aliment Pharmacol Ther 2003; 18(5):525-32AP

Abstract

BACKGROUND

The dilation of oesophageal intercellular spaces, clearly apparent in transmission electron microscopy images, is a marker of cellular damage induced by acid.

AIM

To analyse the presence of dilated intercellular spaces and to quantify the scores in controls and in patients with gastro-oesophageal reflux disease or duodenal gastro-oesophageal reflux accompanied by erosive or non-erosive reflux disease.

METHODS

Thirty-eight symptomatic patients with gastro-oesophageal reflux disease or duodenal gastro-oesophageal reflux and 12 asymptomatic controls, classified on the basis of pH-metry and bilimetry, underwent endoscopy. Six tissue biopsies were taken from the normal mucosa for light microscopy and transmission electron microscopy evaluation. Dilated intercellular spaces were measured on photomicrographs of the specimens (at least 100 transects were measured for each patient).

RESULTS

Twenty-two patients with gastro-oesophageal reflux disease had normal macroscopic mucosa but, at histology, five patients with erosive gastro-oesophageal reflux disease had mild oesophagitis and one had moderate oesophagitis. Seven patients with duodenal gastro-oesophageal reflux had normal mucosa, whilst three with erosive duodenal gastro-oesophageal reflux had mild oesophagitis at histology. At transmission electron microscopy, all controls had dilated intercellular spaces of less than 1.69 microm. Each symptomatic patient had a mean dilated intercellular space value and a mean value of the maximum dilated intercellular space at least three or more times greater than that in controls (P < 0.001). No statistical differences were observed between erosive and non-erosive oesophagitis.

CONCLUSIONS

The dilated intercellular space is an extremely sensitive marker of damage in gastro-oesophageal reflux disease, duodenal gastro-oesophageal reflux and non-erosive reflux disease, and serves as the most appropriate marker of damage evaluation in non-erosive reflux disease reported to date. A mean dilated intercellular space of 0.74 micro m provides a cut-off score for damage. No quantitative or qualitative differences in dilated intercellular space scores were found between pure and mixed acid reflux.

Authors+Show Affiliations

Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy. calabrese.c@med.unibo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12950425

Citation

Calabrese, C, et al. "Dilated Intercellular Spaces as a Marker of Oesophageal Damage: Comparative Results in Gastro-oesophageal Reflux Disease With or Without Bile Reflux." Alimentary Pharmacology & Therapeutics, vol. 18, no. 5, 2003, pp. 525-32.
Calabrese C, Fabbri A, Bortolotti M, et al. Dilated intercellular spaces as a marker of oesophageal damage: comparative results in gastro-oesophageal reflux disease with or without bile reflux. Aliment Pharmacol Ther. 2003;18(5):525-32.
Calabrese, C., Fabbri, A., Bortolotti, M., Cenacchi, G., Areni, A., Scialpi, C., ... Di Febo, G. (2003). Dilated intercellular spaces as a marker of oesophageal damage: comparative results in gastro-oesophageal reflux disease with or without bile reflux. Alimentary Pharmacology & Therapeutics, 18(5), pp. 525-32.
Calabrese C, et al. Dilated Intercellular Spaces as a Marker of Oesophageal Damage: Comparative Results in Gastro-oesophageal Reflux Disease With or Without Bile Reflux. Aliment Pharmacol Ther. 2003 Sep 1;18(5):525-32. PubMed PMID: 12950425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dilated intercellular spaces as a marker of oesophageal damage: comparative results in gastro-oesophageal reflux disease with or without bile reflux. AU - Calabrese,C, AU - Fabbri,A, AU - Bortolotti,M, AU - Cenacchi,G, AU - Areni,A, AU - Scialpi,C, AU - Miglioli,M, AU - Di Febo,G, PY - 2003/9/3/pubmed PY - 2003/11/7/medline PY - 2003/9/3/entrez SP - 525 EP - 32 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 18 IS - 5 N2 - BACKGROUND: The dilation of oesophageal intercellular spaces, clearly apparent in transmission electron microscopy images, is a marker of cellular damage induced by acid. AIM: To analyse the presence of dilated intercellular spaces and to quantify the scores in controls and in patients with gastro-oesophageal reflux disease or duodenal gastro-oesophageal reflux accompanied by erosive or non-erosive reflux disease. METHODS: Thirty-eight symptomatic patients with gastro-oesophageal reflux disease or duodenal gastro-oesophageal reflux and 12 asymptomatic controls, classified on the basis of pH-metry and bilimetry, underwent endoscopy. Six tissue biopsies were taken from the normal mucosa for light microscopy and transmission electron microscopy evaluation. Dilated intercellular spaces were measured on photomicrographs of the specimens (at least 100 transects were measured for each patient). RESULTS: Twenty-two patients with gastro-oesophageal reflux disease had normal macroscopic mucosa but, at histology, five patients with erosive gastro-oesophageal reflux disease had mild oesophagitis and one had moderate oesophagitis. Seven patients with duodenal gastro-oesophageal reflux had normal mucosa, whilst three with erosive duodenal gastro-oesophageal reflux had mild oesophagitis at histology. At transmission electron microscopy, all controls had dilated intercellular spaces of less than 1.69 microm. Each symptomatic patient had a mean dilated intercellular space value and a mean value of the maximum dilated intercellular space at least three or more times greater than that in controls (P < 0.001). No statistical differences were observed between erosive and non-erosive oesophagitis. CONCLUSIONS: The dilated intercellular space is an extremely sensitive marker of damage in gastro-oesophageal reflux disease, duodenal gastro-oesophageal reflux and non-erosive reflux disease, and serves as the most appropriate marker of damage evaluation in non-erosive reflux disease reported to date. A mean dilated intercellular space of 0.74 micro m provides a cut-off score for damage. No quantitative or qualitative differences in dilated intercellular space scores were found between pure and mixed acid reflux. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/12950425/Dilated_intercellular_spaces_as_a_marker_of_oesophageal_damage:_comparative_results_in_gastro_oesophageal_reflux_disease_with_or_without_bile_reflux_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0269-2813&amp;date=2003&amp;volume=18&amp;issue=5&amp;spage=525 DB - PRIME DP - Unbound Medicine ER -