Dilated Intercellular Spaces of Esophageal Epithelium in Nonerosive Reflux Disease Patients with Physiological Esophageal Acid Exposure View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2005-03-01

AUTHORS

Renato Caviglia, Mentore Ribolsi, Nicola Maggiano, Armando M Gabbrielli, Sara Emerenziani, Michele Pier Luca Guarino, Simone Carotti, Fortunéé Irene Habib, Carla Rabitti, Michele Cicala

ABSTRACT

OBJECTIVES: It has been demonstrated that dilation of intercellular spaces of esophageal epithelium is a marker of tissue injury in GERD patients with a pathological esophageal acid exposure time. To evaluate the relationship among ultrastructural changes, acid esophageal exposure, and GERD symptoms, intercellular space diameters have been assessed in nonerosive reflux disease (NERD) patients with/without abnormal acid exposure time. METHODS: Following a pharmacological wash-out, 20 NERD patients underwent upper endoscopy, esophageal manometry, and 24-h pH monitoring. Biopsies were taken at 5 cm above the lower esophageal sphincter and intercellular space diameters were measured on transmission electron microscopy photomicrographs. Seven asymptomatic controls underwent the same protocol. RESULTS: Acid exposure time was in the normal range in all controls and in 11 patients (NERD pH-negative); it was abnormal in 9 patients (NERD pH-positive). Mean intercellular space diameter in NERD pH-negative and in NERD pH-positive patients was three times greater than in controls (1.45 and 1.49 microm vs 0.45, p < 0.001). Mean values of maximum intercellular spaces in all NERD patients were greater, two-fold or more, than those in controls (p < 0.001). No difference in mean and maximal space diameters was observed between NERD pH-positive and pH-negative patients. CONCLUSIONS: Dilation of intercellular spaces is a feature of NERD patients, irrespective of esophageal acid exposure, and can be considered an objective, structural marker of GERD symptoms. Impaired esophageal mucosal resistance, even to small amounts of acid refluxate, plays a key role in the pathophysiology of NERD. More... »

PAGES

ajg200594

Identifiers

URI

http://scigraph.springernature.com/pub.10.1111/j.1572-0241.2005.40978.x

DOI

http://dx.doi.org/10.1111/j.1572-0241.2005.40978.x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1023717421

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/15743349


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26 schema:description OBJECTIVES: It has been demonstrated that dilation of intercellular spaces of esophageal epithelium is a marker of tissue injury in GERD patients with a pathological esophageal acid exposure time. To evaluate the relationship among ultrastructural changes, acid esophageal exposure, and GERD symptoms, intercellular space diameters have been assessed in nonerosive reflux disease (NERD) patients with/without abnormal acid exposure time. METHODS: Following a pharmacological wash-out, 20 NERD patients underwent upper endoscopy, esophageal manometry, and 24-h pH monitoring. Biopsies were taken at 5 cm above the lower esophageal sphincter and intercellular space diameters were measured on transmission electron microscopy photomicrographs. Seven asymptomatic controls underwent the same protocol. RESULTS: Acid exposure time was in the normal range in all controls and in 11 patients (NERD pH-negative); it was abnormal in 9 patients (NERD pH-positive). Mean intercellular space diameter in NERD pH-negative and in NERD pH-positive patients was three times greater than in controls (1.45 and 1.49 microm vs 0.45, p < 0.001). Mean values of maximum intercellular spaces in all NERD patients were greater, two-fold or more, than those in controls (p < 0.001). No difference in mean and maximal space diameters was observed between NERD pH-positive and pH-negative patients. CONCLUSIONS: Dilation of intercellular spaces is a feature of NERD patients, irrespective of esophageal acid exposure, and can be considered an objective, structural marker of GERD symptoms. Impaired esophageal mucosal resistance, even to small amounts of acid refluxate, plays a key role in the pathophysiology of NERD.
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33 schema:keywords GERD patients
34 GERD symptoms
35 NERD
36 NERD patients
37 Ph-negative patients
38 Ph-positive patients
39 abnormal acid exposure time
40 acid exposure
41 acid exposure time
42 acid refluxate
43 amount
44 asymptomatic controls
45 biopsy
46 changes
47 control
48 diameter
49 differences
50 dilation
51 disease patients
52 electron microscopy photomicrographs
53 endoscopy
54 epithelium
55 esophageal acid exposure
56 esophageal acid exposure time
57 esophageal epithelium
58 esophageal exposure
59 esophageal manometry
60 esophageal mucosal resistance
61 esophageal sphincter
62 exposure
63 exposure time
64 features
65 injury
66 intercellular space diameter
67 intercellular spaces
68 key role
69 manometry
70 markers
71 mean intercellular space diameter
72 mean value
73 monitoring
74 mucosal resistance
75 nonerosive reflux disease patients
76 normal range
77 pH monitoring
78 pathophysiology
79 patients
80 photomicrographs
81 protocol
82 range
83 reflux disease patients
84 refluxate
85 relationship
86 resistance
87 role
88 same protocol
89 small amount
90 space
91 sphincter
92 structural markers
93 symptoms
94 time
95 tissue injury
96 transmission electron microscopy photomicrographs
97 ultrastructural changes
98 upper endoscopy
99 values
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