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 Impaired esophageal mucosal resistance
36 Mean intercellular space diameter
37 NERD
38 NERD pH-positive patients
39 NERD patients
40 Ph-negative patients
41 Ph-positive patients
42 Physiological Esophageal Acid Exposure
43 abnormal acid exposure time
44 acid esophageal exposure
45 acid exposure
46 acid exposure time
47 acid refluxate
48 amount
49 asymptomatic controls
50 biopsy
51 changes
52 control
53 diameter
54 differences
55 dilation
56 disease patients
57 electron microscopy photomicrographs
58 endoscopy
59 epithelium
60 esophageal acid exposure
61 esophageal acid exposure time
62 esophageal epithelium
63 esophageal exposure
64 esophageal manometry
65 esophageal mucosal resistance
66 esophageal sphincter
67 exposure
68 exposure time
69 features
70 injury
71 intercellular space diameter
72 intercellular spaces
73 key role
74 manometry
75 markers
76 maximal space diameters
77 maximum intercellular spaces
78 mean value
79 microscopy photomicrographs
80 monitoring
81 mucosal resistance
82 nonerosive reflux disease patients
83 normal range
84 pH monitoring
85 pathological esophageal acid exposure time
86 pathophysiology
87 pathophysiology of NERD
88 patients
89 photomicrographs
90 protocol
91 range
92 reflux disease patients
93 refluxate
94 relationship
95 resistance
96 role
97 same protocol
98 small amount
99 space
100 space diameters
101 sphincter
102 structural markers
103 symptoms
104 time
105 tissue injury
106 transmission electron microscopy photomicrographs
107 ultrastructural changes
108 upper endoscopy
109 values
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