Intercellular Space Volume Is Mainly Increased in the Basal Layer of Esophageal Squamous Epithelium in Patients with GERD
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Helmut Neumann Klaus Mo¨nkemu¨ ller Lucı´a C. Fry Frank Dombrowski Doerthe Kuester Mike Beyer Peter Malfertheiner
- چاپ و سال / کشور: 2010
Description
Background/Aims At present, the dilation of esophageal intercellular spaces (ICS) is considered an early morphologic marker of acid damage in patients with GERD. Nevertheless, previous electron microscopic (EM) studies had focused only on the suprabasal layer of squamous epithelium or did not nearly specify which layer of squamous epithelium was studied. Therefore, we aimed to assess the volumetric amount of the ICS in all layers of SE in patients with GERD. Methods In this study, 48 patients were prospectively included (NERD = 18, ERD = 17; Barrett0s esophagus = 5, controls = 8). All patients with ERD and NERD had typical reflux symptoms, as assessed by a valid GERD questionnaire. ICS volume was assessed by electron microscopy in the superficial, prickle cell, and basal layers of esophageal squamous epithelium using the method of Weibel. Results ERD was associated with increased ICS volume in the basal layer (LA-A, p = 0.038; LA-B, p = 0.005) and prickle cell layer (LA-A, p = 0.006; LA-B, p = 0.007) as compared to controls. Comparisons between NERD and ERD patients revealed more dilated ICS in the basal layer (LA-B, p = 0.007), prickle cell layer (LA-A, p = 0.008; LA-B, p = 0.001) and superficial layer (LA-B, p = 0.018) in patients with ERD. Conclusions Not only the diameter but also the volume of the ICS is increased in patients with GERD. Furthermore, the dilation of ICS is present in all three layers of the SE, being more pronounced in the basal layer. These findings support the concept that the impairment of the esophagus begins in the deeper parts of the esophageal epithelium
Dig Dis Sci (2011) 56:1404–1411 DOI 10.1007/s10620-010-1458-0 Received: 12 August 2010 / Accepted: 5 October 2010 / Published online: 30 October 2010
