Mucosal Integrity Testing Can Detect Differences in the Rectums of Patients with Inflammatory Bowel Disease Compared to Controls: A Pilot Study.
Endoscopy
Inflammatory bowel disease
Intestinal barrier function
Mucosal integrity testing
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
21
12
2020
accepted:
01
02
2021
pubmed:
28
2
2021
medline:
8
3
2022
entrez:
27
2
2021
Statut:
ppublish
Résumé
While the pathogenesis of inflammatory bowel disease (IBD) is incompletely understood, disruption of epithelial integrity is suspected to play a prominent role in disease initiation and progression. Currently, there is no convenient way to measure this in vivo. Our aim is to determine whether a mucosal integrity (MI) testing device that has been used to measure MI in the esophagus can also be used to measure barrier function in the colon during colonoscopy. Mucosal integrity testing was measured in patients with IBD (n = 17) and controls (n = 7) during colonoscopy. During the procedure, an MI catheter was passed down the working channel of the colonoscope and placed along the mucosal wall to measure MI in the rectum, left, transverse, and right colon. In patients with IBD, MI measurements and biopsies were taken in areas which appeared inflamed when present. We then determined if there was a significant difference in MI between patients with IBD and controls. MI was significantly higher in the rectum of patients with IBD (CD and UC combined) versus control colons [767 (618-991) vs. 531 (418-604) ohms, P < 0.01]. There were no significant differences in MI among patients with IBD versus controls in the right, transverse, or left colon. Within the IBD group, there were no significant differences in MI between inflamed versus non-inflamed rectums. There was no correlation between quality of life scores or endoscopic severity with MI, though this study was likely underpowered to detect these differences. Rectal MI is significantly higher in patients with IBD versus controls. Future studies are needed to determine how this information can be used clinically.
Sections du résumé
BACKGROUND
While the pathogenesis of inflammatory bowel disease (IBD) is incompletely understood, disruption of epithelial integrity is suspected to play a prominent role in disease initiation and progression. Currently, there is no convenient way to measure this in vivo.
AIMS
Our aim is to determine whether a mucosal integrity (MI) testing device that has been used to measure MI in the esophagus can also be used to measure barrier function in the colon during colonoscopy.
METHODS
Mucosal integrity testing was measured in patients with IBD (n = 17) and controls (n = 7) during colonoscopy. During the procedure, an MI catheter was passed down the working channel of the colonoscope and placed along the mucosal wall to measure MI in the rectum, left, transverse, and right colon. In patients with IBD, MI measurements and biopsies were taken in areas which appeared inflamed when present. We then determined if there was a significant difference in MI between patients with IBD and controls.
RESULTS
MI was significantly higher in the rectum of patients with IBD (CD and UC combined) versus control colons [767 (618-991) vs. 531 (418-604) ohms, P < 0.01]. There were no significant differences in MI among patients with IBD versus controls in the right, transverse, or left colon. Within the IBD group, there were no significant differences in MI between inflamed versus non-inflamed rectums. There was no correlation between quality of life scores or endoscopic severity with MI, though this study was likely underpowered to detect these differences.
CONCLUSION
Rectal MI is significantly higher in patients with IBD versus controls. Future studies are needed to determine how this information can be used clinically.
Identifiants
pubmed: 33638748
doi: 10.1007/s10620-021-06888-5
pii: 10.1007/s10620-021-06888-5
pmc: PMC8390582
mid: NIHMS1682640
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
639-645Subventions
Organisme : BLRD VA
ID : IK2 BX004648
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK058404
Pays : United States
Informations de copyright
© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.
Références
Gastroenterology. 2019 May;156(6):1617-1626.e1
pubmed: 30711626
Clin Gastroenterol Hepatol. 2020 Jun;18(7):1641-1642
pubmed: 31351133
Am J Gastroenterol. 1999 Oct;94(10):2956-60
pubmed: 10520851
Gastroenterology. 2016 Oct;151(4):616-32
pubmed: 27436072
Am J Gastroenterol. 2001 Oct;96(10):2921-8
pubmed: 11693327
Curr Gastroenterol Rep. 2018 Jun 9;20(7):33
pubmed: 29886566
World J Gastroenterol. 2013 Nov 21;19(43):7544-51
pubmed: 24282344
Am J Gastroenterol. 2010 Jun;105(6):1391-6
pubmed: 19935787
N Engl J Med. 1987 Dec 24;317(26):1625-9
pubmed: 3317057
Gastroenterology. 2015 Feb;148(2):334-43
pubmed: 25448923
Clin Gastroenterol Hepatol. 2015 Jul;13(7):1242-1248.e1
pubmed: 25592662
Clin Gastroenterol Hepatol. 2012 Oct;10(10):1110-6
pubmed: 22642956
Gastrointest Endosc. 2004 Oct;60(4):505-12
pubmed: 15472670
Histol Histopathol. 2011 Jul;26(7):867-72
pubmed: 21630216
World J Gastroenterol. 2014 Feb 7;20(5):1165-79
pubmed: 24574793
Gastroenterology. 2017 Sep;153(3):723-731.e1
pubmed: 28601482
Inflamm Bowel Dis. 2020 Jul 17;26(8):1131-1143
pubmed: 32232386
Mediators Inflamm. 2015;2015:628157
pubmed: 26582965
Clin Gastroenterol Hepatol. 2020 Jul;18(8):1727-1735.e2
pubmed: 31589979
Gut. 2012 Aug;61(8):1146-53
pubmed: 22115910
Langenbecks Arch Surg. 2013 Jan;398(1):1-12
pubmed: 23160753
Curr Opin Gastroenterol. 2007 Jul;23(4):379-83
pubmed: 17545772