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- Aug 14, 2010
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Loss of intestinal barrier function plays an important role in the pathogenesis of inflammatory bowel disease (IBD).
Shedding of intestinal epithelial cells is a potential cause of barrier loss during inflammation.
Professor Watson and colleagues from the United Kingdom determined whether cell shedding and barrier loss in humans can be detected by confocal endomicroscopy, and whether these parameters predict relapse of IBD.
Confocal endomicroscopy was performed in IBD and control patients using intravenous fluorescein to determine the relationship between cell shedding and local barrier dysfunction.
Sensitivity to predict a flare was 63%
Gut
The team devised a grading system based on appearances at confocal endomicroscopy in humans, used to predict relapse in a prospective pilot study of 47 patients with ulcerative colitis and 11 patients with Crohn's disease.
Confocal endomicroscopy in humans detected shedding epithelial cells and local barrier defects as plumes of fluorescein effluxing through the epithelium.
Mouse experiments demonstrated inward flow through some leakage-associated shedding events, which was increased when luminal osmolarity was decreased.
In IBD patients in clinical remission, the research team noted that increased cell shedding with fluorescein leakage was associated with subsequent relapse within 12 months after endomicroscopic examination.
The team noted that sensitivity, specificity and accuracy for the grading system to predict a flare were 63%, 91%, and 79%, respectively.
Professor Watson's team commented, "Cell shedding and barrier loss detected by confocal endomicroscopy predicts relapse of IBD and has potential as a diagnostic tool for the management of the disease."
http://www.gastrohep.com/news/news.asp?id=108938
Shedding of intestinal epithelial cells is a potential cause of barrier loss during inflammation.
Professor Watson and colleagues from the United Kingdom determined whether cell shedding and barrier loss in humans can be detected by confocal endomicroscopy, and whether these parameters predict relapse of IBD.
Confocal endomicroscopy was performed in IBD and control patients using intravenous fluorescein to determine the relationship between cell shedding and local barrier dysfunction.
Sensitivity to predict a flare was 63%
Gut
The team devised a grading system based on appearances at confocal endomicroscopy in humans, used to predict relapse in a prospective pilot study of 47 patients with ulcerative colitis and 11 patients with Crohn's disease.
Confocal endomicroscopy in humans detected shedding epithelial cells and local barrier defects as plumes of fluorescein effluxing through the epithelium.
Mouse experiments demonstrated inward flow through some leakage-associated shedding events, which was increased when luminal osmolarity was decreased.
In IBD patients in clinical remission, the research team noted that increased cell shedding with fluorescein leakage was associated with subsequent relapse within 12 months after endomicroscopic examination.
The team noted that sensitivity, specificity and accuracy for the grading system to predict a flare were 63%, 91%, and 79%, respectively.
Professor Watson's team commented, "Cell shedding and barrier loss detected by confocal endomicroscopy predicts relapse of IBD and has potential as a diagnostic tool for the management of the disease."
http://www.gastrohep.com/news/news.asp?id=108938
