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Ceriotti L, Buratti P, Corazziari ES, Meloni M. Protective Mechanisms of Liquid Formulations for Gastro-Oesophageal Reflux Disease in a Human Reconstructed Oesophageal Epithelium Model. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2022; 15:143-152. [PMID: 35610977 PMCID: PMC9124487 DOI: 10.2147/mder.s363616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose A novel experimental design based on a human-reconstructed oesophageal epithelium (HO2E) model has been applied to quantitively assess the properties of a set of liquid formulations, Device A (Gerdoff® Protection), Device B (Esoxx® One), and Device C (Marial® gel) developed to form a temporary physical barrier on the oesophageal epithelium and modify epithelial permeability so to protect the oesophageal mucosa from refluxate components. Methods The formulations were applied to a prewetted HO2E model for 15 min. Then, a 0.5% caffeine solution was applied, and its penetration kinetics was assessed at 1 h and 2 h in acidic environments (pH= 3.3) to mirror exposure of the oesophageal mucosa to acidic reflux in GORD patients. Caffeine permeated into the basolateral compartment (evaluated by HPLC-UV) and Lucifer yellow (LY) permeability were quantified 15 min after application of the caffeine in acidic environments. Results At the 15 min timepoint, Device A reduced caffeine permeation by 77.2% and LY flux by 30.4% compared to the untreated control and with a faster mode of action than that of the other liquid formulations. Transepithelial caffeine flux was reduced, albeit with different timing and efficiency, by all three compounds up to the end of the 2 hour experiment. At 1 h, Device A reduced the caffeine flux by 79.2%; Device B, by 67.2%; and Device C, by 37%. Conclusion These results confirm the ability of the medical devices tested to interact with the oesophageal epithelium and create a temporary physical protective film for up to 2 hours after their application. The results underline differences in the mechanism of action of the three medical devices, with Device A performing faster than the other formulations. The overall results support the relevance of the reconstructed mucosal model to investigate oesophageal epithelium–product interactions and precisely differentiate liquid formulation performance.
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Affiliation(s)
- Laura Ceriotti
- In vitro Innovation Center, VitroScreen srl, Milan, Italy
- Correspondence: Laura Ceriotti, VitroScreen, in vitro Innovation Center, Via Mosè Bianchi, 103, Milan, 20149, Italy, Email
| | - Paolo Buratti
- In vitro Innovation Center, VitroScreen srl, Milan, Italy
| | | | - Marisa Meloni
- In vitro Innovation Center, VitroScreen srl, Milan, Italy
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Cheng CG, Chien WC, Yu CP, Chung CH, Cheng CA. Association between Reflux Esophagitis Incidence and Palmar Hyperhidrosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124502. [PMID: 32585882 PMCID: PMC7345012 DOI: 10.3390/ijerph17124502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/18/2020] [Accepted: 06/21/2020] [Indexed: 12/13/2022]
Abstract
The autonomic dysfunction in palmar hyperhidrosis (PH) includes not only sympathetic overactivity but also parasympathetic impairment. A decrease of parasympathetic tone has been noted in gastroesophageal reflux disease of neonates and adults. Patients with reflux esophagitis have a defective anti-reflux barrier. The association between reflux esophagitis and PH is deliberated in this article. The National Health Insurance Database in Taiwan was used. At first-time visits, PH patients were identified by the International Classification of Disease, 9th Revision, Clinical Modification disease code of 780.8 without endoscopic thoracic sympathectomy. Patients were matched by age and gender as control groups. The reflux esophagitis incidence was assessed using disease codes 530.11, 530.81, and 530.85. The factors related to reflux esophagitis were established by the Cox proportional regression model. The risk of reflux esophagitis in PH patients had a hazard ratio of 3.457 (95% confidence interval: 3.043-3.928) after adjustment of the other factors. We confirmed the association between reflux esophagitis and PH. Health care providers must be alerted to this relationship and other risk factors of reflux esophagitis to support suitable treatments to improve the quality of life of patients.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan;
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Department of Emergency Medicine, Xin Tai General Hospital, New Taipei 24262, Taiwan
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chia-Peng Yu
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: ; Tel.: +886-2-87927173
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Soumekh A, Schnoll-Sussman FH, Katz PO. Reflux and Acid Peptic Diseases in the Elderly. Clin Geriatr Med 2014; 30:29-41. [DOI: 10.1016/j.cger.2013.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Djeddi DD, Kongolo G, Stéphan-Blanchard E, Ammari M, Léké A, Delanaud S, Bach V, Telliez F. Involvement of autonomic nervous activity changes in gastroesophageal reflux in neonates during sleep and wakefulness. PLoS One 2013; 8:e83464. [PMID: 24349512 PMCID: PMC3862728 DOI: 10.1371/journal.pone.0083464] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 11/05/2013] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND It has been suggested that disturbed activity of the autonomic nervous system is one of the factors involved in gastroesophageal reflux (GER) in adults. We sought to establish whether transient ANS dysfunction (as assessed by heart rate variability) is associated with the occurrence of GER events in neonates during sleep and wakefulness. METHODS Nineteen neonates with suspected GER underwent simultaneous, synchronized 12-hour polysomnography and esophageal multichannel impedance-pH monitoring. We compared changes in HRV parameters during three types of periods (control and prior to and during reflux) with respect to the vigilance state. RESULTS The vigilance state influenced the distribution of GER events (P<0.001), with 53.4% observed during wakefulness, 37.6% observed during active sleep and only 9% observed during quiet sleep. A significant increase in the sympathovagal ratio (+32%, P=0.013) was observed in the period immediately prior to reflux (due to a 15% reduction in parasympathetic activity (P=0.017)), relative to the control period. This phenomenon was observed during both wakefulness and active sleep. CONCLUSION Our results showed that GER events were preceded by a vigilance-state-independent decrease in parasympathetic tone. This suggests that a pre-reflux change in ANS activity is one of the factors contributing to the mechanism of reflux in neonates.
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Affiliation(s)
- Djamal-Dine Djeddi
- PériTox Laboratory (EA4285-UMI 01 INERIS), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
- Pediatric Gastroenterology Unit, Amiens University Medical Center, Amiens, France
| | - Guy Kongolo
- Neonatal and Pediatric Intensive Care Unit, Amiens University Medical Center, Amiens, France
- GRAMFC (INSERM U 1105), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
| | - Erwan Stéphan-Blanchard
- PériTox Laboratory (EA4285-UMI 01 INERIS), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
| | - Mohamed Ammari
- PériTox Laboratory (EA4285-UMI 01 INERIS), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
| | - André Léké
- PériTox Laboratory (EA4285-UMI 01 INERIS), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
- Neonatal and Pediatric Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - Stéphane Delanaud
- PériTox Laboratory (EA4285-UMI 01 INERIS), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
| | - Véronique Bach
- PériTox Laboratory (EA4285-UMI 01 INERIS), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
| | - Frederic Telliez
- PériTox Laboratory (EA4285-UMI 01 INERIS), Faculty of Medicine, Jules Verne University of Picardy, Amiens, France
- * E-mail:
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Kroes RM, Numans ME, Jones RH, de Wit NJ, Verheij TJM. Original Paper: Gastro-oesophageal reflux disease in primary careComparison and evaluation of existing national guidelines and development of uniform European guidelines. Eur J Gen Pract 2009. [DOI: 10.3109/13814789909094270] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ko HH. Pathophysiology of GERD*. Can Pharm J (Ott) 2008. [DOI: 10.3821/1913-701x(2008)141[s9:pog]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Pham CQD. A pharmacist's perspective on GERD management*. Can Pharm J (Ott) 2008. [DOI: 10.3821/1913-701x(2008)141[s7:appogm]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Geriatric GERD: Maximizing Outcomes for a Unique Patient Population. JAAPA 2007. [DOI: 10.1097/01720610-200710000-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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. HK, . ,SK, . MJZ, . SN, . AR, . NH, . SS, . MA. Toxic Reactions to Chronic Use of Benzodiazepines: An Overview. INT J PHARMACOL 2005. [DOI: 10.3923/ijp.2005.376.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Seely AJE, Sundaresan RS, Finley RJ. Principles of laparoscopic surgery of the gastroesophageal junction. J Am Coll Surg 2005; 200:77-87. [PMID: 15631923 DOI: 10.1016/j.jamcollsurg.2004.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2003] [Revised: 06/21/2004] [Accepted: 08/18/2004] [Indexed: 11/30/2022]
Affiliation(s)
- Andrew J E Seely
- Department of Thoracic Surgery, the University of Ottawa, Ottawa Hospital General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada
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Mearin F. [Gastro-esophageal reflux disease]. Med Clin (Barc) 2002; 118:551-6. [PMID: 11988155 DOI: 10.1016/s0025-7753(02)72446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Fermín Mearin
- Servicio de Aparato Digestivo. Instituto de Trastornos Funcionales y Motores Digestivos. Centro Médico Teknon. Barcelona. Spain.
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Marzo M, Alonso P, Bonfill X, Fernández M, Ferrandiz J, Martínez G, Mearín F, Mascort JJ, Piqué JM, Ponce J, Sáez M. [Clinical practice guideline on the management of patients with gastroesophageal reflux disease (GERD)]. GASTROENTEROLOGIA Y HEPATOLOGIA 2002; 25:85-110. [PMID: 11841764 DOI: 10.1016/s0210-5705(02)70245-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- M Marzo
- Centro Cochrane Iberoamericano, Casa de la Convalecencia, Sant Antoni, Barcelona Spain
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Wallner B, Sylvan A, Stenling R, Janunger K. Surg Laparosc Endosc Percutan Tech 2001; 11:235-241. [DOI: 10.1097/00019509-200108000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wallner B, Sylvan A, Stenling R, Janunger KG. A postfundoplication study on Z-line appearance and intestinal metaplasia in the gastroesophageal junction. Surg Laparosc Endosc Percutan Tech 2001; 11:235-41. [PMID: 11525367 DOI: 10.1097/00129689-200108000-00002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The purpose of this study was investigate the Z-line appearance by using a previously proposed classification, the ZAP classification, and to investigate the prevalence of intestinal metaplasia in the Z-line, among fundoplicated patients. Sixty patients, who had undergone fundoplication 2 to 17 years earlier, were included in the study. The prevalence of intestinal metaplasia was 20%. Intestinal metaplasia was found to be associated with age, more than 10 years of symptoms of gastroesophageal reflux disease preoperatively, tongues of columnar epithelium in the distal esophagus, carditis, and ZAP grade. ZAP grade, furthermore, was associated with male gender and more than 10 years of symptoms of gastroesophageal reflux disease preoperatively. Among patients with intestinal metaplasia, different ZAP grades can indicate different etiologic factors. Even among patients undergoing fundoplication (i.e., patients with an anatomically altered gastroesophageal junction), the ZAP classification is a feasible tool to characterize the Z-line appearance. The ZAP classification could prove valuable in selecting patients for follow-up treatment.
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Affiliation(s)
- B Wallner
- Department of Surgical and Perioperative Science, Umeå University Hospital, Sweden.
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Galmiche JP, Letessier E, Scarpignato C. Treatment of gastro-oesophageal reflux disease in adults. BMJ (CLINICAL RESEARCH ED.) 1998; 316:1720-3. [PMID: 9614026 PMCID: PMC1113276 DOI: 10.1136/bmj.316.7146.1720] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- J P Galmiche
- Department of Gastroenterology and Hepatology, Hotel-Dieu University Hospital, 44035 Nantes Cedex 01, France.
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Ortiz-Hidalgo C, De La Vega G, Aguirre-García J. The histopathology and biologic prognostic factors of Barrett's esophagus: a review. J Clin Gastroenterol 1998; 26:324-33. [PMID: 9649022 DOI: 10.1097/00004836-199806000-00024] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In Barrett's esophagus, stratified squamous mucosa of the lower third of the esophagus is replaced by columnar mucosa, as a complication of chronic gastroesophageal reflux. The presence of Barrett's esophagus appears to be a major factor in the progression to adenocarcinoma of the lower third of the esophagus. Therefore it is crucial to identify the subset of patients at risk for the development of adenocarcinoma. Dysplasia is an important histologic feature to evaluate because it identifies those patients who require follow-up. The diagnosis of biopsies with lesser degrees of abnormalities, however, makes microscopic evaluation less helpful in identifying patients who need more frequent endoscopic biopsy surveillance. DNA ploidy and the use of monoclonal antibodies, such as suppressor gene product p53, oncogene cerbB-2, and Ki-67, have added dramatically to our understanding of the biology of Barrett's metaplasia and have given us objective indicators to predict the presence of an increased risk of developing cancer.
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Affiliation(s)
- C Ortiz-Hidalgo
- Department of Surgical Pathology, The American British Cowdray Hospital, Observatorio, Mexico DF, Mexico
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