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Effects of Central Obesity on Esophageal Epithelial Barrier Function. Am J Gastroenterol 2021; 116:1537-1541. [PMID: 33955725 PMCID: PMC8243777 DOI: 10.14309/ajg.0000000000001196] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/22/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION We assessed if obesity perturbs the esophageal epithelial barrier function independent of promotion of gastroesophageal reflux (GER). METHODS Thirty-eight participants were divided into 4 groups: Obesity-/GER-, Obesity+/GER-, Obesity-/GER+, and Obesity+/GER+. Esophageal intercellular space and desmosome density (structural integrity) and fluorescein leak (functional integrity) were measured. RESULTS The Obesity+/GER- group demonstrated increased intercellular space, reduced desmosome density, and increased fluorescein leak compared with control subjects. These changes were similar but not additive to findings seen in Obesity-/GER + and Obesity+/GER+ patients. DISCUSSION Central obesity impairs structural and functional integrity of the esophageal barrier independent of GER, likely predisposing to esophageal injury.
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Englhard AS, Palaras A, Volgger V, Stepp H, Mack B, Libl D, Gires O, Betz CS. Confocal laser endomicroscopy in head and neck malignancies using FITC-labelled EpCAM- and EGF-R-antibodies in cell lines and tumor biopsies. JOURNAL OF BIOPHOTONICS 2017; 10:1365-1376. [PMID: 28106950 DOI: 10.1002/jbio.201600238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/23/2016] [Accepted: 12/23/2016] [Indexed: 06/06/2023]
Abstract
Intraoperative detection of residual malignant cells at tumor margins following excision of primary tumors could help improving surgery and thus patients' outcome. The feasibility of the tumor antigens epidermal growth factor receptor (EGF-R) and epithelial cell adhesion molecule (EpCAM) for antibody-dependent confocal laser scanning endomicroscopy (CLE)-mediated visualization of malignant cells was addressed. Both tumor antigens are highly and frequently expressed in the majority of carcinomas, including head and neck squamous cell carcinomas (HNSCC), and represent prognostic and therapeutic tumor target molecules. FITC-conjugated EGF-R- and EpCAM-specific antibodies served as molecular tools for the detection of antigen-positive cells using the CLE technology. Specificity of both antibodies and their ability to discriminate tumor from non-tumor cells were assessed in vitro with human fibroblasts and PCI-1 HNSCC cell lines, and ex vivo on primary HNSCC samples (n = 11) and healthy mucosa (n = 5). Antigen specificity of the used EpCAM-specific antibody was superior to that of the EGF-R-specific antibody both in vitro and ex vivo (100% vs. 31.25%), and allowed visualization of cellular structures in CLE measurements. These results hold promise for possible future applications in humans.
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Affiliation(s)
- Anna S Englhard
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Alexander Palaras
- Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universität München, Feodor-Lynen-Str. 19, 81377, Munich, Germany
| | - Veronika Volgger
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Herbert Stepp
- Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universität München, Feodor-Lynen-Str. 19, 81377, Munich, Germany
- Department of Urology, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Brigitte Mack
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Darko Libl
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Olivier Gires
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
- Clinical Cooperation Group "Personalized Radiotherapy of Head and Neck Tumors", Helmholtz Zentrum, München, Germany
| | - Christian S Betz
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
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Volgger V, Girschick S, Ihrler S, Englhard AS, Stepp H, Betz CS. Evaluation of confocal laser endomicroscopy as an aid to differentiate primary flat lesions of the larynx: A prospective clinical study. Head Neck 2015; 38 Suppl 1:E1695-704. [DOI: 10.1002/hed.24303] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 08/09/2015] [Accepted: 09/19/2015] [Indexed: 01/26/2023] Open
Affiliation(s)
- Veronika Volgger
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
| | - Susanne Girschick
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
- Laser-Forschungslabor; LIFE Center; Klinikum der Universität München; Munich Germany
| | - Stephan Ihrler
- Labor für Dermatohistologie und Oralpathologie; Munich Germany
| | - Anna Sophie Englhard
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
| | - Herbert Stepp
- Laser-Forschungslabor; LIFE Center; Klinikum der Universität München; Munich Germany
| | - Christian Stephan Betz
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
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Appelman HD, Matejcic M, Parker MI, Riddell RH, Salemme M, Swanson PE, Villanacci V. Progression of esophageal dysplasia to cancer. Ann N Y Acad Sci 2015; 1325:96-107. [PMID: 25266019 DOI: 10.1111/nyas.12523] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the evolution of low-grade squamous and glandular dysplasia to invasive carcinoma; the mutational spectra of Barrett's esophagus and adenocarcinoma; the risk of p53-immunoreactive glandular dysplasia compared to non-immunoreactive mucosa for progression to cancer; the role of lectins in progression to adenocarcinoma; and the role of racemase immunoreactivity in the prediction of risk of adenocarcinoma.
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Affiliation(s)
- Henry D Appelman
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
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Wu TY, Rouse AR, Chambers SK, Hatch KD, Gmitro AF. Confocal microlaparoscope for imaging the fallopian tube. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:116010. [PMID: 25411899 PMCID: PMC4409019 DOI: 10.1117/1.jbo.19.11.116010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/21/2014] [Indexed: 05/18/2023]
Abstract
Recent evidence suggests that ovarian cancer can originate in the fallopian tube. Unlike many other cancers, poor access to the ovary and fallopian tubes has limited the ability to study the progression of this deadly disease and to diagnosis it during the early stage when it is most amenable to therapy. A rigid confocal microlaparoscope system designed to image the epithelial surface of the ovary in vivo was previously reported. A new confocal microlaparoscope with an articulating distal tip has been developed to enable in vivo access to human fallopian tubes. The new microlaparoscope is compatible with 5-mm trocars and includes a 2.2-mm-diameter articulating distal tip consisting of a bare fiber bundle and an automated dye delivery system for fluorescence confocal imaging. This small articulating device should enable the confocal microlaparoscope to image early stage ovarian cancer arising inside the fallopian tube. Ex vivo images of animal tissue and human fallopian tube using the new articulating device are presented along with in vivo imaging results using the rigid confocal microlaparoscope system.
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Affiliation(s)
- Tzu-Yu Wu
- University of Arizona, College of Optical Sciences, 1630 East University Boulevard, Tucson, Arizona 85721, United States
- University of Arizona, Department of Medical Imaging, PO Box 245067, Tucson, Arizona 85724, United States
| | - Andrew R. Rouse
- University of Arizona, College of Optical Sciences, 1630 East University Boulevard, Tucson, Arizona 85721, United States
- University of Arizona, Department of Medical Imaging, PO Box 245067, Tucson, Arizona 85724, United States
- University of Arizona Cancer Center, PO Box 245024, Tucson, Arizona 85724, United States
| | - Setsuko K. Chambers
- University of Arizona Cancer Center, PO Box 245024, Tucson, Arizona 85724, United States
- University of Arizona, Department of Obstetrics and Gynecology, PO Box 245078, Tucson, Arizona 85724, United States
| | - Kenneth D. Hatch
- University of Arizona Cancer Center, PO Box 245024, Tucson, Arizona 85724, United States
- University of Arizona, Department of Obstetrics and Gynecology, PO Box 245078, Tucson, Arizona 85724, United States
| | - Arthur F. Gmitro
- University of Arizona, College of Optical Sciences, 1630 East University Boulevard, Tucson, Arizona 85721, United States
- University of Arizona, Department of Medical Imaging, PO Box 245067, Tucson, Arizona 85724, United States
- University of Arizona Cancer Center, PO Box 245024, Tucson, Arizona 85724, United States
- Address all correspondence to: Arthur F. Gmitro, E-mail:
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Abstract
Barrett’s esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma. Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia. This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett’s esophagus (BE). Several therapies have been developed in attempts to reverse BE and reduce cancer risk. Aggressive medical management of acid reflux, lifestyle modifications, antireflux surgery, and endoscopic treatments have been recommended for many patients with BE. Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial. Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue. Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett’s carcinoma which cannot be managed by endoscopic approach.
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