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Solfisburg QS, Sami SS, Gabre J, Soroush A, Dhaliwal L, Beveridge C, Jin Z, Poneros JM, Falk GW, Ginsberg GG, Wang KK, Lightdale CJ, Iyer PG, Abrams JA. Clinical significance of recurrent gastroesophageal junction intestinal metaplasia after endoscopic eradication of Barrett's esophagus. Gastrointest Endosc 2021; 93:1250-1257.e3. [PMID: 33144238 DOI: 10.1016/j.gie.2020.10.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/17/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS After endoscopic eradication of Barrett's esophagus (BE), recurrence of intestinal metaplasia at the gastroesophageal junction (GEJIM) is common. The clinical significance of this finding is unclear. We assessed whether recurrent GEJIM is associated with increased risk of subsequent dysplasia and whether endoscopic treatment lowers this risk. METHODS A retrospective, multicenter, cohort study was performed of treated BE patients who achieved complete eradication of intestinal metaplasia (IM). Postablation follow-up was performed at standard intervals. Recurrent GEJIM was defined as nondysplastic IM on gastroesophageal junction biopsy specimens without endoscopic evidence of BE. Patients were categorized as "never-GEJIM," "GEJIM-observed," or "GEJIM-treated." Endoscopic treatment for recurrent GEJIM was at the endoscopists' discretion. The primary outcome was dysplasia recurrence. Analyses were performed using log-rank tests and Cox proportional hazards modeling. RESULTS Six hundred thirty-three patients were analyzed; median follow-up was 47 months (interquartile range, 24-69). Most patients (81%) had high-grade dysplasia or intramucosal adenocarcinoma before treatment. Dysplasia recurrence was 2.2% per year. GEJIM-observed patients had the lowest rate of recurrence (.6%/y) followed by GEJIM-treated (2.2%/y) and never-GEJIM (2.6%/y) (log-rank P = .07). In multivariate analyses, compared with never-GEJIM, the risk of dysplasia recurrence was significantly lower in GEJIM-observed patients (adjusted hazard ratio, .19; 95% confidence interval, .05-.81) and not different in GEJIM-treated patients (adjusted hazard ratio, .81; 95% confidence interval, .39-1.67). Older age and longer initial BE length were independently associated with recurrence. CONCLUSIONS Recurrent GEJIM after endoscopic eradication of BE was not associated with an increased risk of subsequent dysplasia. Future studies are warranted to determine if observation is appropriate for this finding.
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Affiliation(s)
- Quinn S Solfisburg
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Sarmed S Sami
- Department of Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK
| | - Joel Gabre
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ali Soroush
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Lovekirat Dhaliwal
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Claire Beveridge
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Zhezhen Jin
- Departments of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - John M Poneros
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Gary W Falk
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gregory G Ginsberg
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kenneth K Wang
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Charles J Lightdale
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
| | - Julian A Abrams
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
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Cruz-Acuña R, Loebel C, Karakasheva T, Gabre J, Burdick J, Rustgi A. Engineered hydrogels to elucidate contributions of matrix mechanics to esophageal adenocarcinoma and identify matrix-activated therapeutic targets. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31200-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Sonali Palchaudhuri
- Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Joel Gabre
- Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Stacey Prenner
- Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Steven Solga
- Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, USA
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Abstract
The culture of organoids has represented a significant advancement in the gastrointestinal research field. Previous research studies have described the oncogenic transformation of human intestinal and mouse gastric organoids. Here we detail the protocol for the oncogenic transformation and orthotopic transplantation of human-derived gastric organoids.
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Affiliation(s)
- Nina Bertaux-Skeirik
- Department of Molecular and Cellular Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jomaris Centeno
- Biology Department, University of Puerto Rico-Río Piedras, San Juan, Puerto Rico
| | - Jian Gao
- Department of Pediatrics, W.F. Maternal & Child Health Hospital, 76 Qingnian Road, Weifang, 261011, People's Republic of China
| | - Joel Gabre
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Yana Zavros
- Department of Molecular and Cellular Physiology, University of Cincinnati College of Medicine, 231 Albert B. Sabin Way, Room 4255 MSB, Cincinnati, OH, 45267-0576, USA.
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Bertaux-Skeirik N, Wunderlich M, Teal E, Chakrabarti J, Biesiada J, Mahe M, Sundaram N, Gabre J, Hawkins J, Jian G, Engevik AC, Yang L, Wang J, Goldenring JR, Qualls JE, Medvedovic M, Helmrath MA, Diwan T, Mulloy JC, Zavros Y. CD44 variant isoform 9 emerges in response to injury and contributes to the regeneration of the gastric epithelium. J Pathol 2017; 242:463-475. [PMID: 28497484 DOI: 10.1002/path.4918] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/28/2017] [Accepted: 04/13/2017] [Indexed: 12/26/2022]
Abstract
The CD44 gene encodes several protein isoforms due to alternative splicing and post translational modifications. Given that CD44 variant isoform 9 (CD44v9) is expressed within Spasmolytic Polypeptide/TFF2-Expressing Metaplasia (SPEM) glands during repair, CD44v9 may be play a funcitonal role during the process of regeneration of the gastric epithelium. Here we hypothesize that CD44v9 marks a regenerative cell lineage responsive to infiltrating macrophages during regeneration of the gastric epithelium. Ulcers were induced in CD44-deficient (CD44KO) and C57BL/6 (BL6) mice by a localized application of acetic acid to the serosal surface of the stomach. Gastric organoids expressing CD44v9 were derived from mouse stomachs and transplanted at the ulcer site of CD44KO mice. Ulcers, CD44v9 expression, proliferation and histology were measured 1, 3, 5 and 7-days post-injury. Human-derived gastric organoids were generated from stomach tissue collected from elderly (>55 years) or young (14-20 years) patients. Organoids were transplanted into the stomachs of NOD scid gamma (NSG) mice at the site of injury. Gastric injury was induced in NRG-SGM3 (NRGS) mice harboring human-derived immune cells (hnNRGS) and the immune profile anlayzed by CyTOF. CD44v9 expression emerged within regenerating glands the ulcer margin in response to injury. While ulcers in BL6 mice healed within 7-days post-injury, CD44KO mice exhibited loss of repair and epithelial regeneration. Ulcer healing was promoted in CD44KO mice by transplanted CD55v9-expressing gastric organoids. NSG mice exhibited loss of CD44v9 expression and gastric repair. Transplantation of human-derived gastric organoids from young, but not aged stomachs promoted repair in NSG mouse stomachs in response to injury. Finally, compared to NRGS mice, huNRGS animals exhibited reduced ulcer sizes, an infiltration of human CD162+ macrophages and an emergence of CD44v9 expression in SPEM. Thus, during repair of the gastic epithelium CD44v9 emerges within a regenerative cell lineage that coincides with macrophage inflitration within the injured mucosa. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Nina Bertaux-Skeirik
- Department of Molecular and Cellular Physiology, University of Cincinnati, Cincinnati, OH, USA
| | - Mark Wunderlich
- Cancer and Blood Disease Institute, Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Emma Teal
- Department of Molecular and Cellular Physiology, University of Cincinnati, Cincinnati, OH, USA
| | - Jayati Chakrabarti
- Department of Molecular and Cellular Physiology, University of Cincinnati, Cincinnati, OH, USA
| | - Jacek Biesiada
- Department of Environmental Health, Division of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Maxime Mahe
- Department of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Nambirajan Sundaram
- Department of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Joel Gabre
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer Hawkins
- Department of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Gao Jian
- Department of Pediatrics, WF Maternal and Child Health Hospital, 76 Qingnian Road, Weifang, 261011, PR China
| | - Amy C Engevik
- Nashville VA Medical Center and Departments of Surgery and Cell and Developmental Biology and the Epithelial Biology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Li Yang
- Department of Molecular and Cellular Physiology, University of Cincinnati, Cincinnati, OH, USA
| | - Jiang Wang
- Department of Pathology and Lab Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James R Goldenring
- Nashville VA Medical Center and Departments of Surgery and Cell and Developmental Biology and the Epithelial Biology Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joseph E Qualls
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mario Medvedovic
- Department of Environmental Health, Division of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael A Helmrath
- Department of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tayyab Diwan
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - James C Mulloy
- Cancer and Blood Disease Institute, Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Yana Zavros
- Department of Molecular and Cellular Physiology, University of Cincinnati, Cincinnati, OH, USA
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Siefert S, Gabre J, Chabasse C, Hoofnagle M, Sarkar R. The Role of T Cells in Resolution of Deep Venous Thrombosis In Vivo◊. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2014.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gabre J, Chabasse C, Cao C, Mukhopadhyay S, Siefert S, Bi Y, Netzel-Arnett S, Sarkar R, Zhang L. Activated protein C accelerates venous thrombus resolution through heme oxygenase-1 induction. J Thromb Haemost 2014; 12:93-102. [PMID: 24119206 PMCID: PMC3891561 DOI: 10.1111/jth.12424] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Thrombus resolution is a complex process that involves thrombosis, leukocyte-mediated thrombolysis, and the final resolution of inflammation. Activated protein C (APC) is an anticoagulant that also possesses immunoregulatory activities. AIM In this study, we sought to examine the effects of APC administration on thrombus resolution using a mouse model of deep vein thrombosis by ligating the inferior vena cava (IVC). METHODS The IVCs of C57BL/6 mice were ligated. Beginning on day 4 post IVC ligation, mice were injected intraperitoneally daily with APC, APC plus an heme oxygenase-1 (HO-1) inhibitor Sn-protoporphyrin IX (SnPP), SnPP alone, or vehicle control. At different time points following surgery, the thrombus-containing IVCs were weighed and then analyzed by use of biochemical assays and histology. RESULTS Venous thrombi reached maximum size on day 4 post ligation. The APC-treated group exhibited a significant reduction in thrombus weights on day 12 but not on day 7 compared with control mice. The enhanced thrombus resolution in APC-treated mice correlated with an increased HO-1 expression and a reduced interleukin-6 production. No significant difference was found in urokinase-type plasminogen activator, plasminogen activator inhibitor-1, or matrix metalloproteinase-2 and -9 between APC-treated and control mice. Coinjection of the HO-1 inhibitor SnPP abolished the ability of APC to enhance thrombus resolution. CONCLUSIONS Our data show that APC enhances the resolution of existing venous thrombi via a mechanism that is in part dependent on HO-1, suggesting that APC could be used as a potential treatment for patients with deep vein thrombosis to accelerate thrombus resolution.
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Affiliation(s)
- Joel Gabre
- Department of Surgery Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Christine Chabasse
- Department of Surgery Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Chunzhang Cao
- Department of Physiology, Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Subhradip Mukhopadhyay
- Department of Surgery Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Suzanne Siefert
- Department of Surgery Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Yanming Bi
- Department of Surgery Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Sarah Netzel-Arnett
- Department of Physiology, Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Rajabrata Sarkar
- Department of Surgery Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
| | - Li Zhang
- Department of Physiology, Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, 800 W Baltimore Street, Baltimore, Maryland 21201, USA
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