Abstract
Using orally administered sucrose as a probe of gastrointestinal permeability, this study focused on determining whether Barrett’s metaplasia exhibits a paracellular transepithelial leak to small nonelectrolytes. Subjects in five separate classes (nonendoscoped, asymptomatic controls; endoscoped, asymptomatic controls; gastroesophageal reflux disease without mucosal complications; grossly visible esophagitis; and Barrett’s esophagus) consumed a sucrose solution at bedtime and collected all overnight urine. Urine volume was measured and sucrose concentration was determined by high-performance liquid chromatography. Patients with Barrett’s were observed to exhibit a transepithelial leak to sucrose whose mean value was threefold greater than that seen in healthy control subjects or patients with reflux but without any mucosal defect. A parallel study of claudin tight junction proteins in endoscopy biopsy samples showed that whereas Barrett’s metaplasia contains dramatically more claudin-2 and claudin-3 than is found in normal esophageal mucosa, it is markedly lower in claudins 1 and 5, indicating very different tight junction barriers.
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Acknowledgments
The authors thank Spencer M. Free, Ph.D., for statistical methodologies and insights of study design. The cooperation of the scheduling secretaries and the nurses, patient care technicians, and anesthesiologists of the Main Line Gastroenterology Associates endoscopy facility is much appreciated. The authors thank Jennifer Swauger, Kathleen Ciavarelli, and Loretta Rossino for assistance in preparation of this manuscript.
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Support by the Cancer Research and Prevention Foundation, the Sharpe-Strumia Foundation, and the Mary L. Smith Foundation.
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Mullin, J.M., Valenzano, M.C., Trembeth, S. et al. Transepithelial Leak in Barrett’s Esophagus. Dig Dis Sci 51, 2326–2336 (2006). https://doi.org/10.1007/s10620-006-9478-5
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DOI: https://doi.org/10.1007/s10620-006-9478-5