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Intercellular Space Volume Is Mainly Increased in the Basal Layer of Esophageal Squamous Epithelium in Patients with GERD

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Abstract

Background/Aims

At present, the dilation of esophageal intercellular spaces (ICS) is considered an early morphologic marker of acid damage in patients with GERD. Nevertheless, previous electron microscopic (EM) studies had focused only on the suprabasal layer of squamous epithelium or did not nearly specify which layer of squamous epithelium was studied. Therefore, we aimed to assess the volumetric amount of the ICS in all layers of SE in patients with GERD.

Methods

In this study, 48 patients were prospectively included (NERD = 18, ERD = 17; Barrett′s esophagus = 5, controls = 8). All patients with ERD and NERD had typical reflux symptoms, as assessed by a valid GERD questionnaire. ICS volume was assessed by electron microscopy in the superficial, prickle cell, and basal layers of esophageal squamous epithelium using the method of Weibel.

Results

ERD was associated with increased ICS volume in the basal layer (LA-A, p = 0.038; LA-B, p = 0.005) and prickle cell layer (LA-A, p = 0.006; LA-B, p = 0.007) as compared to controls. Comparisons between NERD and ERD patients revealed more dilated ICS in the basal layer (LA-B, p = 0.007), prickle cell layer (LA-A, p = 0.008; LA-B, p = 0.001) and superficial layer (LA-B, p = 0.018) in patients with ERD.

Conclusions

Not only the diameter but also the volume of the ICS is increased in patients with GERD. Furthermore, the dilation of ICS is present in all three layers of the SE, being more pronounced in the basal layer. These findings support the concept that the impairment of the esophagus begins in the deeper parts of the esophageal epithelium.

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Acknowledgments

We thank the endoscopy team for their technical assistance. The study was supported by the NBL-3 program of the “Bundesministerium für Forschung und Technik” (01ZZ0407/PFG1) and the “LOM-Program” of the Medical Faculty of the Otto-von-Guericke University Magdeburg.

Conflicts of interest

None of the authors has any conflicts of interest related to this work to declare.

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Authors and Affiliations

  1. Department of Medicine I, University of Erlangen-Nuremberg, Ulmenweg 18, 91054, Erlangen, Germany

    Helmut Neumann

  2. Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany

    Helmut Neumann, Klaus Mönkemüller, Lucía C. Fry, Mike Beyer & Peter Malfertheiner

  3. Department of Internal Medicine/Gastroenterology, Marienhospital Bottrop, Bottrop, Germany

    Klaus Mönkemüller & Lucía C. Fry

  4. Institute of Pathology, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany

    Frank Dombrowski & Doerthe Kuester

  5. Institute of Pathology, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany

    Frank Dombrowski

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  1. Helmut Neumann
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  2. Klaus Mönkemüller
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Correspondence to Peter Malfertheiner.

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Neumann, H., Mönkemüller, K., Fry, L.C. et al. Intercellular Space Volume Is Mainly Increased in the Basal Layer of Esophageal Squamous Epithelium in Patients with GERD. Dig Dis Sci 56, 1404–1411 (2011). https://doi.org/10.1007/s10620-010-1458-0

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  • DOI: https://doi.org/10.1007/s10620-010-1458-0

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