Korean J Neurogastroenterol Motil.
2006 Jun;12(1):19-24.
Dilated Intercellular Spaces of Esophageal Epithelium in Korean Reflux Esophagitis and Its Reversibility after Esomeprazole Treatment
- Affiliations
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- 1Department of Internal Medicine, Inje University College of Medicine, Paik Hospital, Busan, Korea. tokimom@nate.com
- 2Department of Internal Medicine, Inje University College of Medicine, Dongnae Paik Hospital, Busan, Korea.
Abstract
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BACKGROUND/AIMS: It has been demonstrated that dilated intercellular spaces of esophageal epithelium are a marker of tissue injury in Western gastroesophageal reflux disease (GERD); which heals after proton pump inhibitor (PPI) treatment. The aim of this study was to determine whether dilated intercellular spaces are also a feature of acid damage in Korean GERD patients and are also healed after PPI treatment.
METHODS
Ten GERD patients with heartburn and esophageal mucosal breaks on endoscopy, and 10 controls with no symptoms, normal mucosa on endoscopy and negative 24-hour pH monitoring were enrolled. During upper gastrointestinal endoscopy, four biopsies from normal mucosa were taken within the lower 5 cm of the esophagus for transmission electron microscopy (TEM) analysis. One hundred computer measurements were taken on TEM photomicrographs of the specimens in each patient. After eight weeks of esomeprazole 40 mg/day, patients with erosive esophagitis had another endoscopy with biopsies and the intercellular spaces were measured again.
RESULTS
The mean intercellular space diameter, in the erosive esophagitis patients, was greater than in controls (1.49+/-0.10 micrometer vs 0.49+/-0.10 micrometer, p<0.01). The mean intercellular space diameter, in erosive esophagitis patients, improved after PPI treatment.
CONCLUSIONS
Korean erosive esophagitis patients have dilated intercellular spaces of esophageal epithelium and dilated intercellular spaces can be reversed after esomeprazole treatment.
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