Peroral esophageal muscle biopsy (POEM-b) for Eosinophilic esophageal myositis (EoEM)

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K19332
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Gastroenterology
• Research Institution: Niigata University
• Principal Investigator: Sato Hiroki 新潟大学, 医歯学総合病院, 特任助教 (50644556)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 好酸球性食道筋炎 / Jackhammer esophagus / Achalasia / 内視鏡的筋層切開術 / 内視鏡的食道筋層生検 / EoEM / POEM / POEM-b

Outline of Final Research Achievements

We aimed to analyze the relation between high-resolution manometry (HRM) findings and histology of muscularis externa in esophageal motility disorders using POEM-b. Intestinal cells of Cajal were preserved in high numbers in type III achalasia compared to other achalasia types. In some patients with
Jackhammer esophagus, eosinophilic infiltration of the esophageal
muscle layer was observed, possibly related to the hypercontraction on HRM. Quite different gene expression patterns were reported between EoE and EoEM. Furthermore, among our cases of EoEM, no case transformed to EoE during the follow-up period. Therefore, we support a hypothesis that the pathogenesis of EoEM and EoE are completely different.

Free Research Field

消化器内科学

Academic Significance and Societal Importance of the Research Achievements

これまで食道運動異常症は、高解像度内圧検査(high-resolution manometry:HRM)にて機能診断が行われてきたが、我々は内視鏡的食道筋層生検法(POEM-b)の技術開発によって、機能異常に対応する病態診断を可能とし、より包括的な研究が展開できるようになった。今後、病態に対応した最適な治療法の選択・新規治療法の開発が期待される。