Establishment of evaluation method for endoscopic esophageal mucosa permeability and its clinical application

2019 Fiscal Year Final Research Report

• Project/Area Number: 26461050
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Gastroenterology
• Research Institution: Kawasaki Medical School
• Principal Investigator: Manabe Noriaki 川崎医科大学, 医学部, 教授 (50403572)
• Co-Investigator(Kenkyū-buntansha): 畠 二郎 川崎医科大学, 医学部, 教授 (00368630) ; 春間 賢 川崎医科大学, 医学部, 教授 (40156526)
• Project Period (FY): 2014-04-01 – 2020-03-31
• Keywords: 胃食道逆流症 / 慢性微細炎症 / プロトンポンプ阻害薬 / 治療抵抗 / 電気抵抗

Outline of Final Research Achievements

BACKGROUND & AIMS: The first aim of this study is to validate the newly developed bioelectrical admittance method (BAM) in-vitro and in-vivo experiment. METHOD: Impedance was measured using a frequency response analyzer with Caco-2 monolayer and 3D tissue. Next, BAM was clinically applied to the evaluation of esophageal mucosal permeability in heartburn patients without esophageal mucosal break. RESULTS: Impedance was highest with monolayer Caco-2 on 8 layers of normal human dermal fibroblasts. In addition, the admittance value varied depending on the treatment course of the patient. CONCLUSION: BAM detected an abnormality of the subepithelial layer of the esophagus. This measurement was also clinically useful in assessing the permeability of the esophageal mucosa under upper gastrointestinal endoscopy.

Free Research Field

消化器内科学

Academic Significance and Societal Importance of the Research Achievements

本手法が確立されると、内視鏡検査で観察できる全ての消化管各部位の粘膜透過性が測定できる検査法となる。また、これまでの研究から消化管粘膜透過性の変調は、非びらん性胃食道逆流症のみならず機能性胃腸症，薬剤性消化管粘膜障害，過敏性腸症候群，潰瘍性大腸炎，クローン病などの慢性炎症性腸疾患など各種消化管疾患に幅広く関係している可能性があり、これらの疾患の病態解明にも繋がることになる。上記のことから、今後の各種消化管疾患の病態解明、治療方針決定のために幅広く臨床応用される可能性が考えられ、臨床上の有用性は極めて高いと考えられる。