Optical Tools to Investigate Cellular Activity in the Intestinal Wall

Boesmans, Werend; Hao, Marlene M; Berghe, Pieter Vanden

doi:10.5056/jnm15096

Cited by 30 publications

(26 citation statements)

References 141 publications

(119 reference statements)

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“…Although dye-based methods can significantly enhance these approaches in experimental models, their applicability to humans in vivo is unclear. 10,11 In the present study, Othman and colleagues 12 present their results of yet another technique. These investigators used EUS to guide a 19-gauge needle into the deep muscle layer of the gastric antrum in patients with diabetic gastroparesis undergoing neurostimulator placement.…”

mentioning

confidence: 73%

Endoscopy of the “brain”: the next frontier in gastroenterology

Grover

Farrugia

Pasricha³

2016

Gastrointestinal Endoscopy

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mentioning

confidence: 73%

Endoscopy of the “brain”: the next frontier in gastroenterology

Grover

Farrugia

Pasricha³

2016

Gastrointestinal Endoscopy

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“…Enteric neurons have been proposed to have a fast turnover rate compared to neurons in the central nervous system. This imaging technology can monitor enteric neuron development and turnover 72 , which can be a useful technique for analyzing disease models like Hirschsprung's disease, to monitor aganglionosis in the distal colon 73,74 . While in vitro and ex vivo experiments provide useful data regarding ENS dynamics 75,76 , it is more physiologically relevant to monitor the ENS in vivo in which extrinsic pathways are intact and the ENS can interact with immune cells, enteroendocrine cells, and others 49,[77][78][79][80] .…”

Section: Discussionmentioning

confidence: 99%

An intravital window to image the colon in real time

et al. 2019

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Intravital microscopy is a powerful technique to observe dynamic processes with single-cell resolution in live animals. No intravital window has been developed for imaging the colon due to its anatomic location and motility, although the colon is a key organ where the majority of microbiota reside and common diseases such as inflammatory bowel disease, functional gastrointestinal disorders, and colon cancer occur. Here we describe an intravital murine colonic window with a stabilizing ferromagnetic scaffold for chronic imaging, minimizing motion artifacts while maximizing long-term survival by preventing colonic obstruction. Using this setup, we image fluorescently-labeled stem cells, bacteria, and immune cells in live animal colons. Furthermore, we image nerve activity via calcium imaging in real time to demonstrate that electrical sacral nerve stimulation can activate colonic enteric neurons. The simple implantable apparatus enables visualization of live processes in the colon, which will open the window to a broad range of studies.

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“…The limitations of these 2 techniques are the small sample volume of MP and the fragmented samples that can impair proper tissue orientation and impact diagnostic yield. The use of confocal laser endomicroscopy for optical histologic imaging is promising, but depth of imaging may not be sufficient in the stomach and the applicability of dye-based methods in humans is unclear 18,19,20,21 .…”

Section: Discussionmentioning

confidence: 99%

Innovative gastric endoscopic muscle biopsy to identify all cell types, including myenteric neurons and interstitial cells of Cajal in patients with idiopathic gastroparesis: a feasibility study (with video)

Rajan

Gostout

Song

et al. 2016

Gastrointestinal Endoscopy

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Background and Aims The pathophysiology of some gastrointestinal neuromuscular diseases (GINMD) remains largely unknown. This is in part due to the inability to obtain ample deep gastric wall biopsies that include the intermuscular layer of the muscularis propria (MP) to evaluate the enteric nervous system, interstitial cells of Cajal (ICC) and related cells. We report on a novel technique for gastric endoscopic muscle biopsy (gEMB). Methods Patients with idiopathic gastroparesis were prospectively enrolled in a feasibility study using a novel “no hole” gEMB. Main outcome measures were technical success, adverse events and histological confirmation of the intermuscular layer, including myenteric neurons and ICC. The gEMB was a double resection clip–assist technique. A site was identified on the anterior wall of the gastric body as recommended by the International Working Group on histological techniques. Endoscopic mucosal resection was performed to unroof and expose the underlying MP. The exposed MP was then retracted into the cap of an over-the-scope clip. The clip was deployed and the pseudopolyp of MP created was resected. This resulted in a “nohole” gEMB. Results Three patients with idiopathic gastroparesis underwent gEMB. Patients had severe delayed gastric emptying with a mean of 49 ± 16.8% of retained gastric contents at 4 hours. They had no history of gastric or small-bowel surgery, and did not use steroids or other immunosuppressive drugs. The gEMB procedure was successfully performed with no procedural adverse events. Postprocedure abdominal pain was controlled with nonsteroidal anti-inflammatory agents and opioid analgesics. Mean length of resected MP was 10.3 ± 1.5 mm. Mean procedure time was 25.7 ± 6 minutes. Tissue samples on hematoxylin and eosin (H&E) stain confirmed presence of both inner circular and outer longitudinal muscle as well as the intermuscular layer. H&E stain showed reduced myenteric ganglia in 1 patient. In 2 patients, specialized immunohistochemistry was performed, which showed marked decrease in myenteric neurons as delineated by an antibody to Protein Gene Product (PGP) 9.5 and severe decrease in ICC across the muscle layers. At 1 month follow-up, upper endoscopy showed a well-healed scar in 2 patients and minimal ulceration with retained clip in 1 patient. CT abdomen confirmed the integrity of the gastric wall in all patients. Due to lack of an immune infiltrate in the resected samples, patients were not considered suitable for immunosuppressive or steroid therapy. Conclusions gEMB is feasible and easy to perform, with acquisition of tissue close to surgical samples to identify myenteric ganglia, ICC and multiple cell types. The ability to perform gEMB represents a paradigm shift in endoscopic tissue diagnosis of gastric neuromuscular pathologies.

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Optical Tools to Investigate Cellular Activity in the Intestinal Wall

Cited by 30 publications

References 141 publications

Endoscopy of the “brain”: the next frontier in gastroenterology

Endoscopy of the “brain”: the next frontier in gastroenterology

An intravital window to image the colon in real time

Innovative gastric endoscopic muscle biopsy to identify all cell types, including myenteric neurons and interstitial cells of Cajal in patients with idiopathic gastroparesis: a feasibility study (with video)

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