JNM : Original Article ; Relevance of Ultrastructural Alterations of Intercellular Junction Morphology in Inflamed Human Esophagus
의약학 > 내과학
( Chia Chin Liu ) , ( Jeng Woei Lee ) , ( Tso Tsai Liu ) , ( Chih Hsun Yi ) , ( Chien Lin Chen )
대한소화기기능성질환·운동학회(구 대한소화관운동학회)
Journal of Neurogastroenterology and Motility 2013년, 제19권 제3호, 324~331페이지(총8페이지)
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    Background/Aims Detailed characterization of the ultrastructural morphology of intercellular space in gastroesophageal reflux disease has not been fully studied. We aimed to investigate whether subtle alteration in intercellular space structure and tight junction proteins might differ among patients with gastroesophageal reflux disease. Methods Esophageal biopsies at 5 cm above the gastroesophageal junction were obtained from 6 asymptomatic controls, 10 patients with reflux symptoms but without erosions, and 18 patients with erosions. The biopsies were morphologically evaluated by transmission electron microscopy, and by using immunohistochemistry for tight junction proteins (claudin-1 and claudin-2 proteins). Results The expressions of tight junction proteins did not differ between asymptomatic controls and gastroesophageal reflux disease patients. In patients with gastroesophageal reflux disease, altered desmosomal junction morphology was only found in upper stratified squamous epithelium. Dilated intercellular space occurred only in upper stratified squamous epithelium and in patients with erosive esophagitis.Conclusions This study suggests that dilated intercellular space may not be uniformly present inside the esophageal mucosa and predom - inantly it is located in upper squamous epithelium. Presence of desmosomal junction alterations is associated with increased severity of gastroesophageal reflux disease. Besides dilated intercellular space, subtle changes in ultrastructural morphology of intercellular space allow better identification of inflamed esophageal mucosa relevant to acid reflux. (J Neurogastroenterol Motil 2013; 19:324-331)
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