AIM： To evaluate the feasibility and utility of confocal laser endomicroscopy （CLE） in the description of normal gastrointestinal （GI） mucosa and in the diagnosis of GI disorders in children, in comparison to his...AIM： To evaluate the feasibility and utility of confocal laser endomicroscopy （CLE） in the description of normal gastrointestinal （GI） mucosa and in the diagnosis of GI disorders in children, in comparison to histology.METHODS： Forty-four patients （19 female） median age 10.9 years （range 0.7-16.6 years） with suspected or known GI pathology underwent esophago-gastro- duodenoscopy （OGD） （n = 36） and/or ileocolonoscopy （IC） （n = 31） with CLE using sodium fluorescein and acriflavine as contrast agents. Histological sections were compared with same site confocal images by two experienced pediatric and GI histopathologists and endoscopists, respectively.RESULTS： Duodenum and ileum were intubated in all but one patient undergoing OGD and IC. The median procedure time was 16.4 min （range 7-25 rain） for OGD and 27.9 min （range 15-45 min） for IC. A total of 4798 confocal images were compared with 153 biopsies from the upper GI tract from 36 procedures, and 4661 confocal images were compared with 188 biopsies from the ileocolon from 31 procedures.Confocal images were comparable to conventional histology both in normal and in pathological conditions such as esophagitis, Helicobacter pylori gastritis, celiac disease, inflammatory bowel disease, colonic heterotopia, and graft versus host disease.CONCLUSION： CLE offers the prospect of targeting biopsies to abnormal mucosa, thereby increasing diagnostic yield, reducing the number of biopsies, decreasing the burden on the histopathological services, and reducing costs.展开更多
AIM:To compare quantities of predominant and pathogenic bacteria in mucosal and faecal samples.METHODS:Twenty patients undergoing diagnostic colonoscopy with endoscopically and histologically normal mucosa were recrui...AIM:To compare quantities of predominant and pathogenic bacteria in mucosal and faecal samples.METHODS:Twenty patients undergoing diagnostic colonoscopy with endoscopically and histologically normal mucosa were recruited to the study,14 subjects of which also supplied faecal(F) samples between 15 d to 105 d post colonoscopy.Mucosal biopsies were taken from each subject from the midportion of the ascending colon(right side samples,RM) and the sigmoid(left side samples,LM).Predominant intestinal and mucosal bacteria including clostridial 16S rRNA gene clusters Ⅳ and ⅩⅣab,Bacteroidetes,Enterobacteriaceae,Bifidobacterium spp.,Akkermansia muciniphila(A.muciniphila),Veillonella spp.,Collinsella spp.,Faecalibacterium prausnitzii(F.prausnitzii) and putative pathogens such asEscherichia coli(E.coli),Clostridium difficile(C.difficile),Helicobacter pylori(H.pylori) and Staphylococcus aureus(S.aureus) were analysed by quantitative polymerase chain reaction(qPCR).Host DNA was quantified from the mucosal samples with human glyceraldehyde 3-phosphate dehydrogenase gene targeting qPCR.Paired t tests and the Pearson correlation were applied for statistical analysis.RESULTS:The most prominent bacterial groups were clostridial groups Ⅳ and ⅩⅣa+b andBacteroidetes and bacterial species F.prausnitzii in both sample types.H.pylori and S.aureus were not detected and C.difficile was detected in only one mucosal sample and three faecal samples.E.coli was detected in less than half of the mucosal samples at both sites,but was present in all faecal samples.All detected bacteria,except Enterobacteriaceae,were present at higher levels in the faeces than in the mucosa,but the different locations in the colon presented comparable quantities(RM,LM and F followed byP 1 for RMvs F,P 2 for LMvs F andP 3 for RM vs LM:4.17 ± 0.60 log 10 /g,4.16 ± 0.56 log 10 /g,5.88 ± 1.92 log 10 /g,P 1 = 0.011,P 2 = 0.0069,P 3 = 0.9778 forA.muciniphila;6.25 ± 1.3 log 10 /g,6.09 ± 0.81 log 10 /g,8.84 ± 1.38 log 10 /g,P 1 < 0.0001,P 2 = 0.0002,P 3 = 0.6893 forBacteroidetes;5.27 ± 1.68 log 10 /g,5.38 ± 2.06 log 10 /g,8.20 ± 1.14 log 10 /g,P 1 < 0.0001,P 2 ≤ 0.0001,P 3 = 0.7535 forBifidobacterium spp.;6.44 ± 1.15 log 10 /g,6.07 ±1.45 log 10 /g,9.74 ±1.13 log 10 /g,P 1 < 0.0001,P 2 ≤ 0.0001,P 3 = 0.637 forClostridium cluster Ⅳ;6.65 ± 1.23 log 10 /g,6.57 ± 1.52 log 10 /g,9.13 ± 0.96 log 10 /g,P 1 < 0.0001,P 2 ≤ 0.0001,P 3 = 0.9317 forClostridium cluster ⅩⅣa;4.57 ± 1.44 log10/g,4.63 ± 1.34 log10/g,7.05 ± 2.48 log 10 /g,P 1 = 0.012,P 2 = 0.0357,P 3 = 0.7973 for Collinsella spp.;7.66 ± 1.50 log 10 /g,7.60 ± 1.05 log 10 /g,10.02 ± 2.02 log 10 /g,P 1 ≤ 0.0001,P 2 = 0.0013,P 3 = 0.9919 forF.prausnitzsii;6.17 ± 1.3 log 10 /g,5.85 ± 0.93 log 10 /g,7.25 ± 1.01 log 10 /g,P 1 = 0.0243,P 2 = 0.0319,P 3 = 0.6982 for Veillonella spp.;4.68 ± 1.21 log 10 /g,4.71 ± 0.83 log 10 /g,5.70 ± 2.00 log 10 /g,P 1 = 0.1927,P 2 = 0.0605,P 3 = 0.6476 forEnterobacteriaceae).TheBifidobacterium spp.counts correlated significantly between mucosal sites and mucosal and faecal samples(Pearson correlation coefficients 0.62,P = 0.040 and 0.81,P = 0.005 between the right mucosal sample and faeces and the left mucosal sample and faeces,respectively).CONCLUSION:Non-invasive faecal samples do not reflect bacterial counts on the mucosa at the individual level,except for bifidobacteria often analysed in probiotic intervention studies.展开更多
基金Supported by Peel Research Foundation and Yorkshire Cancer ResearchThe Egyptian Cultural Bureau
文摘AIM： To evaluate the feasibility and utility of confocal laser endomicroscopy （CLE） in the description of normal gastrointestinal （GI） mucosa and in the diagnosis of GI disorders in children, in comparison to histology.METHODS： Forty-four patients （19 female） median age 10.9 years （range 0.7-16.6 years） with suspected or known GI pathology underwent esophago-gastro- duodenoscopy （OGD） （n = 36） and/or ileocolonoscopy （IC） （n = 31） with CLE using sodium fluorescein and acriflavine as contrast agents. Histological sections were compared with same site confocal images by two experienced pediatric and GI histopathologists and endoscopists, respectively.RESULTS： Duodenum and ileum were intubated in all but one patient undergoing OGD and IC. The median procedure time was 16.4 min （range 7-25 rain） for OGD and 27.9 min （range 15-45 min） for IC. A total of 4798 confocal images were compared with 153 biopsies from the upper GI tract from 36 procedures, and 4661 confocal images were compared with 188 biopsies from the ileocolon from 31 procedures.Confocal images were comparable to conventional histology both in normal and in pathological conditions such as esophagitis, Helicobacter pylori gastritis, celiac disease, inflammatory bowel disease, colonic heterotopia, and graft versus host disease.CONCLUSION： CLE offers the prospect of targeting biopsies to abnormal mucosa, thereby increasing diagnostic yield, reducing the number of biopsies, decreasing the burden on the histopathological services, and reducing costs.
基金Supported by Grants from the Swedish Cancer Society and the Swedish State under the LUA-ALF Agreement
文摘AIM:To compare quantities of predominant and pathogenic bacteria in mucosal and faecal samples.METHODS:Twenty patients undergoing diagnostic colonoscopy with endoscopically and histologically normal mucosa were recruited to the study,14 subjects of which also supplied faecal(F) samples between 15 d to 105 d post colonoscopy.Mucosal biopsies were taken from each subject from the midportion of the ascending colon(right side samples,RM) and the sigmoid(left side samples,LM).Predominant intestinal and mucosal bacteria including clostridial 16S rRNA gene clusters Ⅳ and ⅩⅣab,Bacteroidetes,Enterobacteriaceae,Bifidobacterium spp.,Akkermansia muciniphila(A.muciniphila),Veillonella spp.,Collinsella spp.,Faecalibacterium prausnitzii(F.prausnitzii) and putative pathogens such asEscherichia coli(E.coli),Clostridium difficile(C.difficile),Helicobacter pylori(H.pylori) and Staphylococcus aureus(S.aureus) were analysed by quantitative polymerase chain reaction(qPCR).Host DNA was quantified from the mucosal samples with human glyceraldehyde 3-phosphate dehydrogenase gene targeting qPCR.Paired t tests and the Pearson correlation were applied for statistical analysis.RESULTS:The most prominent bacterial groups were clostridial groups Ⅳ and ⅩⅣa+b andBacteroidetes and bacterial species F.prausnitzii in both sample types.H.pylori and S.aureus were not detected and C.difficile was detected in only one mucosal sample and three faecal samples.E.coli was detected in less than half of the mucosal samples at both sites,but was present in all faecal samples.All detected bacteria,except Enterobacteriaceae,were present at higher levels in the faeces than in the mucosa,but the different locations in the colon presented comparable quantities(RM,LM and F followed byP 1 for RMvs F,P 2 for LMvs F andP 3 for RM vs LM:4.17 ± 0.60 log 10 /g,4.16 ± 0.56 log 10 /g,5.88 ± 1.92 log 10 /g,P 1 = 0.011,P 2 = 0.0069,P 3 = 0.9778 forA.muciniphila;6.25 ± 1.3 log 10 /g,6.09 ± 0.81 log 10 /g,8.84 ± 1.38 log 10 /g,P 1 < 0.0001,P 2 = 0.0002,P 3 = 0.6893 forBacteroidetes;5.27 ± 1.68 log 10 /g,5.38 ± 2.06 log 10 /g,8.20 ± 1.14 log 10 /g,P 1 < 0.0001,P 2 ≤ 0.0001,P 3 = 0.7535 forBifidobacterium spp.;6.44 ± 1.15 log 10 /g,6.07 ±1.45 log 10 /g,9.74 ±1.13 log 10 /g,P 1 < 0.0001,P 2 ≤ 0.0001,P 3 = 0.637 forClostridium cluster Ⅳ;6.65 ± 1.23 log 10 /g,6.57 ± 1.52 log 10 /g,9.13 ± 0.96 log 10 /g,P 1 < 0.0001,P 2 ≤ 0.0001,P 3 = 0.9317 forClostridium cluster ⅩⅣa;4.57 ± 1.44 log10/g,4.63 ± 1.34 log10/g,7.05 ± 2.48 log 10 /g,P 1 = 0.012,P 2 = 0.0357,P 3 = 0.7973 for Collinsella spp.;7.66 ± 1.50 log 10 /g,7.60 ± 1.05 log 10 /g,10.02 ± 2.02 log 10 /g,P 1 ≤ 0.0001,P 2 = 0.0013,P 3 = 0.9919 forF.prausnitzsii;6.17 ± 1.3 log 10 /g,5.85 ± 0.93 log 10 /g,7.25 ± 1.01 log 10 /g,P 1 = 0.0243,P 2 = 0.0319,P 3 = 0.6982 for Veillonella spp.;4.68 ± 1.21 log 10 /g,4.71 ± 0.83 log 10 /g,5.70 ± 2.00 log 10 /g,P 1 = 0.1927,P 2 = 0.0605,P 3 = 0.6476 forEnterobacteriaceae).TheBifidobacterium spp.counts correlated significantly between mucosal sites and mucosal and faecal samples(Pearson correlation coefficients 0.62,P = 0.040 and 0.81,P = 0.005 between the right mucosal sample and faeces and the left mucosal sample and faeces,respectively).CONCLUSION:Non-invasive faecal samples do not reflect bacterial counts on the mucosa at the individual level,except for bifidobacteria often analysed in probiotic intervention studies.
