Mucosal Barrier Defects in Functional Dyspepsia by Confocal Laser Endomicroscopy
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Purpose
There has been recent interest into the potential role of mucosal barrier defects in the pathophysiology of functional gastrointestinal disorders (FGIDs). There has been evidence of increased intestinal permeability in patients of IBS,and abnormal tissue resistance in NERD. Although the mucosa of Functional dyspepsia (FD) patients is endoscopically and histologically "normal," it contains ultrastructural changes, activated immune cells, along with evidence of an increased release of mediators leading to gastric dysfunction. There is now consistent evidence indicating that mucosal barrier defects allow the passage of an increased load of bacteria, antigens and toxins which, in turn evoke activation of mucosal immune responses involved in the FD symptom.
| Condition |
|---|
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Functional Dyspepsia |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Minimal Changes of Gastric Mucosal Barrier in the Pathophysiologic Mechanisms of Functional Dyspepsia |
- Specific microscopic changes in the gastric mucosa as seen under the confocal endomicroscope [ Time Frame: Within the 30 minutes after injection of fluorescein ] [ Designated as safety issue: No ]
- the relationship among minimal changes, FD symptoms , neuropeptides and immune responses. [ Time Frame: after the immunohistochemistry of biopsy ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples With DNA
Biopsies during endoscopy
| Estimated Enrollment: | 80 |
| Study Start Date: | July 2009 |
| Estimated Study Completion Date: | July 2010 |
| Estimated Primary Completion Date: | March 2010 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
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Healthy controls
Asymptomatic individuals admitted for health surveillance or patients for follow up after polypectomy.
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Functional dyspepsia-EPS
Functional dyspepsia-EPS(epigastric pain syndrome) Patients admitted to outpatient department with symptoms meeting ROME III criteria
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Functional dyspepsia-PDS
Functional dyspepsia-PDS(postprandial distress syndrome) Patients admitted to outpatient department with symptoms meeting ROME III criteria
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Detailed Description:
Confocal laser endomicrosopy is a newly developed device which allows in vivo and real time observation of gastrointestinal mucosa.In our pilot study we found that the contrast agent fluorescein sodium shew differences of leakage into intercellular spaces and crypt lumen among different patients of FD.
This study is aimed to determine if there is microscopic changes detectable in the gastric mucosal epithelium through confocal endomicroscopy of FD patients, and to evaluate the relationship among minimal changes(transmission electron microscopy and Confocal laser endomicrosopy ), FD symptoms(symptom index form) , neuropeptides and immune responses(immunohistochemistry).
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
Patients with indications for upper-endoscopy in Qilu Hospital outpatient and inpatient department are the study population of this study.
Inclusion Criteria:
- patients meeting IBS diagnosis criteria and indications for endoscopy investigation.
- Asymptomatic individuals for health surveillance or patients for follow up after polypectomy.
Exclusion Criteria:
- Esophageal, gastric or duodenal cancer or other malignancy
- History of esophagus, stomach, or duodenum surgery
- Conditions that preclude safe biopsies (coagulopathy, haemophilia, esophageal varices,and patients on warfarin and antiplatelets)
- A history of bronchial asthma, or known allergy to fluorescein
- Pregnant or breast‐feeding (for females)
- Below 18 or above 75 years of age
- Severe co‐morbidities
- Unable or unwilling to give informed consent
Contacts and Locations| Contact: Yanqing Li, PhD. MD. | 86-531-8216923 | qiluliyanqign@gmail.com |
| China, Shandong | |
| Department of Gastroenterology, Qilu Hospital, Shandong University | Recruiting |
| Jinan, Shandong, China, 250012 | |
| Contact: Yanqing Li, PhD. MD. 86-531-82169236 ext 82169508 qiluliyanqing@gmail.com | |
| Contact: Rui Ji, MD. 86-531-88396062 ext 82169328 jirui905@gmail.com | |
| Principal Investigator: Yanqing Li, PhD. MD. | |
| Sub-Investigator: Rui Ji, MD. | |
| Study Director: | Yanqing Li, PhD. MD. | Department of Gastroenterology, Qilu Hospital |
More Information
No publications provided
| Responsible Party: | Yan-Qing Li, Department of Gastroenterology, Qilu Hospital, Shandong University |
| ClinicalTrials.gov Identifier: | NCT01006642 History of Changes |
| Other Study ID Numbers: | 2009SDU-QILU-G04 |
| Study First Received: | November 2, 2009 |
| Last Updated: | November 2, 2009 |
| Health Authority: | China: Ministry of Health |
Additional relevant MeSH terms:
|
Dyspepsia Gastritis Signs and Symptoms, Digestive Signs and Symptoms |
Gastroenteritis Gastrointestinal Diseases Digestive System Diseases Stomach Diseases |
ClinicalTrials.gov processed this record on May 16, 2013