Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease
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Citações na Scopus
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
GEORG THIEME VERLAG KG
Autores
TSAKMAKI, Anastasia
BEWICK, Gavin A.
Citação
ENDOSCOPY INTERNATIONAL OPEN, v.7, n.5, p.E685-E690, 2019
Resumo
Background and study aims Minimally invasive procedures that replicate aspects of bariatric surgery with more favorable safety and tolerability offer an attractive alternative in management of metabolic disease. Duodenal mucosal resurfacing (DMR), an endoscopic procedure using hydrothermal ablation, is designed to remove surface epithelium to allow subsequent epithelial regeneration and a reset to a more insulin-sensitive state. Materials and methods DMR was performed on a healthy pig under general ancthesia, approximating the procedure designed for use in humans. Immediately post-DMR, analysis of the histological landscape was conducted in distinct duodenal areas that received ablation treatment. Results DMR submucosal lift and hydrothermal ablation elicited disruption of villous tips and partial disruption of the crypt base with no damage to deeper tissue. Excessive ablation (purposeful double ablation exposure) did incur damage to the underlying muscle layer. Conclusion Our results confirmed that DMR elicits superficial ablation of duodenal villi and crypts. Defining the cellular consequences of ablation and regeneration of the epithelium will aid our understanding of how and why DMR affects metabolic homeostasis.
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Referências
- Buchwald H, 2009, AM J MED, V122, P248, DOI 10.1016/j.amjmed.2008.09.041
- Cummings D E, 2012, COMMUNITY CORNER HEA, V18, P2011
- Cummings DE, 2018, DIABETOLOGIA, V61, P257, DOI 10.1007/s00125-017-4513-y
- de Jonge C, 2013, OBES SURG, V23, P1354, DOI 10.1007/s11695-013-0921-3
- Flum DR, 2009, NEW ENGL J MED, V361, P445, DOI 10.1056/NEJMoa0901836
- Ikramuddin S, 2013, JAMA-J AM MED ASSOC, V309, P2240, DOI 10.1001/jama.2013.5835
- Kindel TL, 2009, J GASTROINTEST SURG, V13, P1762, DOI 10.1007/s11605-009-0912-9
- Obeid NR, 2016, SURG OBES RELAT DIS, V12, P11, DOI 10.1016/j.soard.2015.04.011
- PORIES WJ, 1995, ANN SURG, V222, P339, DOI 10.1097/00000658-199509000-00011
- Rajagopalan H, 2016, DIABETES CARE, V39, P2254, DOI 10.2337/dc16-0383
- Rubino F, 2006, ANN SURG, V244, P741, DOI 10.1097/01.sla.0000224726.61448.1b
- Machado CJS, 2009, SCIENCE, V324, P1643, DOI 10.1126/science.324_1643
- Schauer PR, 2012, NEW ENGL J MED, V366, P1567, DOI 10.1056/NEJMoa1200225
- Van Baar ACG, 2018, DIABETES, V67, DOI 10.2337/db18-1137-P
- Yan Y, 2016, MEDICINE, V95, DOI 10.1097/MD.0000000000003462