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World J Gastroenterol. Oct 7, 2008; 14(37): 5712-5716
Published online Oct 7, 2008. doi: 10.3748/wjg.14.5712
Esophageal epithelial surface in patients with gastroesophageal reflux disease: An electron microscopic study
Takane Azumi, Kyoichi Adachi, Kenji Furuta, Shuji Nakata, Shunji Ohara, Kenji Koshino, Masaharu Miki, Terumi Morita, Takashi Tanimura, Nobuo Ashizawa, Yoshikazu Kinoshita
Takane Azumi, Kyoichi Adachi, Kenji Furuta, Shuji Nakata, Shunji Ohara, Kenji Koshino, Masaharu Miki, Terumi Morita, Takashi Tanimura, Nobuo Ashizawa, Yoshikazu Kinoshita, Second Department of Internal Medicine, Shimane University School of Medicine, Shimane 693-8501, Japan
Author contributions: Azumi T and Adachi K contributed equally to this work; Adachi K, Ashizawa N and Kinoshita Y designed research; Azumi T, Adachi K, Furuta K, Nakata S, Ohara S, Koshino K, Miki M, Morita T, Tanimura T performed research; Azumi T and Adachi K contributed new reagents/analytic tools; Azumi T and Adachi K analyzed data; and Azumi T, Adachi K and Kinoshita Y wrote the paper.
Supported by The Grants-in-Aid from Science Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan, No. 19590724
Correspondence to: Kyoichi Adachi, MD, PhD, Second Department of Internal Medicine, Shimane University School of Medicine, 89-1, Enya-cho, Izumo-shi, Shimane 693-8501, Japan. kadachi@med.shimane-u.ac.jp
Telephone: +81-853-202190 Fax: +81-853-202187
Received: August 3, 2008
Revised: September 16, 2008
Accepted: September 23, 2008
Published online: October 7, 2008
Abstract

AIM: To investigate the intercellular spaces between the most superficially located esophageal epithelial cells in patients with gastroesophageal reflux disease (GERD).

METHODS: Eighteen patients with erosive esophagitis, 10 patients with non-erosive reflux disease (NERD), and 18 normal asymptomatic volunteers were enrolled. Biopsy specimens were obtained from the lower esophageal mucosa without ulcer or erosion. Scanning electron microscopy was employed to investigate the tightness of the superficial cellular attachment.

RESULTS: The intercellular space between the most superficially located epithelial cells in patients with erosive esophagitis or NERD was not different from that in asymptomatic healthy individuals.

CONCLUSION: Widened luminal intercellular spaces of esophageal superficial epithelium are not responsible for the induction of reflux symptoms in patients with GERD.

Keywords: Reflux esophagitis; Non-erosive gastroesophageal reflux diseases; Electron microscopy; Questionnaire