Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity

Abstract Food allergy (FA) affects approximately 3 to 4% of the adult population in westernized countries. Suspected FA is even more prevalent and requires extensive diagnostic work-up. Within this study, we evaluated whether assessment of the integrity of the epithelial barrier by confocal laser en...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Timo Rath, Walburga Dieterich, Christiane Kätscher-Murad, Markus F. Neurath, Yurdagül Zopf
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/58f38d83527b4ab6839748a37d5f4bd6
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:58f38d83527b4ab6839748a37d5f4bd6
record_format	dspace
spelling	oai:doaj.org-article:58f38d83527b4ab6839748a37d5f4bd62021-12-02T17:41:09ZCross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity10.1038/s41598-021-92262-42045-2322https://doaj.org/article/58f38d83527b4ab6839748a37d5f4bd62021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92262-4https://doaj.org/toc/2045-2322Abstract Food allergy (FA) affects approximately 3 to 4% of the adult population in westernized countries. Suspected FA is even more prevalent and requires extensive diagnostic work-up. Within this study, we evaluated whether assessment of the integrity of the epithelial barrier by confocal laser endomicroscopy (CLE) during colonoscopy can be used as a screening tool to identify patients with FA. 60 patients with suspected FA were prospectively included. Serology with total and food-specific IgE, anti-tissue transglutaminase, skin prick testing, food intolerance tests, food intake registration and assessment of clinical complaints were performed. During colonocopy, standardized CLE was performed in the terminal ileum and at two colorectal sites. Analysis of CLE images included functional (i.e. presence of epithelial barrier dysfunction) and quantitative parameters of intestinal architecture. 27 of 60 patients (45%) were diagnosed with FA. Barrier dysfunction was analyzed on 65.837 ileal and on 93.251 colonic images. 96% of patients with FA exhibited functional and structural barrier defects while barrier dysfunction was found in only 33% of patients without FA (p < 0.0001). Visualizing barrier dysfunction with CLE for in vivo diagnosis of FA had a sensitivity and specificity of 96% and 67%, respectively, with a positive and negative prediction of 70% and 96%, respectively. Parameters intrinsic to the crypt architecture including crypt diameter, intercrypt distance, crypt lumen diameter and colonic vasculature were not different between patients with and without FA. CLE-based imaging of the intestinal barrier during colonoscopy might help in stratifying patients with suspected FA for further diagnostic work-up.Timo RathWalburga DieterichChristiane Kätscher-MuradMarkus F. NeurathYurdagül ZopfNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Timo Rath Walburga Dieterich Christiane Kätscher-Murad Markus F. Neurath Yurdagül Zopf Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity
description	Abstract Food allergy (FA) affects approximately 3 to 4% of the adult population in westernized countries. Suspected FA is even more prevalent and requires extensive diagnostic work-up. Within this study, we evaluated whether assessment of the integrity of the epithelial barrier by confocal laser endomicroscopy (CLE) during colonoscopy can be used as a screening tool to identify patients with FA. 60 patients with suspected FA were prospectively included. Serology with total and food-specific IgE, anti-tissue transglutaminase, skin prick testing, food intolerance tests, food intake registration and assessment of clinical complaints were performed. During colonocopy, standardized CLE was performed in the terminal ileum and at two colorectal sites. Analysis of CLE images included functional (i.e. presence of epithelial barrier dysfunction) and quantitative parameters of intestinal architecture. 27 of 60 patients (45%) were diagnosed with FA. Barrier dysfunction was analyzed on 65.837 ileal and on 93.251 colonic images. 96% of patients with FA exhibited functional and structural barrier defects while barrier dysfunction was found in only 33% of patients without FA (p < 0.0001). Visualizing barrier dysfunction with CLE for in vivo diagnosis of FA had a sensitivity and specificity of 96% and 67%, respectively, with a positive and negative prediction of 70% and 96%, respectively. Parameters intrinsic to the crypt architecture including crypt diameter, intercrypt distance, crypt lumen diameter and colonic vasculature were not different between patients with and without FA. CLE-based imaging of the intestinal barrier during colonoscopy might help in stratifying patients with suspected FA for further diagnostic work-up.
format	article
author	Timo Rath Walburga Dieterich Christiane Kätscher-Murad Markus F. Neurath Yurdagül Zopf
author_facet	Timo Rath Walburga Dieterich Christiane Kätscher-Murad Markus F. Neurath Yurdagül Zopf
author_sort	Timo Rath
title	Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity
title_short	Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity
title_full	Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity
title_fullStr	Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity
title_full_unstemmed	Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity
title_sort	cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/58f38d83527b4ab6839748a37d5f4bd6
work_keys_str_mv	AT timorath crosssectionalimagingofintestinalbarrierdysfunctionbyconfocallaserendomicroscopycanidentifypatientswithfoodallergyinvivowithhighsensitivity AT walburgadieterich crosssectionalimagingofintestinalbarrierdysfunctionbyconfocallaserendomicroscopycanidentifypatientswithfoodallergyinvivowithhighsensitivity AT christianekatschermurad crosssectionalimagingofintestinalbarrierdysfunctionbyconfocallaserendomicroscopycanidentifypatientswithfoodallergyinvivowithhighsensitivity AT markusfneurath crosssectionalimagingofintestinalbarrierdysfunctionbyconfocallaserendomicroscopycanidentifypatientswithfoodallergyinvivowithhighsensitivity AT yurdagulzopf crosssectionalimagingofintestinalbarrierdysfunctionbyconfocallaserendomicroscopycanidentifypatientswithfoodallergyinvivowithhighsensitivity
_version_	1718379705777782784

Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity

Ejemplares similares