Clinical–Alimentary TractIdentification of Epithelial Gaps in Human Small and Large Intestine by Confocal Endomicroscopy
Section snippets
Patients
Patients undergoing colonoscopy for cancer screening or investigation of abdominal pain were recruited. Patients with known active inflammatory bowel diseases, acute gastrointestinal bleeding, coagulopathy (prothrombin time <50% of control; partial thromboplastin time >50 seconds), impaired renal function (creatinine level >1.2 mg/dL), pregnancy or breast-feeding, inability to give informed consent, and known allergy to fluorescein or acriflavine were excluded. Patients with inadequate bowel
Results
We have previously used the nuclear stain Hoechst 33258 to find discontinuities in the murine epithelial layer, identified by the absence of a nucleus. Acriflavine has been reported as a dye for confocal microendoscopy that stains nuclei and, unlike Hoechst 33258, is approved for use in human endoscopy.10
Discussion
Confocal endomicroscopy is an emerging technology that presents an unfamiliar view of intestinal morphology. We have taken a translational approach to help identify and interpret one of the more unexpected features observed using this imaging modality. In brief summary, we provide evidence that inhomogeneities in acriflavine staining of the intestinal epithelium are explained by 2 features: lack of goblet cell staining and occasional epithelial discontinuities (gaps). As confocal endomicroscopy
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Supported by the HVC Foundation (grant 10). R.K. holds an unrestricted grant from Pentax Europe.
The authors report that no conflicts of interest exist.
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R.K. and M.G. share first authorship.