Farrell C, Morgan M, Tully O, Wolov K, Kearney K, Ngo B, Mercogliano G, Thornton JJ, Valenzano MC, Mullin JM. Transepithelial leak in Barrett's esophagus patients: The role of proton pump inhibitors. World J Gastroenterol 2012; 18(22): 2793-2797 [PMID: 22719187 DOI: 10.3748/wjg.v18.i22.2793]
Corresponding Author of This Article
James M Mullin, PhD, Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA 19096, United States. mullinj@mlhs.org
Article-Type of This Article
Brief Article
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World J Gastroenterol. Jun 14, 2012; 18(22): 2793-2797 Published online Jun 14, 2012. doi: 10.3748/wjg.v18.i22.2793
Transepithelial leak in Barrett's esophagus patients: The role of proton pump inhibitors
Christopher Farrell, Melissa Morgan, Owen Tully, Kevin Wolov, Keith Kearney, Benjamin Ngo, Giancarlo Mercogliano, James J Thornton, Mary Carmen Valenzano, James M Mullin
Christopher Farrell, Melissa Morgan, Owen Tully, Kevin Wolov, Keith Kearney, Benjamin Ngo, Giancarlo Mercogliano, James J Thornton, Division of Gastroenterology, Lankenau Hospital, Wynnewood, PA 19096, United States
Mary Carmen Valenzano, James M Mullin, Lankenau Institute for Medical Research, Wynnewood, PA 19096, United States
Author contributions: Farrell C and Mullin JM jointly wrote this paper; Farrell C, Morgan M, Tully O, Wolov K, Kearney K, Ngo B, Mercogliano G and Thornton JJ were responsible for patient recruitment, informed consent and exclusions; Farrell C and Mullin J formulated study protocols and obtained The Main Line Hospitals Institutional Review Board approval; Valenzano MC prepared sucrose permeability test kits, measured urine sucrose concentrations and scheduled all patient testing.
Supported by Sharpe-Strumia Research Foundation of the Bryn Mawr Hospital
Correspondence to: James M Mullin, PhD, Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA 19096, United States. mullinj@mlhs.org
Telephone: +1-484-4762703 Fax: +1-484-4762205
Received: September 1, 2011 Revised: October 19, 2011 Accepted: May 12, 2012 Published online: June 14, 2012
Abstract
AIM: To determine if the observed paracellular sucrose leak in Barrett’s esophagus patients is due to their proton pump inhibitor (PPI) use.
METHODS: The in vivo sucrose permeability test was administered to healthy controls, to Barrett’s patients and to non-Barrett’s patients on continuous PPI therapy. Degree of leak was tested for correlation with presence of Barrett’s, use of PPIs, and length of Barrett’s segment and duration of PPI use.
RESULTS: Barrett’s patients manifested a near 3-fold greater, upper gastrointestinal sucrose leak than healthy controls. A decrease of sucrose leak was observed in Barrett’s patients who ceased PPI use for 7 d. Although initial introduction of PPI use (in a PPI-naïve population) results in dramatic increase in sucrose leak, long-term, continuous PPI use manifested a slow spontaneous decline in leak. The sucrose leak observed in Barrett’s patients showed no correlation to the amount of Barrett’s tissue present in the esophagus.
CONCLUSION: Although future research is needed to determine the degree of paracellular leak in actual Barrett’s mucosa, the relatively high degree of leak observed with in vivo sucrose permeability measurement of Barrett’s patients reflects their PPI use and not their Barrett’s tissue per se.
