PMID- 29156514
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220311
IS  - 2093-0879 (Print)
IS  - 2093-0887 (Electronic)
IS  - 2093-0879 (Linking)
VI  - 24
IP  - 1
DP  - 2018 Jan 30
TI  - Esophageal Baseline Impedance Reflects Mucosal Integrity and Predicts Symptomatic 
      Outcome With Proton Pump Inhibitor Treatment.
PG  - 43-50
LID - 10.5056/jnm17032 [doi]
AB  - BACKGROUND/AIMS: Esophageal baseline impedance, which is decreased in 
      gastroesophageal reflux disease (GERD) patients, is related to the severity of 
      acid reflux and the integrity of the esophageal mucosa. The study aims to compare 
      the baseline impedance and the dilated intercellular spaces (DIS) within patients 
      with typical reflux symptoms and to evaluate the correlation of baseline 
      impedance with DIS, esophageal acid exposure, as well as the efficacy of proton 
      pump inhibitor (PPI) treatment. METHODS: Ninety-two patients and 10 healthy 
      controls were included in the study. Erosive esophagitis (EE) was defined by 
      esophageal mucosal erosion under upper endoscopy. Patients without mucosa erosion 
      were divided into groups with pathologic acid reflux (non-erosive reflux disease 
      [NERD]) or with hypersensitive esophagus. The biopsies of esophageal mucosa were 
      taken 2-4 cm above the gastroesophageal junction Z-line during upper endoscopy 
      for DIS measurement. All the patients received esomeprazole 20 mg twice-daily 
      treatment for 8 weeks. The efficacy of esomeprazole was evaluated among all 
      patients. RESULTS: The intercellular spaces were dilated in both EE and NERD 
      patients (P < 0.05). The value 0.73 microm could be used as the cut-off DIS value to 
      distinguish patients from controls (area under the curve [AUC] = 0.849, P < 
      0.01). One thousand seven hundred sixty-four ohms could be used as the cut-off 
      impedance values to distinguish patients from controls (AUC = 0.794, P < 0.01). 
      The baseline impedance was decreased in both EE patients and NERD patients, and 
      negatively correlated to the acid exposure time (r = -0.527, P < 0.05). There was 
      a weak correlation between DIS and baseline impedance (r = -0.230, P < 0.05). 
      "Baseline impedance > 1764 Omega" was an independent predictor for PPI failure (OR, 
      11.9; 95% CI, 2.4-58.9; P < 0.01). CONCLUSIONS: The DIS and decreased baseline 
      impedance was observed in patients with mucosa erosion or pathological acid 
      reflux. The baseline impedance reflected the mucosal integrity, it was more 
      sensitive to esophageal acid exposure. Patients with high impedance might not 
      benefit from the PPI treatment.
FAU - Xie, Chenxi
AU  - Xie C
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, Guangzhou, China.
FAU - Sifrim, Daniel
AU  - Sifrim D
AD  - Wingate Institute of Neurogastroenterology, Bart's and the London School of 
      Medicine, Queen Mary, University of London, London, UK.
FAU - Li, Yuwen
AU  - Li Y
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, Guangzhou, China.
FAU - Chen, Minhu
AU  - Chen M
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, Guangzhou, China.
FAU - Xiao, Yinglian
AU  - Xiao Y
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, Guangzhou, China.
LA  - eng
PT  - Journal Article
PL  - Korea (South)
TA  - J Neurogastroenterol Motil
JT  - Journal of neurogastroenterology and motility
JID - 101530189
PMC - PMC5753902
OTO - NOTNLM
OT  - Impedance
OT  - Intercellular spaces
OT  - Proton pump inhibitor
COIS- Conflicts of interest: None.
EDAT- 2017/11/22 06:00
MHDA- 2017/11/22 06:01
PMCR- 2018/01/01
CRDT- 2017/11/21 06:00
PHST- 2017/03/01 00:00 [received]
PHST- 2017/04/23 00:00 [revised]
PHST- 2017/07/12 00:00 [accepted]
PHST- 2017/11/22 06:00 [pubmed]
PHST- 2017/11/22 06:01 [medline]
PHST- 2017/11/21 06:00 [entrez]
PHST- 2018/01/01 00:00 [pmc-release]
AID - jnm17032 [pii]
AID - jnm-24-043 [pii]
AID - 10.5056/jnm17032 [doi]
PST - ppublish
SO  - J Neurogastroenterol Motil. 2018 Jan 30;24(1):43-50. doi: 10.5056/jnm17032.