Confocal Endomicroscopy for Permeability of Esophageal Wall in Refractory Gastroesophageal Reflux Disease (GERD)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Pritesh R Mutha, MD,MPH
- Phone Number: 5021 804-675-5000
- Email: pritesh.mutha@va.gov
Study Locations
-
-
Virginia
-
Richmond, Virginia, United States, 23249
- Recruiting
- Hunter Holmes McGuire VA Medical Center
-
Contact:
- Pritesh R Pritesh, MD,MPH
- Phone Number: 5021 804-675-5000
- Email: pritesh.mutha@va.gov
-
Principal Investigator:
- Pritesh R Pritesh, MD,MPH
-
Sub-Investigator:
- Tilak Shah, MD
-
Sub-Investigator:
- Mitchell Schubert, MD
-
Sub-Investigator:
- Alvin Zfass, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age > 18 years
- Ability to give informed consent
Exclusion Criteria:
- Pregnancy
- Esophageal varices
- Prior esophageal or gastric surgery
- Active gastrointestinal bleeding
- Evidence of esophageal malignancy
- Inability to provide informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Non-erosive reflux disease (NERD)
Patient's with GERD refractory to PPI with no evidence of erosive esophagitis on endoscopy.
Confocal endomicroscopy, endoscopic biopsies and mucosal impedance (MI) will be performed.
|
Confocal laser endomicroscopy (CLE) permits real-time in-vivo histologic analysis of esophageal mucosa at the time of upper endoscopy.
The technology is based on the principle of illuminating a tissue with a low-power laser and then detecting fluorescent light reflected from the tissue.
Because CLE relies upon tissue fluorescence, intravenous fluorescein is generally used to highlight the vasculature and intercellular spaces of the tissue being examined.
Other Names:
Additional biopsies will be obtained of the esophageal mucosa.These will be obtained with a standard biopsy forceps inserted through the channel in gastroscope.
MI balloon measures epithelial impedance along a 10 cm length of esophagus.
The gastroscope will be withdrawn and the MI balloon will be advanced into the esophagus through the mouth.
The balloon will be inflated so that the sensors contact the esophageal mucosa.
After MI measurements are obtained, the balloon will be deflated and withdrawn.
|
|
Active Comparator: Barrett's esophagus/erosive esophagitis
Patient's with Barrett's esophagus or with erosive esophagitis on endoscopy.
Confocal endomicroscopy, endoscopic biopsies and mucosal impedance (MI) will be performed.
|
Confocal laser endomicroscopy (CLE) permits real-time in-vivo histologic analysis of esophageal mucosa at the time of upper endoscopy.
The technology is based on the principle of illuminating a tissue with a low-power laser and then detecting fluorescent light reflected from the tissue.
Because CLE relies upon tissue fluorescence, intravenous fluorescein is generally used to highlight the vasculature and intercellular spaces of the tissue being examined.
Other Names:
Additional biopsies will be obtained of the esophageal mucosa.These will be obtained with a standard biopsy forceps inserted through the channel in gastroscope.
MI balloon measures epithelial impedance along a 10 cm length of esophagus.
The gastroscope will be withdrawn and the MI balloon will be advanced into the esophagus through the mouth.
The balloon will be inflated so that the sensors contact the esophageal mucosa.
After MI measurements are obtained, the balloon will be deflated and withdrawn.
|
|
Placebo Comparator: Control
Patient's with no h/o GERD or Barrett's esophagus who are undergoing endoscopy for non-GERD related indication.
Confocal endomicroscopy, endoscopic biopsies and mucosal impedance (MI) will be performed.
|
Confocal laser endomicroscopy (CLE) permits real-time in-vivo histologic analysis of esophageal mucosa at the time of upper endoscopy.
The technology is based on the principle of illuminating a tissue with a low-power laser and then detecting fluorescent light reflected from the tissue.
Because CLE relies upon tissue fluorescence, intravenous fluorescein is generally used to highlight the vasculature and intercellular spaces of the tissue being examined.
Other Names:
Additional biopsies will be obtained of the esophageal mucosa.These will be obtained with a standard biopsy forceps inserted through the channel in gastroscope.
MI balloon measures epithelial impedance along a 10 cm length of esophagus.
The gastroscope will be withdrawn and the MI balloon will be advanced into the esophagus through the mouth.
The balloon will be inflated so that the sensors contact the esophageal mucosa.
After MI measurements are obtained, the balloon will be deflated and withdrawn.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Correlation between the time from intravenous injection of fluorescein to visualization of fluorescein on probe based confocal endomicroscopy (pCLE) with esophageal permeability (i.e. - epithelial barrier function).
Time Frame: Through study completion, an average of 1 year.
|
Through study completion, an average of 1 year.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Compare the time from intravenous injection of fluorescein to visualization of fluorescein on probe based confocal endomicroscopy (pCLE) in patients with Barrett's esophagus and controls
Time Frame: Through study completion, an average of 1 year.
|
Through study completion, an average of 1 year.
|
|
Compare the time from intravenous injection of fluorescein to visualization of fluorescein on probe based confocal endomicroscopy (pCLE) in patients with symptoms of refractory GERD and Barrett's esophagus
Time Frame: Through study completion, an average of 1 year.
|
Through study completion, an average of 1 year.
|
|
Correlation between the Ussing's chamber findings (esophageal permeability) and confocal endomicroscopy findings of patients with symptoms of refractory GERD and Barrett's esophagus
Time Frame: Through study completion, an average of 1 year.
|
Through study completion, an average of 1 year.
|
|
Correlation between the Ussing's chamber findings (esophageal permeability) and confocal endomicroscopy findings of patients with symptoms of refractory GERD and controls
Time Frame: Through study completion, an average of 1 year.
|
Through study completion, an average of 1 year.
|
|
Correlation between the Ussing's chamber findings (esophageal permeability) and Mucosal impedance findings of patients with symptoms of refractory GERD and controls
Time Frame: Through study completion, an average of 1 year.
|
Through study completion, an average of 1 year.
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Vaezi MF, Choksi Y. Mucosal Impedance: A New Way To Diagnose Reflux Disease and How It Could Change Your Practice. Am J Gastroenterol. 2017 Jan;112(1):4-7. doi: 10.1038/ajg.2016.513. Epub 2016 Dec 13. No abstract available.
- Cui R, Zhou L, Lin S, Xue Y, Duan L, Xia Z, Jin Z, Zhang H, Zhang J, Song Z, Yan X. The feasibility of light microscopic measurements of intercellular spaces in squamous epithelium in the lower-esophagus of GERD patients. Dis Esophagus. 2011 Jan;24(1):1-5. doi: 10.1111/j.1442-2050.2010.01083.x.
- Tobey NA, Carson JL, Alkiek RA, Orlando RC. Dilated intercellular spaces: a morphological feature of acid reflux--damaged human esophageal epithelium. Gastroenterology. 1996 Nov;111(5):1200-5. doi: 10.1053/gast.1996.v111.pm8898633.
- Chu CL, Zhen YB, Lv GP, Li CQ, Li Z, Qi QQ, Gu XM, Yu T, Zhang TG, Zhou CJ, Rui-Ji, Li YQ. Microalterations of esophagus in patients with non-erosive reflux disease: in-vivo diagnosis by confocal laser endomicroscopy and its relationship with gastroesophageal reflux. Am J Gastroenterol. 2012 Jun;107(6):864-74. doi: 10.1038/ajg.2012.44. Epub 2012 Mar 13.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2282
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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