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Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease
Background and study aims Minimally invasive procedures that replicate aspects of bariatric surgery with more favorable safety and tolerability offer an attractive alternative in management of metabolic disease. Duodenal mucosal resurfacing (DMR), an endoscopic procedure using hydrothermal ablation...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
© Georg Thieme Verlag KG
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519358/ https://www.ncbi.nlm.nih.gov/pubmed/31098390 http://dx.doi.org/10.1055/a-0862-0263 |
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author | de Moura, Eduardo G. H. Ponte-Neto, Alberto M. Tsakmaki, Anastasia Aiello, Vera Demarchi Bewick, Gavin A. Brunaldi, Vitor O. |
author_facet | de Moura, Eduardo G. H. Ponte-Neto, Alberto M. Tsakmaki, Anastasia Aiello, Vera Demarchi Bewick, Gavin A. Brunaldi, Vitor O. |
author_sort | de Moura, Eduardo G. H. |
collection | PubMed |
description | Background and study aims Minimally invasive procedures that replicate aspects of bariatric surgery with more favorable safety and tolerability offer an attractive alternative in management of metabolic disease. Duodenal mucosal resurfacing (DMR), an endoscopic procedure using hydrothermal ablation, is designed to remove surface epithelium to allow subsequent epithelial regeneration and a reset to a more insulin-sensitive state. Materials and methods DMR was performed on a healthy pig under general anethesia, approximating the procedure designed for use in humans. Immediately post-DMR, analysis of the histological landscape was conducted in distinct duodenal areas that received ablation treatment. Results DMR submucosal lift and hydrothermal ablation elicited disruption of villous tips and partial disruption of the crypt base with no damage to deeper tissue. Excessive ablation (purposeful double ablation exposure) did incur damage to the underlying muscle layer. Conclusion Our results confirmed that DMR elicits superficial ablation of duodenal villi and crypts. Defining the cellular consequences of ablation and regeneration of the epithelium will aid our understanding of how and why DMR affects metabolic homeostasis. |
format | Online Article Text |
id | pubmed-6519358 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | © Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-65193582019-05-16 Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease de Moura, Eduardo G. H. Ponte-Neto, Alberto M. Tsakmaki, Anastasia Aiello, Vera Demarchi Bewick, Gavin A. Brunaldi, Vitor O. Endosc Int Open Background and study aims Minimally invasive procedures that replicate aspects of bariatric surgery with more favorable safety and tolerability offer an attractive alternative in management of metabolic disease. Duodenal mucosal resurfacing (DMR), an endoscopic procedure using hydrothermal ablation, is designed to remove surface epithelium to allow subsequent epithelial regeneration and a reset to a more insulin-sensitive state. Materials and methods DMR was performed on a healthy pig under general anethesia, approximating the procedure designed for use in humans. Immediately post-DMR, analysis of the histological landscape was conducted in distinct duodenal areas that received ablation treatment. Results DMR submucosal lift and hydrothermal ablation elicited disruption of villous tips and partial disruption of the crypt base with no damage to deeper tissue. Excessive ablation (purposeful double ablation exposure) did incur damage to the underlying muscle layer. Conclusion Our results confirmed that DMR elicits superficial ablation of duodenal villi and crypts. Defining the cellular consequences of ablation and regeneration of the epithelium will aid our understanding of how and why DMR affects metabolic homeostasis. © Georg Thieme Verlag KG 2019-05 2019-05-03 /pmc/articles/PMC6519358/ /pubmed/31098390 http://dx.doi.org/10.1055/a-0862-0263 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | de Moura, Eduardo G. H. Ponte-Neto, Alberto M. Tsakmaki, Anastasia Aiello, Vera Demarchi Bewick, Gavin A. Brunaldi, Vitor O. Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease |
title | Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease |
title_full | Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease |
title_fullStr | Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease |
title_full_unstemmed | Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease |
title_short | Histologic assessment of the intestinal wall following duodenal mucosal resurfacing (DMR): a new procedure for the treatment of insulin-resistant metabolic disease |
title_sort | histologic assessment of the intestinal wall following duodenal mucosal resurfacing (dmr): a new procedure for the treatment of insulin-resistant metabolic disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519358/ https://www.ncbi.nlm.nih.gov/pubmed/31098390 http://dx.doi.org/10.1055/a-0862-0263 |
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