Confocal Endomicroscopy During Endoscopy

University of Alberta220 enrolled

Overview

The main objective of this study is to determine the role of epithelial cell homeostasis in the pathogenesis of intestinal diseases. Background: Alterations in intestinal barrier function may play a significant role in the pathogenesis of chronic intestinal diseases such as inflammatory bowel disease (IBD). The intestinal epithelium functions as a barrier to the luminal contents, thereby preventing undesirable solutes, micro-organisms and other luminal antigens from entering the body. Confocal endomicroscopy has recently been shown that increased epithelial cell shedding may contribute to increased intestinal permeability, at least locally. In our study, we want to determine the contribution of epithelial cell shedding to intestinal permeability in vivo in patients with inflammatory bowel disease compared to controls. Scope: In inflammatory bowel disease patients and controls (patients undergoing endoscopy for other indications). Methods: We will perform confocal endoscopy during the patient's endoscopic procedure. Procedure: The patient will receive intravenous fluorescein, followed by confocal imaging of the gastrointestinal tissue. The images are captured on the computer. The proposed study will provide important insights into epithelial cell shedding as a contributor to altered intestinal permeability.

Study Type

OBSERVATIONAL

Enrollment

220

Conditions

Inflammatory Bowel Disease

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria for patients includes: 1. Subjects over 18 years of age. 2. Subjects undergoing endoscopic procedures such as gastroscopy, colonoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasound will all be included. Exclusion Criteria: 1. Under 18 years of age. 2. Cognitively impaired. 3. Residing in institutions (eg. prison, extended care facility) 4. Employees of research(s)' organization 5. In emergency or life-threatening situations 6. Have language barriers (eg. illiterate, not English-speaking, dysphasic) preventing adequate consent process 7. Resides in another country

Outcomes

Primary Outcomes

The intestinal morphology as visualized using confocal laser endomicroscopy

Intestinal morphology as measured by epithelial cells and gaps, presence of bacteria in the epithelial lining and the lamina propria will be quantitated.

Time frame: 3 years.

Secondary Outcomes

Clinical outcome and pathologic/molecular correlation with intestinal morphology

The clinical outcomes of inflammatory bowel patients, location and severity of their disease, and correlation with molecular studies including tissue cytokine levels will be studied.