Molecular endoscopic imaging for the detection of Barrett’s metaplasia using biodegradable inorganic nanoparticles: An ex-vivo pilot study on human tissue

Abstract

Background and study aims Despite major technical advancements, endoscopic surveillance for detecting premalignant lesions in Barrett's esophagus is challenging because of their flat appearance with only subtle morphological changes. Molecular endoscopic imaging (MEI) using nanoparticles (NPs), coupled with fluorescently labeled antibody permits visualization of disease-specific molecular alterations. The aim of this ex vivo study was to assess the diagnostic applicability of MEI with NPs to detect Barrett's metaplasia. Patients and methods Seven patients undergoing endoscopic surveillance of known Barrett's esophagus were recruited. Freshly resected biopsy specimens were incubated with NPs coupled with FITC labeled Muc-2 antibodies and examined with MEI. Fluorescence intensity from Barrett's mucosa and control specimens were compared, followed by histological confirmation. Results Fluorescence signals, indicating the presence of goblet cells, were noted for traditional MEI using Muc-2 antibodies in Barrett's intestinal metaplasia. Significantly stronger fluorescence signals were achieved with NPs coupled with FITC-conjugated Muc-2 antibodies. The results of MEI with NPs for the prediction of Barrett's metaplasia correlated with the final histopathological examination in all the cases. Conclusions Highly-specific NPs detected Barrett's metaplasia more efficiently than conventional MEI in this first feasibility study. MEI was as effective as standard histopathology for identifying

Development of Advanced Imaging and Molecular Imaging for Barrett’s Neoplasia

“…NPs may be clinically useful because of their properties, such as a spherical shape and small diameter from 10 to 90 nm, and they can distribute widely in Barrett’s mucosa to penetrate biological barriers of the mucosa. Ahmed et al revealed the diagnostic specificity of FITC-conjugated Muc-2 antibodies for the identification of goblet cells of metaplasia in biopsy specimens from all BE patients [ 75 ]. Despite the lack of evidence of the NPs for neoplastic BE, various candidate peptides have been investigated to achieve high sensitivity and specificity for diagnosing Barrett’s neoplasia [ 65 , 76 , 77 ].…”