A swallowed string may someday replace the invasive, uncomfortable endoscope now used to diagnose a devastating childhood disease of the esophagus.
Steven J. Ackerman of University of Illinois at Chicago College of Medicine and Dr. Glenn T. Furuta, his colleague at the University of Colorado Denver, were recently awarded three grants for an all-fronts attack on eosinophilic esophagitis, an inflammatory disease in which defense cells called eosinophils mistakenly attack the esophagus, causing it to narrow until food can't pass.
"Most cases are first encountered in the emergency room, where a child is brought in because something he ate is caught in his esophagus," said Ackerman, professor of biochemistry and molecular genetics at UIC.
To diagnose the disease, doctors insert an instrument called an endoscope down the esophagus and take six to eight samples of tissue, from the top, middle and distal end, near the stomach. Under a microscope, they count the number of eosinophils, "which are not normally present in the esophagus at all," Ackerman said. The procedure, he said, is not only expensive but uncomfortable and carries some risks. And because repeat testing is needed over the course of treatment, a child may need to undergo as many as 20 endoscopies within three or four years.
Ackerman and his colleagues hope they can replace the endoscope by having children swallow a string encased in a gelatin capsule. As the capsule travels down the esophagus, the string plays out of the dissolving capsule, stretching through the esophagus, the stomach and the small intestine. The string is left in place overnight, then pulled out.
"We can determine which part of the string was in the esophagus, versus in the stomach, mouth or small intestine," said Ackerman. They then look on the string for certain inflammatory proteins that are expressed only by eosinophils.
The test will be done the day before an endoscopic test is
|Contact: Jeanne Galatzer-Levy|
University of Illinois at Chicago