1. The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction
- Author
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Alexander J. Thompson, Sacha Loiseau, Tudor Thomas, Guang-Zhong Yang, Alexander Meining, Thomas J. Miller, Cadman L. Leggett, Rebecca Richards-Kortum, Guillermo J. Tearney, Peter Delaney, Paul Kelly, Michael Hughes, William A. Faubion, Salzitsa Anastasova, Laurie S. Conklin, Francois Lacombe, and Engineering & Physical Science Research Council (EPSRC)
- Subjects
medicine.medical_specialty ,DIFFUSE-REFLECTANCE SPECTROSCOPY ,IRRITABLE-BOWEL-SYNDROME ,Population ,Disease ,COHERENCE TOMOGRAPHY ,01 natural sciences ,Gastroenterology ,Coeliac disease ,010309 optics ,CONFOCAL LASER ENDOMICROSCOPY ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,0103 physical sciences ,Biopsy ,medicine ,DEVELOPING-COUNTRIES ,education ,Intensive care medicine ,Irritable bowel syndrome ,IN-VIVO ,education.field_of_study ,Science & Technology ,Hepatology ,medicine.diagnostic_test ,Gastroenterology & Hepatology ,PEDIATRIC-PATIENTS ,business.industry ,WIRELESS CAPSULE ENDOSCOPY ,CELIAC-DISEASE ,Gold standard (test) ,Optical Biopsy ,medicine.disease ,BARRETTS-ESOPHAGUS ,Position paper ,030211 gastroenterology & hepatology ,business ,Life Sciences & Biomedicine - Abstract
Environmental enteric dysfunction (EED) is a disease of the small intestine affecting children and adults in low and middle income countries. Arising as a consequence of repeated infections, gut inflammation results in impaired intestinal absorptive and barrier function, leading to poor nutrient uptake and ultimately to stunting and other developmental limitations. Progress towards new biomarkers and interventions for EED is hampered by the practical and ethical difficulties of cross-validation with the gold standard of biopsy and histology. Optical biopsy techniques - which can provide minimally invasive or noninvasive alternatives to biopsy - could offer other routes to validation and could potentially be used as point-of-care tests among the general population. This Consensus Statement identifies and reviews the most promising candidate optical biopsy technologies for applications in EED, critically assesses them against criteria identified for successful deployment in developing world settings, and proposes further lines of enquiry. Importantly, many of the techniques discussed could also be adapted to monitor the impaired intestinal barrier in other settings such as IBD, autoimmune enteropathies, coeliac disease, graft-versus-host disease, small intestinal transplantation or critical care.
- Published
- 2017