The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction
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Author(s)
Type
Journal Article
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.
Date Issued
2017-11-15
Date Acceptance
2017-11-15
Citation
Nature Reviews Gastroenterology and Hepatology, 2017, 14 (12), pp.727-738
ISSN
1759-5045
Publisher
Nature Publishing Group
Start Page
727
End Page
738
Journal / Book Title
Nature Reviews Gastroenterology and Hepatology
Volume
14
Issue
12
Copyright Statement
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a C r e a t i v e C o m m o n s
Attribution 4.0 International
License. The images or other
third party material in this
article are included in the article’s Creative Commons license,
unless indicated otherwise in the credit line; if the material
is not included under the Creative Commons license, users
will need to obtain permission from the license holder to
reproduce the material. To view a copy of this license, visit
http://creativecommons.org/licenses/by/4.0/.
a C r e a t i v e C o m m o n s
Attribution 4.0 International
License. The images or other
third party material in this
article are included in the article’s Creative Commons license,
unless indicated otherwise in the credit line; if the material
is not included under the Creative Commons license, users
will need to obtain permission from the license holder to
reproduce the material. To view a copy of this license, visit
http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
Engineering & Physical Science Research Council (EPSRC)
Grant Number
EP/L014149/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
CONFOCAL LASER ENDOMICROSCOPY
DIFFUSE-REFLECTANCE SPECTROSCOPY
WIRELESS CAPSULE ENDOSCOPY
IRRITABLE-BOWEL-SYNDROME
IN-VIVO
COHERENCE TOMOGRAPHY
DEVELOPING-COUNTRIES
CELIAC-DISEASE
BARRETTS-ESOPHAGUS
PEDIATRIC-PATIENTS
Publication Status
Published