CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(02): E149-E156
DOI: 10.1055/a-2000-8801
Original article

Mechanisms of esophageal stricture after extensive endoscopic resection: a transcriptomic analysis

Maximilien Barret
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Université de Paris, France
3   INSERM U1016, Institut Cochin, Paris, France
,
Ludivine Doridot
2   Université de Paris, France
3   INSERM U1016, Institut Cochin, Paris, France
4   Department of Immunology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Morgane Le Gall
5   3P5 Proteom’IC facility, Université de Paris, Institut Cochin, INSERM, CNRS, F-75014, France
,
Frédéric Beuvon
6   Genomʼic CNRS UMR8104, Paris, France
7   Department of Pathology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, Paris, France
,
Sébastien Jacques
2   Université de Paris, France
6   Genomʼic CNRS UMR8104, Paris, France
,
Anna Pellat
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Université de Paris, France
,
Arthur Belle
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Einas Abou Ali
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Marion Dhooge
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Sarah Leblanc
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
8   Department of Gastroenterology, Jean Mermoz Private Hospital, Lyon, France
,
Marine Camus
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
9   Department of Gastroenterology, St Antoine Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Carole Nicco
2   Université de Paris, France
3   INSERM U1016, Institut Cochin, Paris, France
,
Romain Coriat
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Université de Paris, France
3   INSERM U1016, Institut Cochin, Paris, France
,
Stanislas Chaussade
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Université de Paris, France
,
Frédéric Batteux
2   Université de Paris, France
3   INSERM U1016, Institut Cochin, Paris, France
4   Department of Immunology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
,
Frédéric Prat
1   Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hôpitaux de Paris, France
2   Université de Paris, France
3   INSERM U1016, Institut Cochin, Paris, France
› Author Affiliations
This work was funded by a grant from the Societé Nationale Francaise de Gastro-Entérologie (SNFGE).

Abstract

Background and study aims Esophageal stricture is the most frequent adverse event after endoscopic resection for early esophageal neoplasia. Currently available treatments for the prevention of esophageal stricture are poorly effective and associated with major adverse events. Our aim was to identify transcripts specifically overexpressed or repressed in patients who have developed a post-endoscopic esophageal stricture, as potential targets for stricture prevention.

Patients and methods We conducted a prospective single-center study in a tertiary endoscopy center. Patients scheduled for an endoscopic resection and considered at risk of esophageal stricture were offered inclusion in the study. The healthy mucosa and resection bed were biopsied on Days 0, 14, and 90. A transcriptomic analysis by microarray was performed, and the differences in transcriptomic profile compared between patients with and without esophageal strictures.

Results Eight patients, four with esophageal stricture and four without, were analyzed. The mean ± SD circumferential extension of the mucosal defect was 85 ± 11 %. The transcriptomic analysis in the resection bed at day 14 found an activation of the interleukin (IL)-1 group (Z score = 2.159, P = 0.0137), while interferon-gamma (INFγ) and NUPR1 were inhibited (Z score = –2.375, P = 0.0022 and Z score = –2.333, P = 0.00131) in the stricture group. None of the activated or inhibited transcripts were still significantly so in any of the groups on Day 90.

Conclusions Our data suggest that IL-1 inhibition or INFγ supplementation could constitute promising targets for post-endoscopic esophageal stricture prevention.



Publication History

Received: 24 May 2022

Accepted after revision: 16 December 2022

Accepted Manuscript online:
19 December 2022

Article published online:
02 February 2023

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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