Position paper: The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction
Position paper: The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction
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立场文件：光学活检在环境肠功能障碍研究和诊断中的潜在作用
DOI：
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Guang
中科院分区：
文献类型：
--
作者：
A. Thompson;M. Hughes;S. Anastasova;L. Conklin;Tudor Thomas;C. Leggett;W. Faubion;Thomas J Miller;P. Delaney;F. Lacombe;S. Loiseau;A. Meining;R. Richards;G. Tearney;P. Kelly;Guang
环境性肠功能障碍（EED）是一种影响低收入和中等收入国家儿童和成人的小肠疾病。由于反复感染，肠道炎症导致肠道吸收和屏障功能受损，导致营养吸收不良，最终导致发育迟缓和其他发育限制。新的EED生物标志物和干预措施的进展受到活检和组织学金标准交叉验证的实际和伦理困难的阻碍。光学活检技术-可以提供微创或非侵入性活检替代方案-可以提供其他验证途径，并可能用作普通人群的即时检测。该共识声明确定并审查了最有前途的候选光学活检技术在EED中的应用，严格评估他们对标准确定在发展中国家的成功部署，并提出了进一步的调查路线。重要的是，许多讨论的技术也可以适用于监测其他环境中受损的肠道屏障，如IBD，自身免疫性肠病，乳糜泻，移植物抗宿主病，小肠移植或重症监护。
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.
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