Exposing and Confronting Destructive Chronic Inflammation in Acid Reflux (GERD)

Principal Investigator: Marie-Pier Tétreault, PhD, Research Assistant Professor of Medicine (Gastroenterology and Hepatology), Northwestern University Feinberg School of Medicine Gastroesophageal reflux disease (GERD/acid reflux) affects over ¼ (up to 27 percent) of U.S. adults, resulting in more than 7 million patient visits annually. GERD leads to complications such as erosive esophagitis, Barrett’s esophagus and esophageal cancer. Learning more about the molecular basis for the development and progression of GERD is critical to improving treatment options and decreasing the risks for these esophageal conditions. Dr. Tetreault is looking at the role of the crucial mediator of inflammation IKKβ in the development of chronic GERD. The team will use molecular approaches to shut down the expression of IKKβ and evaluate the impact of this loss on the development of GERD. This project will also employ a new technology called single-cell RNA sequencing (scRNA-seq) that enables the rapid determination of the precise gene expression patterns of tens of thousands of individual cells. Employing scRNA-seq should help give greater insight into how IKKβ signaling impacts the regulation of the inflammatory process in chronic gastroesophageal reflux. Interrupting the disease process of GERD can crucially impact long term patient prognosis and risk of...

Assessing a New Imaging Probe to Evaluate Gastroesophageal Reflux

Gastroesophageal reflux disease (GERD) is a common condition that often involves heartburn and/or regurgitation. If left untreated, scarring of the esophagus or “food pipe” may result. GERD leads to millions of outpatient visits annually. For some individuals, increased laxity at the end of the muscular esophagus may contribute to GERD. Assessing the extent of this laxity helps to determine the most appropriate strategies for treating the disease and preventing further damage to the esophagus. The motility of the esophagus—a tube that moves food from the throat to the stomach via muscular movement—can reveal much about its function and well-being. Manometry tests are currently used to measure the strength and muscle coordination of a patient’s esophagus while swallowing. During the manometry test, a thin, pressure-sensitive tube is passed through the nose and down the esophagus. While effective, manometry sometimes causes significant discomfort for the patient, which could hinder the diagnostic evaluation. Funded by the Digestive Health Foundation, researchers in Northwestern Medicine’s Division of Gastroenterology and Hepatology are investigating the expanded use of a new device, the functional lumen imaging probe (FLIP). Already commercially available and FDA-approved, the FLIP offers a promising alternative to manometry. Because it can be quickly performed during a sedated upper endoscopy, FLIP is much more comfortable for patients than previous techniques. Led by Dustin Carlson, MD, the Northwestern team recently developed a novel, customized, patent-pending FLIP analysis technique. Dubbed FLIP topography, it allows for the assessment of esophageal motility. To further evaluate and substantiate FLIP’s clinical viability, the investigators will use the device and new technique in 40 patients with GERD during standard-of-care endoscopy procedures. In...