A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth.
Background A major limitation to understanding the etiopathogenesis of environmental enteric dysfunction (EED) is the lack of a comprehensive, reproducible histologic framework for characterizing the small bowel lesions. We hypothesized that the development of such a system will identify unique hist...
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ftdoajarticles:oai:doaj.org/article:c1b0dd36aa384bf6be66f36831be9806 2023-05-15T15:16:50+02:00 A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. Ta-Chiang Liu Kelley VanBuskirk Syed A Ali M Paul Kelly Lori R Holtz Omer H Yilmaz Kamran Sadiq Najeeha Iqbal Beatrice Amadi Sana Syed Tahmeed Ahmed Sean Moore I Malick Ndao Michael H Isaacs John D Pfeifer Hannah Atlas Phillip I Tarr Donna M Denno Christopher A Moskaluk 2020-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0007975 https://doaj.org/article/c1b0dd36aa384bf6be66f36831be9806 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0007975 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007975 https://doaj.org/article/c1b0dd36aa384bf6be66f36831be9806 PLoS Neglected Tropical Diseases, Vol 14, Iss 1, p e0007975 (2020) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1371/journal.pntd.0007975 2022-12-31T00:26:12Z Background A major limitation to understanding the etiopathogenesis of environmental enteric dysfunction (EED) is the lack of a comprehensive, reproducible histologic framework for characterizing the small bowel lesions. We hypothesized that the development of such a system will identify unique histology features for EED, and that some features might correlate with clinical severity. Methods Duodenal endoscopic biopsies from two cohorts where EED is prevalent (Pakistan, Zambia) and North American children with and without gluten sensitive enteropathy (GSE) were processed for routine hematoxylin & eosin (H&E) staining, and scanned to produce whole slide images (WSIs) which we shared among study pathologists via a secure web browser-based platform. A semi-quantitative scoring index composed of 11 parameters encompassing tissue injury and response patterns commonly observed in routine clinical practice was constructed by three gastrointestinal pathologists, with input from EED experts. The pathologists then read the WSIs using the EED histology index, and inter-observer reliability was assessed. The histology index was further used to identify within- and between-child variations as well as features common across and unique to each cohort, and those that correlated with host phenotype. Results Eight of the 11 histologic scoring parameters showed useful degrees of variation. The overall concordance across all parameters was 96% weighted agreement, kappa 0.70, and Gwet's AC 0.93. Zambian and Pakistani tissues shared some histologic features with GSE, but most features were distinct, particularly abundance of intraepithelial lymphocytes in the Pakistani cohort, and marked villous destruction and loss of secretory cell lineages in the Zambian cohort. Conclusions We propose the first EED histology index for interpreting duodenal biopsies. This index should be useful in future clinical and translational studies of this widespread, poorly understood, and highly consequential disorder, which might be caused by ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 14 1 e0007975 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Ta-Chiang Liu Kelley VanBuskirk Syed A Ali M Paul Kelly Lori R Holtz Omer H Yilmaz Kamran Sadiq Najeeha Iqbal Beatrice Amadi Sana Syed Tahmeed Ahmed Sean Moore I Malick Ndao Michael H Isaacs John D Pfeifer Hannah Atlas Phillip I Tarr Donna M Denno Christopher A Moskaluk A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background A major limitation to understanding the etiopathogenesis of environmental enteric dysfunction (EED) is the lack of a comprehensive, reproducible histologic framework for characterizing the small bowel lesions. We hypothesized that the development of such a system will identify unique histology features for EED, and that some features might correlate with clinical severity. Methods Duodenal endoscopic biopsies from two cohorts where EED is prevalent (Pakistan, Zambia) and North American children with and without gluten sensitive enteropathy (GSE) were processed for routine hematoxylin & eosin (H&E) staining, and scanned to produce whole slide images (WSIs) which we shared among study pathologists via a secure web browser-based platform. A semi-quantitative scoring index composed of 11 parameters encompassing tissue injury and response patterns commonly observed in routine clinical practice was constructed by three gastrointestinal pathologists, with input from EED experts. The pathologists then read the WSIs using the EED histology index, and inter-observer reliability was assessed. The histology index was further used to identify within- and between-child variations as well as features common across and unique to each cohort, and those that correlated with host phenotype. Results Eight of the 11 histologic scoring parameters showed useful degrees of variation. The overall concordance across all parameters was 96% weighted agreement, kappa 0.70, and Gwet's AC 0.93. Zambian and Pakistani tissues shared some histologic features with GSE, but most features were distinct, particularly abundance of intraepithelial lymphocytes in the Pakistani cohort, and marked villous destruction and loss of secretory cell lineages in the Zambian cohort. Conclusions We propose the first EED histology index for interpreting duodenal biopsies. This index should be useful in future clinical and translational studies of this widespread, poorly understood, and highly consequential disorder, which might be caused by ... |
format |
Article in Journal/Newspaper |
author |
Ta-Chiang Liu Kelley VanBuskirk Syed A Ali M Paul Kelly Lori R Holtz Omer H Yilmaz Kamran Sadiq Najeeha Iqbal Beatrice Amadi Sana Syed Tahmeed Ahmed Sean Moore I Malick Ndao Michael H Isaacs John D Pfeifer Hannah Atlas Phillip I Tarr Donna M Denno Christopher A Moskaluk |
author_facet |
Ta-Chiang Liu Kelley VanBuskirk Syed A Ali M Paul Kelly Lori R Holtz Omer H Yilmaz Kamran Sadiq Najeeha Iqbal Beatrice Amadi Sana Syed Tahmeed Ahmed Sean Moore I Malick Ndao Michael H Isaacs John D Pfeifer Hannah Atlas Phillip I Tarr Donna M Denno Christopher A Moskaluk |
author_sort |
Ta-Chiang Liu |
title |
A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. |
title_short |
A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. |
title_full |
A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. |
title_fullStr |
A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. |
title_full_unstemmed |
A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. |
title_sort |
novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pntd.0007975 https://doaj.org/article/c1b0dd36aa384bf6be66f36831be9806 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 14, Iss 1, p e0007975 (2020) |
op_relation |
https://doi.org/10.1371/journal.pntd.0007975 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007975 https://doaj.org/article/c1b0dd36aa384bf6be66f36831be9806 |
op_doi |
https://doi.org/10.1371/journal.pntd.0007975 |
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PLOS Neglected Tropical Diseases |
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14 |
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1 |
container_start_page |
e0007975 |
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