Research Sheila Krishnadath

Abstract

An endoscopic brush is a medical device used to collect tissue during endoscopy of the gastrointestinal system, bile ducts and lungs, among others. Tissue sampling can help in detecting infection, inflammation and cancer. By rubbing the organ wall with the brush, cellular material sticks between the bristles that can be examined in a laboratory. An endoscopy is stressful for the patient and carries risks. For example, a bile duct examination poses the risk of pancreatitis. It is therefore important that the first sample collection is successful so that no further attempts (= repeats) must be made. However, during a biliary tract examination, only 45% of the samples yield sufficient cellular material to allow a diagnosis to be made, often necessitating a repeat, and this again poses risk. This problem of insufficient yield also presents itself in other examinations where endoscopic brushes are used. Repeats are desirable to avoid in all examinations. Based on clinical findings during use of endoscopic brushes, the researchers propose a number of improvements to the endoscopic brush to improve cellular yield. Based on these proposals, we preliminary developed a conceptual design for a new endoscopic brush. This project aims to further develop the concept and translate it into a working prototype. In a second phase, the prototype will be tested in vitro by a number of endoscopists affiliated with UZA. Various valorisation routes will be examined during the course of the project so that steps can be taken toward commercialization by the end of the project.

Researcher(s)

• Promoter: Van Campenhout Lukas
• Co-promoter: Krishnadath Sheila

Research team(s)

• Product development

Project type(s)

• Research Project

Abstract

In many European countries the recent rise in incidence of esophageal adenocarcinoma (EAC) is without precedent. EAC is notorious for its highly aggressive biological behavior leading to invasive disease and early metastases. The only way to reduce mortality is through treatment in early stage of the cancer. EAC has a well recognized premalignant precursor lesion identified as esophageal metaplasia, or Barrett's Esophagus (BE), which offers important opportunities for treatment in early stages of cancer which may reach 5 years survival rates up to 80%. However, these patients need to be monitored constantly for timely intervention in case of disease recurrence or metastases. The problem is that after endoscopic treatment up to 30% of cases will develop recurring cancers or even present with metastases, which requires additional endoscopic treatments or surgery. Currently it is impossible to predict which of the treated BE patients with will have stable disease and which will recur or progress to invasive cancer. As a consequence all treated patients need to remain in frequent endoscopic surveillance. Thisleadsto over-treatment of a large group of BE patients and under-treatment of those with more aggressive disease. There is a low cost effectiveness of endoscopic therapies, low quality of life of patients and poor satisfaction of care providers. An accurate risk stratification method for early AEC in BE patients is therefore an unmet clinical need. The ambition of the ENDEAVOR consortium is to implement an innovative risk stratification method, which encompasses minimally invasive cell collection supplemented by single cell genomic analysis to address this specific need. Taking into account patient characteristics, gender dimensions, an optimal risk model will be tested in a randomized controlled prospective trial. Future implementation of this method will reduce health care costs, increase quality of life and satisfaction of health care providers. This action is part of the Cancer Mission cluster of projects on Diagnostics and Treatment.

Researcher(s)

• Promoter: Krishnadath Sheila
• Co-promoter: Van Dongen Stefan
• Co-promoter: Van Hal Guido

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project website

Project type(s)

• Research Project