title: Targeted imaging of esophageal neoplasia with a fluorescently labeled peptide: first-in-human results.
abstract: Esophageal adenocarcinoma is rising rapidly in incidence and usually develops from Barrett's esophagus, a precursor condition commonly found in patients with chronic acid reflux. Premalignant lesions are challenging to detect on conventional screening endoscopy because of their flat appearance. Molecular changes can be used to improve detection of early neoplasia. We have developed a peptide that binds specifically to high-grade dysplasia and adenocarcinoma. We first applied the peptide ex vivo to esophageal specimens from 17 patients to validate specific binding. Next, we performed confocal endomicroscopy in vivo in 25 human subjects after topical peptide administration and found 3.8-fold greater fluorescence intensity for esophageal neoplasia compared with Barrett's esophagus and squamous epithelium with 75% sensitivity and 97% specificity. No toxicity was attributed to the peptide in either animal or patient studies. Therefore, our first-in-human results show that this targeted imaging agent is safe and may be useful for guiding tissue biopsy and for early detection of esophageal neoplasia and potentially other cancers of epithelial origin, such as bladder, colon, lung, pancreas, and stomach.
authors: Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
authors: Matthew B
authors: MB
authors: Sturm
authors: Bishnu P
authors: BP
authors: Joshi
authors: Shaoying
authors: S
authors: Lu
authors: Cyrus
authors: C
authors: Piraka
authors: Supang
authors: S
authors: Khondee
authors: Badih Joseph
authors: BJ
authors: Elmunzer
authors: Richard S
authors: RS
authors: Kwon
authors: David G
authors: DG
authors: Beer
authors: Henry D
authors: HD
authors: Appelman
authors: Danielle Kim
authors: DK
authors: Turgeon
authors: Thomas D
authors: TD
authors: Wang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D045744:Cell Line, Tumor; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D006801:Humans; D010455:Peptides
chemical_list: D010455:Peptides
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