title: Hydrothermal Duodenal Mucosal Resurfacing: Role in the Treatment of Metabolic Disease.
abstract: The duodenum has become recognized as a metabolic signaling center that is involved in regulating insulin action and, therefore, insulin resistance states such as type 2 diabetes. Bariatric surgery and other manipulations of the upper intestine, in particular the duodenum, have shown that limiting nutrient exposure or contact in this key region exerts powerful metabolic effects. Early human clinical trial data suggest that endoscopic hydrothermal duodenal mucosal resurfacing is well tolerated in human subjects and has an acceptable safety profile. This article describes the rationale for this endoscopic approach and its early human use, including safety, tolerability, and early efficacy.
authors.affiliation: Molecular Physiology & Biophysics, Vanderbilt University School of Medicine, 704A/710 Robinson Research Building, 2200 Pierce Avenue, Nashville, TN 37232-0615, USA. Electronic address: alan.cherrington@vanderbilt.edu.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Cherrington
authors.affiliation: Fractyl Laboratories, Inc, 17 Hartwell Avenue, Lexington, MA 02421, USA.
authors.forename: Harith
authors.initials: H
authors.lastname: Rajagopalan
authors.affiliation: Fractyl Laboratories, Inc, 17 Hartwell Avenue, Lexington, MA 02421, USA.
authors.forename: David
authors.initials: D
authors.lastname: Maggs
authors.affiliation: Medical-Surgical Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, Brussels 1070, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Devière
mesh_terms: D050110:Bariatric Surgery / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery; D004384:Duodenoscopy / Q000379:methods*; D004386:Duodenum / Q000601:surgery*; D005234:Fatty Liver / Q000601:surgery; D006801:Humans; D007333:Insulin Resistance; D007413:Intestinal Mucosa / Q000601:surgery*; D024821:Metabolic Syndrome / Q000601:surgery
keywords: Duodenal mucosal resurfacing; Duodenum; Endoscopic treatment; Hydrothermal ablation; Insulin resistance; Metabolic disease; Nonalcoholic fatty liver disease; Type 2 diabetes