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Detection of a Shared Colon Epithelial Epitope on Barrett Epithelium by a Novel Monoclonal Antibody

Kiron M. Das, MD, PhD; Ishwari Prasad, MD, PhD; Sudha Garla, MD; and Peter S. Amenta, MD, PhD
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From the Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital, New Brunswick, New Jersey. Requests for Reprints: Kiron M. Das, MD, PhD, Department of Medicine, UMDNJ—Robert Wood Johnson Medical School, One Robert Wood Johnson Place, New Brunswick, NJ 08903-0019. Grant Support: In part by RO1 DK 44314 from the National Institutes of Diabetes and Digestive and Kidney Diseases, National Institute of Health, and by Astra/Merck Group of Merck & Co, Inc.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1994;120(9):753-756. doi:10.7326/0003-4819-120-9-199405010-00006
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Objective: To determine if there is a reactive epitope common to colonic epithelium and Barrett epithelium, a premalignant metaplastic columnar-lined esophagus, usually arising as a complication of chronic reflux esophagitis.

Design: A monoclonal antibody, 7E12H12 (IgM isotype), developed against a colonic epithelial protein was used in a sensitive immunoperoxidase assay using formalin-fixed, paraffin-embedded tissue. One hundred sixteen tissue specimens from the esophagus, stomach, duodenum, and jejunum were examined. Twenty-two biopsy specimens were taken from 22 patients with benign Barrett epithelium, and 12 specimens were obtained from 12 patients with adenocarcinoma of the esophagus arising in Barrett epithelium. The remaining 85 tissue specimens were obtained from various parts of the upper gastrointestinal tract of patients with or without disease states.

Results: 21 of 22 (95%) Barrett epithelium specimens and all 12 adenocarcinomas arising from Barrett epithelium reacted with the 7E12H12 monoclonal antibody. Other tissues from esophagus, gastroesophageal junction, stomach, duodenum, or jejunum did not react. Squamous cell carcinoma of the esophagus also did not react.

Conclusions: Barrett epithelium shares phenotypic expression of colonic epithelium. The 7E12H12 monoclonal antibody may provide insight into the origin and cellular lineage of Barrett epithelium.

Figures

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Figure 1.
The immunoreactivity of 7E12H12 monoclonal antibody against the specialized type of Barrett epithelium and colonic mucosal epithelium as shown by the immunoperoxidase assay. A and B.arrowheadsC.1212D and E.F.1212G and H.I.arrowsA and BCD to I

Biopsy of intestinal-like columnar epithelium containing goblet cells ( ) characteristic of Barrett esophagus. Note the squamous epithelium (*). A serial section of the above biopsy reacted with 7E H monoclonal antibody. The glandular elements are diffusely reactive; whereas the squamous epithelium (*) is nonreactive. The squamous and glandular elements of the normal esophagogastric junction are nonreactive. Colonic epithelium used as a positive control demonstrates apical and basolateral reactivity with 7E H monoclonal antibody. Adenocarcinoma arising in a Barrett esophagus shows diffuse reactivity of the glandular elements with the monoclonal antibody. In panel G, note that the normal gastric mucosa (*) is nonreactive. Squamous cell carcinoma ( ) of the esophagus is typically nonreactive. Stained with ( ) hematoxylin and eosin; ( ) no counterstain used; ( ) Toluidine blue as counterstain. (Original magnifications, A, D, G, × 33; C and E × 66; B, F, H, and I, × 132.).

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