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In Vivo Confocal Laser Endomicroscopy with Cellvizio® allows the discovery of a previously unknown human structure, the interstitium

3 April 2018

According to the publication in Nature Group’s Scientific Reports, this discovery may have significance in cancer metastasis and other diseases and could lead to new therapeutic approaches for cancer

Mauna Kea Technologies today announced the publication of an investigator-sponsored study that utilized Cellvizio to identify an up-to-now unknown human structure of an “interstitium” that had never been identified using standard histological techniques. The article, entitled “Structure and Distribution of an Unrecognized Interstitium in Human Tissues,” was published in Scientific Reports (2018, 8:4947 DOI:10.1038/s41598-018-23062-6) and can be downloaded here: https://www.nature.com/articles/s41598-018-23062-6. “Cellvizio is the only probe-based Confocal Laser Endomicroscopy system available to physicians for clinical use and scientists for research,” said Sacha Loiseau, Ph.D., CEO and co-founder of Mauna Kea Technologies.

“Cellvizio enables direct visualization of human tissues at the cellular scale and allows physicians to detect anomalies invisible with standard techniques in particular within the gastrointestinal, urinary and pulmonary tracts. Cellvizio is now used in clinical routine by hundreds of gastroenterologists in order to provide their patients suffering from gastro-esophageal reflux disease, Barrett’s esophagus, early gastric cancer and other pathologies. This study demonstrates once again that viewing tissue in its living and natural state at the microscopic level leads to major discoveries with major consequences on our understanding of cancer and its treatments.”

The study investigated in vivo real-time histological imaging of the extrahepatic bile duct using Cellvizio (pCLE). Cellvizio identified a fluid-filled interstitial space that had not been previously reported using standard histological techniques. The fluid-filled space is located in the submucosa, drains into lymph nodes and is supported by collagen bundles. The structures observed in the bile duct were also observed by the investigators in other submucosal tissues including the gastrointestinal tract, bladder, skin and lung. The authors conclude that this tissue, referred to as the interstitium, could be important in a number of pathological conditions including cancer metastasis, tissue edema and fibrosis.

“We initially conducted a study using real-time Cellvizio to identify the precise tissues we were imaging in the bile duct of patients and this led us to realize that traditional histopathology of specimens fixed in formalin had given us a false knowledge of the nature of many tissues," said David L. Carr-Locke, M.D., Clinical Director of the Center for Advanced Digestive Care, Weill Cornell Medical College and New York Presbyterian Hospital, and President of the International Society for Endomicroscopy. “As our work evolved, we were astounded to discover a microanatomical network of interconnected spaces, filled with fluid and lined by collagen with a unique arrangement, that had not been realized before and that appears to be present throughout the body. This could have enormous clinical significance in normal and many disease states. We hope that our findings encourage others to validate ours and employ new approaches, of which confocal laser endomicroscopy is a good example, to question old beliefs and investigate human microanatomy."

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