Feasibility and Safety of Endoscopic Balloon-Assisted Laser Treatment (EBLT) for Gastroesophageal Reflux Disease: Functional, Structural, and Gene Expression Analysis in Preclinical Model
Abstract
Gastroesophageal reflux disease (GERD) is a prevalent disorder caused by lower esophageal sphincter (LES) dysfunction, often requiring long-term treatment. This study assessed the feasibility of endoscopic balloon-assisted laser treatment (EBLT) using a porcine GERD model. One week after GERD induction, EBLT was performed on three animals, while one served as a control. A 980 nm continuous-wave laser was delivered at 30 W for 90 s (energy = 2700 J and power density = 2.17 W/cm2) in a circumferential, non-contact manner using a balloon-assisted catheter. Real-time mucosal temperature monitoring was achieved using a fiber Bragg grating (FBG) sensor integrated with the balloon, maintaining temperatures below 40 °C. Endoscopic ultrasound and manometry were used to evaluate LES thickness and pressure before and after treatment. After a 12-week observation period, esophageal tissues were harvested for histological and gene expression analysis. Compared to the control, the treated group showed an increase in LES thickness (3.6 ± 0.2 mm vs. 1.5 mm) and relative LES pressure changes (2.9 ± 1.6 vs. 0.6). Upregulation of fibrosis- and hypertrophy-related genes suggested structural remodeling of the LES. No adverse effects or mucosal injury were observed. These findings support EBLT as a promising and minimally invasive strategy for GERD treatment.
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