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Updated: Jul 5, 2026

Production, Characterization and Potential Uses of a 3D Tissue-engineered Human Esophageal Mucosal Model
Published on: May 18, 2015
Dilated intercellular spaces: a morphological feature of acid reflux--damaged human esophageal epithelium
N A Tobey1, J L Carson, R A Alkiek
1Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Background & Aims:
Dilated intercellular spaces are a sign of epithelial damage in acid-perfused rabbit esophagus, a change best identified by transmission electron microscopy. The aim of this study was to determine if this change is also a feature of acid damage to human esophageal epithelium.
Methods:
Endoscopic esophageal biopsy specimens from patients with (n = 11) and without (n = 13) recurrent heartburn were examined using transmission electron microscopy. Of 11 patients with heartburn, 6 had erosive esophagitis and 5 had normal-appearing mucosa on endoscopy; 13 controls had no symptoms or signs of esophageal disease. Using a computer, intercellular space diameter was measured from transmission electron microscopy photomicrographs of the specimen from each patient.
Results:
Intercellular space diameter was significantly greater in specimens from patients with heartburn than those from controls; this was true irrespective of whether the patient had erosive or nonerosive disease. Space diameters of > or = 2.4 microns were present in 8 of 11 patients with heartburn and in no controls.
Conclusions:
Dilated intercellular spaces are a feature of reflux damage to human esophageal epithelium. As a morphological marker of increased paracellular permeability, its presence in patients without endoscopic abnormalities may help explain their development of heartburn.
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