VILLA BALBIANELLO (Special Sessions)

Attenzione: apre in una nuova finestra.

Special Session 1 Sunday, September 2, 8:00 - 9:45 am
Esophageal tissue resistance
Chairs: N.J. Buttar (Rochester) – R.C. Orlando (Chapel Hill)
Discussant: K. Dvorak (Tucson)

Developmental biology of esophageal squamous epithelium L.X. Chen (Durham)
Endoscopic morphology of esophageal squamous epithelium H. Neumann (Erlangen)
Microscopic morphology of esophageal squamous epithelium H.D. Appelman (Ann Arbor)
Ion transport in esophageal squamous epithelium R.C. Orlando (Chapel Hill)
Barrier function in esophageal squamous epithelium J. Sarosiek (El Paso)
Intraluminal impedance in the evaluation of the esophageal mucosa R. Farre (Leuven)
Sensory innervation in esophageal squamous epithelium Q. Aziz (London)
Neosquamous epithelium: Comparison with native esophageal squamous epithelium R.D. Odze (Boston)
Experimental acid injury to esophageal squamous epithelium D.O. Castell (Charleston)
Experimental bile salt (non-acid) injury to esophageal epithelium J.E. Richter (Tampa)
Pathology of reflux-induced injury to human esophageal epithelium A.M. Bellizzi (Iowa City)
Inflammation in human reflux esophagitis G. Nardone (Naples)
Inflammation in eosinophilic esophagitis A.J. Lucendo (Ciudad Real)
Motor consequences of reflux-induced inflammation in esophageal epithelium S. Bor (Izmir)
DNA damage and repair in reflux esophagitis K. Dvorak (Tucson)

Special Session 2 Sunday, September 2, 10:15 am - 12:00 pm
GI sensitivity
Chairs: A.M. Drewes (Aalborg) – G. Nardone (Naples)
Discussant: M. Kollarik (Baltimore)

How does refluxed gastric acid initiate heartburn in those with GERD? R.C. Orlando (Chapel Hill)
Are there vagal afferent nociceptive nerves in the esophagus? M. Kollarik (Baltimore)
Does ATP play a role in sensory transmission in the esophagus? C. Brock (Aalborg)
Are P2X and P2Y receptors involved in esophageal hypersensitivity? A.M. Altomare (Rome)
Are neural purinergic receptors upregulated in GERD? C. Lottrup (Aalborg)
What role do adenosine receptors play in esophageal pain? M. Kollarik (Baltimore)
Is TRPV1 a major acid receptor in esophageal epithelium? G. Nardone (Naples)
What kind of acid sensitive receptors could be involved in the genesis of gastro-esophageal reflux disease symptoms? A. Lund-Krarup (Aalborg)
What is known about the cortical perception of refluxed acid in healthy subjects and those with heartburn of GERD? R. Shaker (Milwaukee)
What new methods exist for evaluation of esophageal pain? A.M. Drewes (Aalborg)
Which morphologic and/or neuro-physiological factors could be responsible for hypersensitivity in  NERD patients? Q. Aziz (London)
Are there histological alterations that can distinguish non-erosive reflux disease (NERD) from erosive reflux disease (ERD) patients? F. Hvid-Jensen (Aalborg)
Are inflammatory processes involved in the genesis of NERD symptoms? R.F. Souza (Dallas)
Does the impaired esophageal mucosal integrity play a role in the symptoms generation of gastro- esophageal reflux disease (GERD) C. Calabrese (Bologna)
Is the volume of refluxate involved in the perception of reflux episodes? A.M. Altomare (Rome)

Special Session 3 Sunday, September 2, 2:30 – 4:15 pm
Animal Models
Chairs: M.K. Gibson (Pittsburgh) – S. Marks (Los Angeles)

Spontaneous models of canine dysphagia. S.L. Marks (Los Angeles)
Ovine models of dysphagia. P.C. Belafsky (Los Angeles)
Porcine and murine models of oro-pharyngeal function. E. Plowman
Use of animal models for the study of cancer drug development and mechanisms in esophageal adenocarcinoma. M.K. Gibson (Pittsburgh)

Special Session 4 Sunday, September 2, 4:30.- 6:15 pm
Cancer biology
Chairs: K. Das (New Brunswick) – X.L. Chen (Durham)
Discussant: R.C. Fitzgerald (Cambridge)

How do the components of gastric refluxate, especially acid and bile salts, promote carcinogenesis in metaplastic Barrett’s esophagus? R.F. Souza (Dallas)
- Effects on DNA damage
- Effects on proliferation
- Effects on apoptotic resistance

Is there a specific cell phenotype in BE that is more prone to development of EAC? K. Das (New Brunswick)
What is the role of gastrin in progression of BE to esophageal adenocarcinoma? J.A. Abrams (New York)
What is the effect of inflammatory cytokines linked to obesity on the activation of cell death pathways and cell survival in BE and esophageal cancer? J.V. Reynolds (Dublin)
Can acid and bile induce chromosomal instability and clonal selection during the progression of BE to EAC? M. Bajpai (New Brunswick)
In BE is there a point of “no return” from metaplasia to dysplasia? Can gene expression panels predict outcomes for patients with esophageal adenocarcinoma? P. Malfertheiner (Magdeburg)
Do Barrett’s epithelial cells undergo senescence with the development of dysplasia? K.K. Wang (Rochester, MN)
What is the role of autophagy in Barrett’s esophagus and esophageal cancer development? K. Dvorak (Tucson)
May SNPs in promoter regions of pro-inflammatory genes predict the development of EAC? D.G. Beer (Ann Arbor)
Is p53 mutation a major event in the carcinogenesis process of benign BE cells to malignancy? G. Prasad (Rochester, MN)
Can this be utilized for diagnosis and therapeutic purposes?
How the Genome wide changes in DNA methylation and transcription are involved in BE carcinogenesis? A. Verma (New York)
What is the role of nitric oxide in promoting invasion and metastasis of Barrett’s-associated esophageal adenocarcinoma? R.C. Fitzgerald (Cambridge)
What is the potential role of microRNA in the development of BE and EAC? K.S. Garman (Durham)
During the early development of chromosomal instability in Barrett’s esophagus, are DNA chromosomal loss or gains focal or widespread? K.K. Wang (Rochester, MN)

What animal models may be used for BE and EAC research? X.L. Chen (Durham)

Special Session 5 Monday, September 3, 8:15 - 10:00 am
Pharyngeal reflux
ENT and GERD
Chairs: P. Belafsky (Los Angeles) – R. Shaker (Milwaukee)
Discussant: S. Bor (Izmir)

What are the current diagnostic tests for LPR? P. Dettmar (Hull)
Is pepsin a sensitive and specific marker for LPR? N. Johnston (Milwaukee)
What is the prevalence and role of LPR in laryngeal cancer? N. Johnston (Milwaukee)
Do in vitro studies support a role for LPR in laryngeal cancer? J. Allen (Auckland)
– Do animal in vivo studies support a role for LPR in laryngeal cancer?
– Do human studies support a role for LPR in laryngeal cancer?
What laryngo-pharyngeal symptoms are attributable to LPR? P. Belafsky (Los Angeles)
What objective evidence supports a role for EER in CRS? J.M. Del Gaudio (Atlanta)
Does CRS respond to treatment of EER? What is the appropriate treatment of CRS J.M. Del Gaudio (Atlanta)
What is the evidence for airway protective role of aerodigestive reflexes in preventing aspiration? (excluding laryngeal adductor reflex). R. Shaker (Milwaukee)
What are criteria by which gastro-esophageal reflux is not the cause of ENT symptoms? R. Tutuian (Bern)
What treatments should we offer patients with ENT symptoms and normal reflux monitoring tests? R. Tutuian (Bern)
How long should the PPI trial be in patients with ENT symptoms suspected to be due to GERD? W.W. Chan (Boston)
Which ENT symptom is most likely associated with GERD? R. Tutuian (Bern)
What are the options for treating hypo-pharyngeal/high cervical esophageal strictures in patients treated for head and neck cancers? K.S. Dua (Milwaukee)

Special Session 6 Monday, September 3, 10:15 am - 12:00 pm
Neuro-physiology of the esophagus
Chairs: A.R. Hobson (London) – Q. Aziz (London)
Discussant: A.M. Drewes (Aalborg)
Secretary: A. Lund-Krarup (Aalborg)

What is the role of electrophysiology and inverse brain modeling methodologies in esophageal pain? C. Brock (Aalborg)
What is the role of neuroimaging methodologies in esophageal pain? J.B. Frøkjær (Aalborg)
What is the role of vagal and spinal afferents in mediating esophageal sensation? A. Blackshaw (London)
What is the role of ENS in controlling esophageal sensory and motor function? A. Lund-Krarup (Aalborg)
What is the clinical relevance of the difference in the afferent innervation of the proximal and distal esophagus? P. Woodland (London)
What is the role of the cortex and brain stem in mediating esophageal function? S. Hamdy (Manchester)
How does the brain process subliminal and luminal human esophageal sensation? S.J. Coen (London)
Do psychological factors modulate the brain processing of esophageal sensation? S.J. Coen (London)
What is the role of physiological stress response systems (ANS/HPA Axis) in mediating esophageal pain? A. Farmer (London)
What are the neural mechanisms of acid induced esophageal hypersensitivity Q. Aziz (London)
What is the pharmacological management of esophageal hypersensitivity? Q. Aziz (London)
What is the role of mucosa in esophageal hypersensitivity? D. Sifrim (London)
What is the role of placebo analgesia in managing esophageal pain? A.R. Hobson (London)
What happens to esophageal sensitivity in Barrett’s esophagus? A.M. Drewes (Aalborg)
Can neuro-physiological techniques be used to understand the patho-physiology of esophageal hypersensitivity? A.R. Hobson (London)

Special Session 7 Monday, September 3, 2:30 – 4:15 pm
Respiratory manifestations of GERD
Chairs: S.M. Harding Hawkins (Birmingham, AL) – D. Sifrim (London)
Discussant: P. Belafsky (Los Angeles)

Are ENT and pulmonary symptoms the same extra-esophageal manifestations of GERD? R. Tutuian of GERD? (Bern)
What is the mechanism of cough induced by GER? K. Blondeau (Leuven)
What is the role of Extra Esophageal Reflux in cough? J. Allen (Auckland)
Does nonacid GER play a role in cough? Non-acid GER? D. Sifrim (London)
When is fundoplication indicated for cough? C.A. Pellegrini (Seattle)
Is impedance-manometry necessary for the diagnosis of reflux-related cough? D. Sifrim (London)
Are reflux and airway stenosis actually related? J. Allen (Auckland)
Does weakly acidic or non-acidic reflux play a role in airway stenosis? J. Blumin (Milwaukee)
What is the role of pH monitoring in these patients? J. Allen (Auckland)
What are the results of anti-reflux surgery for cough? C.A. Pellegrini (Seattle)
Should an empiric trial of baclofen be performed prior to anti-reflux surgery? P. Belafsky (Los Angeles)
Can airway obstruction, by lowering LESP and increasing the Nb of reflux episodes, predispose to asthma? S.M. Harding Hawkins (Birmingham, AL)
What is the efficacy of PPIs on asthma outcome? W.W. Chan (Boston)
Is a vagally mediated reflex involved in the development of cough? R. Shaker (Milwaukee)
Is a vagally mediated reflex involved in the development of asthma? S. Harding Hawkins (Birmingham, AL)

Special Session 8 Monday, September 3, 4:30 – 6:15 pm
Endotherapy for GERD
Chairs: R.I. Rothstein (Lebanon) – P. Siersema (Utrecht)
Discussant: T. Ponchon (Lyons)

Can gastro-esophageal reflux disease be treated endoscopically? P.D. Siersema (Utrecht)
What is the history of endoluminal devices in GERD. Have we learned anything? (Stretta – Endocinch – Enteryx - Suture devices – Gatekeeper) R.I. Rothstein (Lebanon)
RF, plication or injectables – which therapy has the best long-term outcomes at this point? R.I. Rothstein (Lebanon)
What are the data of current endoluminal devices: A. Roy-Schapira (Beer Sheva)
- The Medigus SRS Endoscopy Systems
- Do we have enough data to go prime time?
What is the role for (the newly revived) Stretta in the treatment of GERD related to transient LES relaxation? H. Mashimo (Boston)
TIF and the advanced endoscopy trained gastroenterologist - - Is this a procedure that I should learn or is it better left to a surgical endoscopist? J. Horwhat (Bethesda)
What are the valid alternatives to laparoscopic fundoplication? R. Tutuian (Bern)
How should future studies be designed to assess mechanisms? R. Lambert (Lyons)
Results of the trial on electrical stimulation of the LES. V. Sharma (Gilbert)
What is the appropriate outcomes measure for endoluminal ARS: symptom scores or objective testing? J.M. Inadomi (Seattle)
How do endoluminal antireflux procedures compare to laparoscopic fundoplication. Is the investment worth the outcome? G. R.Locke (Rochester)
Is there any room for any endoscopic treatment of GERD? T. Ponchon (Lyons)

Special Session 9 Tuesday, September 4, 7:45 – 9:30 am
Tailored multi-disciplinary therapeutic approach to the GERD patient
Chairs: D. Armstrong (Hamilton) – B. Gayet (Paris)
Discussant: P.O. Katz (Philadelphia)

Is SAP of greater value than SI in assessment of symptom reflux association? J.E. Richter (Tampa)
What is the clinical relevance of nocturnal acid reflux? V. Savarino (Genoa)
Which patients with GERD should have endoscopy? M. Hongo (Sendai)
– Is there any value for endoscopy in NERD?
Inlet patch: is there any indication for biopsies? for treatment? T. Ponchon (Lyons)
Is there a role for esophageal manometry in the clinical management of GERD? D. Armstrong (Hamilton)
Should GERD patients be evaluated, before starting PPI therapy, with respect to their risks for respiratory tract infections, gastrointestinal infections, vitamin B12 deficiency and bone health? D. Armstrong (Hamilton)
How should response to a PPI be determined in clinical practice? S. Nasseri-Moghaddam (Tehran)
– How long PPIs can be used safely?
Should ‘step down’ therapy be offered to all GERD patients who have responded to PPI therapy? D. Armstrong (Hamilton)
What is the relationship between obesity and PPI resistance? E. Savarino (Genoa)
What drugs have proven, sustained and clinically relevant effect on performance of esophageal peristalsis?
Following PPI failure, is ARS likely to be successful in GERD patients? B. Gayet (Paris)
How do existing and yet-to-be-developed techniques compare with standard medical or surgical therapy? L.L. Swanström (Portland)
What is the role of pH-impedance in the choice of treatment other than PPI? R. Tutuian (Bern)
Do prokinetic agents enhance esophageal contraction amplitude, velocity or peristalsis? P.O. Katz (Philadelphia)
What is appropriate patient selection for endoluminal antireflux procedures? R.I. Rothstein (Lebanon)

Special Session 10 Tuesday, September 4, 9:40 – 11:25 am
The refractory GERD
Chairs: V. Savarino (Genoa) – R.K. Wong (Bethesda)
Discussant: M. Hongo (Sendai)
Secretary: A.M. Altomare (Rome)

What is the difference between GERD hypersensitivity and refractory GERD? F. Di Mario (Treviso)
What are the data concerning acid hypersensitivity and sensory receptors (vallinoid, TRPV1) causing refractory GERD? F. Zerbib (Bordeaux)
How sensitive and specific is an increase in visceral adiposity in determining whether an individual may be refractory to PPIs? F. Pace (Milan)
What is the effect of gastric components other than acid on refractory GERD? R. Tutuian (Bern)
What is the relevance of weakly acidic reflux in refractory GERD? R. Tutuian (Bern)
Is microscopic esophagitis relevant in determining symptoms of NERD? V. Savarino (Genova)
Do concomitant functional GI disorders affect the PPI response in NERD? F. Zerbib (Bordeaux)
When a patient has truly refractory GERD? S. Nasseri-Moghaddam (Tehran)
What is the contribution of emotional stress in development of refractory GERD? S. Nasseri-Moghaddam (Tehran)
How effective are anti-depressives and SSRI’s in treating refractory GERD? F.J. Moawad (Bethesda)
What is the evidence that a functional esophagus is associated with IBS? S. Armbruster (Bethesda)
Why are delayed release PPI’s less effective in NERD? C. Scarpignato (Parma)
Are delayed release PPI’s the answer to refractory GERD? S. Armbruster (Bethesda)
What is the role of GABA agonists in the treatment of refractory GERD? S. Armbruster(Bethesda)
What is the role of biofeedback in refractory GERD? F.J. Moawad (Bethesda)
What is the best therapeutic choice in patients with functional heartburn? R. Tutuian (Bern)
What new endoscopic procedures (NOTES) are being studied to treat refractory GERD? J.D. Horwhat (Washington)