- Email: [email protected]
Trends in Social Media Reach and Engagement at Gastroenterological Conferences
AGA Abstracts
Table 2. Sample survey questions and results
Sa1137 TRENDS IN SOCIAL MEDIA REACH AND ENGAGEMENT AT GASTROENTEROLOGICAL CONFERENCES Austin L. Chiang, Loren Rabinowitz, Walter W. Chan Figure 1.: NIH DOM funding versus GI Division funding. While DOM funding correlated with GI funding, much of this correlation was due to little funding in either and displayed large variations, making DOM funding a less than ideal measure for GI Divisional funding.
Background: Social media has been recognized as a powerful method of engagement and education in healthcare for medical professionals and the general public. Gastroenterological (GI) societies use social media platforms such as Twitter, in order to disseminate new data presented at conferences such as Digestive Disease Week (DDW), The Liver Meeting (AASLD), and the American College of Gastroenterology annual scientific meeting (ACG). The efficacy of social media for increasing awareness of conference content has not yet been comprehensively studied. Aim: To determine the trends of social media reach and engagement at three major GI conferences in recent years. Methods: Conference-specific activity at the three major GI conferences were identified using conference-specific hashtags formally registered at health care social media analytics website Symplur.com. Data was available for DDW and AASLD from 2012 to 2016, and ACG from 2013 to 2016, including conference impressions, tweets, and participants for the duration spanning one week preceding and after the meeting. A linear regression was used to detect significant trends in these parameters between conference and years. Results: By 2016, impressions gained from tweets at DDW, ACG, and AASLD have reached over 23-55 million people at each conference. Tweets at the most recent meetings in 2016 were 14,825, 5,629, and 9,990 tweets at each meeting, respectively. On linear regression, all three major conferences demonstrated significantly more impressions (p=0.007), tweets (p=0.007), and participants (p=0.004) over time. However, the actual tweets per participant and impressions per tweet did not demonstrate any significant increase over the years (p=0.792 and p=0.462, respectively). Conclusion: Social media use at meetings has risen substantially in recent years. Impressions, tweets, and participants have all risen significantly over the past five years, but not tweets per participant and impressions per tweet. This, therefore, suggests that despite an increase in overall impression along with more participants tweeting online, each individual tweet may not be reaching more people. Methods of augmenting reach at GI conferences using social media should be further studied. Twitter data by conference
Sa1136 SOCIAL MEDIA IN GI TRAINING PROGRAMS: PRELIMINARY RESULTS OF A NATIONAL SURVEY OF GI FELLOWSHIP PROGRAM DIRECTORS Austin L. Chiang, Allison L. Yang, Navin L. Kumar, Molly L. Perencevich, Walter W. Chan Background: Social media (SoMe) has been increasingly utilized in general communication as well as medical education. Previous literature has demonstrated a general lack of institutional policies and guidance embedded in trainee education for SoMe despite high use among general surgery training program leadership. Integration of SoMe into trainee education and guidance on its use in the professional setting remains unclear in gastroenterology. Aim: To determine experience and views of gastroenterology fellowship program directors (PD) with regards to social media in training programs. Methods: A 25-question survey was distributed electronically to 168 PD nationwide. Questions included program director demographic information, personal use of SoMe, perceptions of SoMe use among trainees, interactions with trainees on SoMe, observed effects of SoMe use by trainees, and opinions about social media and its role in gastroenterology fellow training. Associations between program director characteristics and views regarding social media were assessed using Chi-squared test or Wilcoxon-Mann-Whitney test. Results: A total of 53 PD (25.49% feamle, 54% <5 years experience as PD) responded to the survey (31.5% response rate). 33.33% had personal Twitter accounts, and 50% had personal Facebook accounts. Only 11.78% reported a divisional or program-specific social media account and only 3.92% used SoMe as an educational or administrative tool on a regular basis. However, the majority agreed (58.5%) that trainees should be encouraged to use SoMe in the professional setting and that additional social media resources and/or guidance are needed. Among the responders, PD with a personal Twitter account were more likely to encourage trainees to adopt social media use for professional activities (OR 5.42, p=0.0334). Program directors who often used social media were more likely to encourage trainee social media use (Chi-square 6.343, p=0.012). Conclusion: Despite general agreement that trainees should be trained in professional social media use and that more resources and guidance are necessary, incorporation of divisionspecific social media accounts and integration of social media into trainee education remains limited. As the use of social media use becomes more prevalent among trainees and program leadership, greater attention should be paid to understanding the role social media plays in GI training programs. Program director demographics
AGA Abstracts
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Sa1139 IDENTIFICATION OF GENOMIC REGIONS ASSOCIATED WITH SUSCEPTIBILITY TO BARRETT'S ESOPHAGUS AND ESOPHAGEAL ADENOCARCINOMA IN AFRICAN AMERICANS: THE CROSS BETRNET ADMIXTURE STUDY Xiangqing Sun, Apoorva K. Chandar, Marcia I. Canto, Prashanthi N. Thota, Malcom Brock, Nicholas J. Shaheen, David G. Beer, Jean S. Wang, Gary W. Falk, Prasad G. Iyer, Julian A. Abrams, Medha Venkat-Ramani, Martina Veigl, Alexander miron, Joseph Willis, Deepa T. Patil, Ilke Nalbantoglu, Kishore Guda, Sanford D. Markowitz, Xiaofeng zhu, Robert Elston, Amitabh Chak INTRODUCTION: Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) are far more prevalent in European Americans than African Americans. Hypothesizing that this racial disparity in prevalence might represent a genetic susceptibility, we used an admixture approach to interrogate disease association with genomic differences in European and African ancestry. METHODS: Formalin fixed paraffin embedded samples were identified from 54 rare AAs with BE or EAC through review of pathology databases at participating BETRNet institutions. DNA was extracted from normal tissue, and genotyped on the Illumina OmniQuad SNP chip. Strict quality controls were performed. Haplotype phases were inferred by Beagle 3.3.2, which generates the required format for inferring Local African and European ancestries by SABER+. Case-only admixture mapping analysis was performed. The number of independent tests when testing all SNPs was estimated by Galwey's method based on the correlation matrix of the local ancestry. RESULTS: Mean European ancestry in the sample set was calculated as 32%(+20%). The association of excess European ancestry on chromosome 11p (Figure) reached a 5% genome-wide significance threshold, corresponding to -log10 (P) = 3.7, one-tailed t-test. A second peak on chromosome 8q (Figure) reached -log10(P) = 3.0. The converse analysis examining for excess African ancestry found no genomic BE locus associated with significantly excess African ancestry. On average, the regions on chromosomes 8q and 11p show 46% and 52% European ancestry, i.e. excess European ancestry of 14% and 20%, respectively. Assuming an additive model the estimated relative risks for European alleles in the chromosome 8q and 11p regions are 1.79 and 2.68, respectively. CONCLUSIONS: Chromosomal regions on 11p15 and 8q23/24 are associated with excess European ancestry in African Americans with BE and EAC. These regions likely harbor low frequency or rare disease associated variants and/or multiple disease associated variants that confer susceptibility to developing BE and EAC.
Sa1138 NOVEL INTERACTIVE FLASHCARD EDUCATION IMPROVES COLONOSCOPY PREP KNOWLEDGE Mitchell Kang, Shefali N. Shah, Shelini Sooklal, Peter Sohn, Savanna Thor, Neilanjan Nandi Introduction Suboptimal bowel preparation continues to be an issue at endoscopy centers nationwide. Various educational modalities have been used, such as pamphlets[1] and videos[2] and do not account for suboptimal health literacy rates. There is limited evidence suggesting any of these methods improve patients' understanding about proper bowel preparation[2]. We sought to test the efficacy of a novel flashcard feedback system. Methods In this single center tertiary institution pilot study, subjects presenting to the outpatient clinic for screening colonoscopies were enrolled. They completed a preliminary questionnaire about the foods they believed they were allowed to consume the day prior to colonoscopy. They then received a randomized form of education: either standard verbal instructions (control group), or flashcard education which involved images of various foods on one side, and images of a well prepped colon or a poorly prepped colon on the other along with standard verbal instructions (flashcard group). They then completed the same questionnaire post-education to assess new knowledge. Data was analyzed with SPSS software, using MannWhitney U, ANOVA, and Spearman's correlation coefficient. Results Thirty five patients were enrolled: 18 men (51.4%) and 17 women (48.6%). The mean ages were 58.6 years for men, and 55.2 years for women. Fifteen (43%) were randomized to the control group, and 20 (57%) were in the flashcard group. The mean numbers of incorrect answers in the control group were 3.6 pre-instructions, and 2.5 post-instructions. In comparison, the mean numbers of incorrect answers in the flashcard group were 4.3 pre-flashcards and 1.45 postflashcards. Subjects who received flashcard instructions had greater improvement in the numbers of incorrect answers than in the standard instruction group (2.85 vs 1.13; p= 0.037). Of the 35 patients, 7 (20%) reported their highest level of education as less than high school graduate; 14 (40%) were high school graduates; 8 (22.9%) were college graduates; and 5 (14.3%) reported higher than college graduate. The correlation between education level and change in incorrect survey answers was -0.362 (one-tailed p=0.0027) which showed statistical significance. Furthermore, education level was further dichotomized between high school graduate and lower, and college graduate and higher. A one-tailed p value of 0.048 was obtained, which further illustrates the significant impact of our flashcard instruction on subjects with lower education levels. Conclusions This pilot study illustrates that interactive flashcard education improves pre-colonoscopy bowel preparation knowledge. Visual flashcard education had a more profound impact on subjects with lower educational levels, specifically, those who had attained a maximum of high school education.
Genome wide excess European ancestry (left); excess African ancestry (2nd from left); chromosome 8 q (3rd from left) and 11p (right) have peak lod score of 3.0 and 3.7, respectively.
Sa1140 ASPIRIN PREVENTS NF-κB ACTIVATION AND CDX2 EXPRESSION INDUCED BY ACID AND BILE SALTS IN ESOPHAGEAL SQUAMOUS CELLS OF PATIENTS WITH BARRETT'S ESOPHAGUS Xiaofang Huo, Xi Zhang, Chunhua Yu, Edaire Cheng, Qiuyang D. Zhang, Kerry B. Dunbar, Thai Pham, John P. Lynch, David H. Wang, Robert S. Bresalier, Stuart J. Spechler, Rhonda F. Souza Introduction: In previous studies using esophageal squamous cells from patients with Barrett's esophagus (NES-B cells), we showed that acidic bile salts induced NF-κB activation (as evidenced by increased phosphorylation of IKKβ and IκB, and increased nuclear translocation of the p65 NF-κB subunit). We also showed that acidic bile salts induced NES-B cells to express CDX2, an NF-κB target gene that is expressed in Barrett's metaplasia and that is known to direct the formation of intestinal epithelium. These findings suggested that refluxinduced NF-κB activation leading to CDX2 expression might underlie the pathogenesis of Barrett's intestinal metaplasia. Recent case-control studies have found that aspirin, but not other NSAIDs, protects against the development of Barrett's esophagus, and aspirin is unique among the NSAIDs in its ability to prevent NF-κB activation by inhibiting IKKβ, the kinase that phosphorylates IκB. To explore how aspirin might protect against the development of Barrett's esophagus, we studied effects of aspirin on CDX2 expression induced by acidic bile salts in NES-B cells. Methods: We treated 2 telomerase-immortalized esophageal squamous cell lines (NES-B3T and NES-B10T) and 3 primary cultures of esophageal squamous cells from Barrett's patients (NES-B3, NES-B6, and NES-B7) with acidic bile salt medium, with or without aspirin (100 µM), for up to 24 hours; neutral full-growth medium with or without aspirin served as the control. We determined: 1) phospho-IκB and total IκB protein levels (an index of IKKβ activity) by Western blot, 2) p65 nuclear translocation by immunofluorescence, 3) CDX2 promoter activity by a luciferase reporter assay, and 4) CDX2 mRNA expression by PCR. Results: In NES-B10T cells, exposure to acidic bile salts increased phospho-IκB levels, nuclear translocation of p65, CDX2 promoter activity, and CDX2 mRNA expression. Aspirin treatment abolished the increase in phospho-IκB levels and in p65 nuclear translocation, and significantly reduced the increases in CDX2 promoter activity and mRNA expression induced by acidic bile salts; this aspirin-induced reduction of CDX2 mRNA expression was confirmed in NES-B3T cells. In all 3 primary NES-B cell cultures, acidic bile salts caused a significant increase in CDX2 promoter activity that was blocked by aspirin. Conclusions: In esophageal squamous cells from patients with Barrett's esophagus that are exposed to acid and bile salts, aspirin blocks CDX2 expression by inhibiting NF-κB activity. This study identifies molecular mechanisms that could explain why aspirin is unique among the NSAIDs in affording protection against the development of Barrett's esophagus. Furthermore, since Barrett's metaplasia re-develops frequently after radiofrequency ablation, our findings suggest a potential role for aspirin to prevent this troublesome clinical problem.
Interactive flash cards - Top: Orange jello (left), with corresponding clean colon prep image (right). Bottom: Chocolate pudding (left), with corresponding poor colon prep image (right).
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AGA Abstracts
AGA Abstracts
Table 2: Linear regression to assess trend in impressions and tweets at each conference over years
Table 2. Sample survey questions and results
Sa1137 TRENDS IN SOCIAL MEDIA REACH AND ENGAGEMENT AT GASTROENTEROLOGICAL CONFERENCES Austin L. Chiang, Loren Rabinowitz, Walter W. Chan Figure 1.: NIH DOM funding versus GI Division funding. While DOM funding correlated with GI funding, much of this correlation was due to little funding in either and displayed large variations, making DOM funding a less than ideal measure for GI Divisional funding.
Background: Social media has been recognized as a powerful method of engagement and education in healthcare for medical professionals and the general public. Gastroenterological (GI) societies use social media platforms such as Twitter, in order to disseminate new data presented at conferences such as Digestive Disease Week (DDW), The Liver Meeting (AASLD), and the American College of Gastroenterology annual scientific meeting (ACG). The efficacy of social media for increasing awareness of conference content has not yet been comprehensively studied. Aim: To determine the trends of social media reach and engagement at three major GI conferences in recent years. Methods: Conference-specific activity at the three major GI conferences were identified using conference-specific hashtags formally registered at health care social media analytics website Symplur.com. Data was available for DDW and AASLD from 2012 to 2016, and ACG from 2013 to 2016, including conference impressions, tweets, and participants for the duration spanning one week preceding and after the meeting. A linear regression was used to detect significant trends in these parameters between conference and years. Results: By 2016, impressions gained from tweets at DDW, ACG, and AASLD have reached over 23-55 million people at each conference. Tweets at the most recent meetings in 2016 were 14,825, 5,629, and 9,990 tweets at each meeting, respectively. On linear regression, all three major conferences demonstrated significantly more impressions (p=0.007), tweets (p=0.007), and participants (p=0.004) over time. However, the actual tweets per participant and impressions per tweet did not demonstrate any significant increase over the years (p=0.792 and p=0.462, respectively). Conclusion: Social media use at meetings has risen substantially in recent years. Impressions, tweets, and participants have all risen significantly over the past five years, but not tweets per participant and impressions per tweet. This, therefore, suggests that despite an increase in overall impression along with more participants tweeting online, each individual tweet may not be reaching more people. Methods of augmenting reach at GI conferences using social media should be further studied. Twitter data by conference
Sa1136 SOCIAL MEDIA IN GI TRAINING PROGRAMS: PRELIMINARY RESULTS OF A NATIONAL SURVEY OF GI FELLOWSHIP PROGRAM DIRECTORS Austin L. Chiang, Allison L. Yang, Navin L. Kumar, Molly L. Perencevich, Walter W. Chan Background: Social media (SoMe) has been increasingly utilized in general communication as well as medical education. Previous literature has demonstrated a general lack of institutional policies and guidance embedded in trainee education for SoMe despite high use among general surgery training program leadership. Integration of SoMe into trainee education and guidance on its use in the professional setting remains unclear in gastroenterology. Aim: To determine experience and views of gastroenterology fellowship program directors (PD) with regards to social media in training programs. Methods: A 25-question survey was distributed electronically to 168 PD nationwide. Questions included program director demographic information, personal use of SoMe, perceptions of SoMe use among trainees, interactions with trainees on SoMe, observed effects of SoMe use by trainees, and opinions about social media and its role in gastroenterology fellow training. Associations between program director characteristics and views regarding social media were assessed using Chi-squared test or Wilcoxon-Mann-Whitney test. Results: A total of 53 PD (25.49% feamle, 54% <5 years experience as PD) responded to the survey (31.5% response rate). 33.33% had personal Twitter accounts, and 50% had personal Facebook accounts. Only 11.78% reported a divisional or program-specific social media account and only 3.92% used SoMe as an educational or administrative tool on a regular basis. However, the majority agreed (58.5%) that trainees should be encouraged to use SoMe in the professional setting and that additional social media resources and/or guidance are needed. Among the responders, PD with a personal Twitter account were more likely to encourage trainees to adopt social media use for professional activities (OR 5.42, p=0.0334). Program directors who often used social media were more likely to encourage trainee social media use (Chi-square 6.343, p=0.012). Conclusion: Despite general agreement that trainees should be trained in professional social media use and that more resources and guidance are necessary, incorporation of divisionspecific social media accounts and integration of social media into trainee education remains limited. As the use of social media use becomes more prevalent among trainees and program leadership, greater attention should be paid to understanding the role social media plays in GI training programs. Program director demographics
AGA Abstracts
S-232
Sa1139 IDENTIFICATION OF GENOMIC REGIONS ASSOCIATED WITH SUSCEPTIBILITY TO BARRETT'S ESOPHAGUS AND ESOPHAGEAL ADENOCARCINOMA IN AFRICAN AMERICANS: THE CROSS BETRNET ADMIXTURE STUDY Xiangqing Sun, Apoorva K. Chandar, Marcia I. Canto, Prashanthi N. Thota, Malcom Brock, Nicholas J. Shaheen, David G. Beer, Jean S. Wang, Gary W. Falk, Prasad G. Iyer, Julian A. Abrams, Medha Venkat-Ramani, Martina Veigl, Alexander miron, Joseph Willis, Deepa T. Patil, Ilke Nalbantoglu, Kishore Guda, Sanford D. Markowitz, Xiaofeng zhu, Robert Elston, Amitabh Chak INTRODUCTION: Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) are far more prevalent in European Americans than African Americans. Hypothesizing that this racial disparity in prevalence might represent a genetic susceptibility, we used an admixture approach to interrogate disease association with genomic differences in European and African ancestry. METHODS: Formalin fixed paraffin embedded samples were identified from 54 rare AAs with BE or EAC through review of pathology databases at participating BETRNet institutions. DNA was extracted from normal tissue, and genotyped on the Illumina OmniQuad SNP chip. Strict quality controls were performed. Haplotype phases were inferred by Beagle 3.3.2, which generates the required format for inferring Local African and European ancestries by SABER+. Case-only admixture mapping analysis was performed. The number of independent tests when testing all SNPs was estimated by Galwey's method based on the correlation matrix of the local ancestry. RESULTS: Mean European ancestry in the sample set was calculated as 32%(+20%). The association of excess European ancestry on chromosome 11p (Figure) reached a 5% genome-wide significance threshold, corresponding to -log10 (P) = 3.7, one-tailed t-test. A second peak on chromosome 8q (Figure) reached -log10(P) = 3.0. The converse analysis examining for excess African ancestry found no genomic BE locus associated with significantly excess African ancestry. On average, the regions on chromosomes 8q and 11p show 46% and 52% European ancestry, i.e. excess European ancestry of 14% and 20%, respectively. Assuming an additive model the estimated relative risks for European alleles in the chromosome 8q and 11p regions are 1.79 and 2.68, respectively. CONCLUSIONS: Chromosomal regions on 11p15 and 8q23/24 are associated with excess European ancestry in African Americans with BE and EAC. These regions likely harbor low frequency or rare disease associated variants and/or multiple disease associated variants that confer susceptibility to developing BE and EAC.
Sa1138 NOVEL INTERACTIVE FLASHCARD EDUCATION IMPROVES COLONOSCOPY PREP KNOWLEDGE Mitchell Kang, Shefali N. Shah, Shelini Sooklal, Peter Sohn, Savanna Thor, Neilanjan Nandi Introduction Suboptimal bowel preparation continues to be an issue at endoscopy centers nationwide. Various educational modalities have been used, such as pamphlets[1] and videos[2] and do not account for suboptimal health literacy rates. There is limited evidence suggesting any of these methods improve patients' understanding about proper bowel preparation[2]. We sought to test the efficacy of a novel flashcard feedback system. Methods In this single center tertiary institution pilot study, subjects presenting to the outpatient clinic for screening colonoscopies were enrolled. They completed a preliminary questionnaire about the foods they believed they were allowed to consume the day prior to colonoscopy. They then received a randomized form of education: either standard verbal instructions (control group), or flashcard education which involved images of various foods on one side, and images of a well prepped colon or a poorly prepped colon on the other along with standard verbal instructions (flashcard group). They then completed the same questionnaire post-education to assess new knowledge. Data was analyzed with SPSS software, using MannWhitney U, ANOVA, and Spearman's correlation coefficient. Results Thirty five patients were enrolled: 18 men (51.4%) and 17 women (48.6%). The mean ages were 58.6 years for men, and 55.2 years for women. Fifteen (43%) were randomized to the control group, and 20 (57%) were in the flashcard group. The mean numbers of incorrect answers in the control group were 3.6 pre-instructions, and 2.5 post-instructions. In comparison, the mean numbers of incorrect answers in the flashcard group were 4.3 pre-flashcards and 1.45 postflashcards. Subjects who received flashcard instructions had greater improvement in the numbers of incorrect answers than in the standard instruction group (2.85 vs 1.13; p= 0.037). Of the 35 patients, 7 (20%) reported their highest level of education as less than high school graduate; 14 (40%) were high school graduates; 8 (22.9%) were college graduates; and 5 (14.3%) reported higher than college graduate. The correlation between education level and change in incorrect survey answers was -0.362 (one-tailed p=0.0027) which showed statistical significance. Furthermore, education level was further dichotomized between high school graduate and lower, and college graduate and higher. A one-tailed p value of 0.048 was obtained, which further illustrates the significant impact of our flashcard instruction on subjects with lower education levels. Conclusions This pilot study illustrates that interactive flashcard education improves pre-colonoscopy bowel preparation knowledge. Visual flashcard education had a more profound impact on subjects with lower educational levels, specifically, those who had attained a maximum of high school education.
Genome wide excess European ancestry (left); excess African ancestry (2nd from left); chromosome 8 q (3rd from left) and 11p (right) have peak lod score of 3.0 and 3.7, respectively.
Sa1140 ASPIRIN PREVENTS NF-κB ACTIVATION AND CDX2 EXPRESSION INDUCED BY ACID AND BILE SALTS IN ESOPHAGEAL SQUAMOUS CELLS OF PATIENTS WITH BARRETT'S ESOPHAGUS Xiaofang Huo, Xi Zhang, Chunhua Yu, Edaire Cheng, Qiuyang D. Zhang, Kerry B. Dunbar, Thai Pham, John P. Lynch, David H. Wang, Robert S. Bresalier, Stuart J. Spechler, Rhonda F. Souza Introduction: In previous studies using esophageal squamous cells from patients with Barrett's esophagus (NES-B cells), we showed that acidic bile salts induced NF-κB activation (as evidenced by increased phosphorylation of IKKβ and IκB, and increased nuclear translocation of the p65 NF-κB subunit). We also showed that acidic bile salts induced NES-B cells to express CDX2, an NF-κB target gene that is expressed in Barrett's metaplasia and that is known to direct the formation of intestinal epithelium. These findings suggested that refluxinduced NF-κB activation leading to CDX2 expression might underlie the pathogenesis of Barrett's intestinal metaplasia. Recent case-control studies have found that aspirin, but not other NSAIDs, protects against the development of Barrett's esophagus, and aspirin is unique among the NSAIDs in its ability to prevent NF-κB activation by inhibiting IKKβ, the kinase that phosphorylates IκB. To explore how aspirin might protect against the development of Barrett's esophagus, we studied effects of aspirin on CDX2 expression induced by acidic bile salts in NES-B cells. Methods: We treated 2 telomerase-immortalized esophageal squamous cell lines (NES-B3T and NES-B10T) and 3 primary cultures of esophageal squamous cells from Barrett's patients (NES-B3, NES-B6, and NES-B7) with acidic bile salt medium, with or without aspirin (100 µM), for up to 24 hours; neutral full-growth medium with or without aspirin served as the control. We determined: 1) phospho-IκB and total IκB protein levels (an index of IKKβ activity) by Western blot, 2) p65 nuclear translocation by immunofluorescence, 3) CDX2 promoter activity by a luciferase reporter assay, and 4) CDX2 mRNA expression by PCR. Results: In NES-B10T cells, exposure to acidic bile salts increased phospho-IκB levels, nuclear translocation of p65, CDX2 promoter activity, and CDX2 mRNA expression. Aspirin treatment abolished the increase in phospho-IκB levels and in p65 nuclear translocation, and significantly reduced the increases in CDX2 promoter activity and mRNA expression induced by acidic bile salts; this aspirin-induced reduction of CDX2 mRNA expression was confirmed in NES-B3T cells. In all 3 primary NES-B cell cultures, acidic bile salts caused a significant increase in CDX2 promoter activity that was blocked by aspirin. Conclusions: In esophageal squamous cells from patients with Barrett's esophagus that are exposed to acid and bile salts, aspirin blocks CDX2 expression by inhibiting NF-κB activity. This study identifies molecular mechanisms that could explain why aspirin is unique among the NSAIDs in affording protection against the development of Barrett's esophagus. Furthermore, since Barrett's metaplasia re-develops frequently after radiofrequency ablation, our findings suggest a potential role for aspirin to prevent this troublesome clinical problem.
Interactive flash cards - Top: Orange jello (left), with corresponding clean colon prep image (right). Bottom: Chocolate pudding (left), with corresponding poor colon prep image (right).
S-233
AGA Abstracts
AGA Abstracts
Table 2: Linear regression to assess trend in impressions and tweets at each conference over years