March 21, 2019

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Is This Tissue a New Organ? Maybe. A Conduit for Cancer? It Seems Likely.

Is This Tissue a New Organ? Maybe. A Conduit for Cancer? It Seems Likely.
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“We have never understood the mechanism of how that happens,” said Dr. Neil Theise, a pathologist and professor at the New York University School of Medicine and a senior author of the published paper. “Now we have the ability. If we figure out the mechanism, we can figure out how to interfere with it.”

The paper referred to this “widespread, macroscopic, fluid-filled space within and between tissues” as the interstitium (pronounced inter-STISH-um).

The research began in 2014 when two endoscopists and gastroenterology experts, Petros Benias and David Carr-Locke, were using a newer imaging technology to examine a patient’s bile duct at Mount Sinai Beth Israel Hospital in Manhattan.

The probe-based technology essentially allows doctors to examine live tissue at a microscopic level inside the body and in real time. They captured images of fluid-filled cavities that they wanted to understand better, so they took them to Dr. Theise.

Photo

Dr. Neil Theise, a pathologist at the New York University School of Medicine, collaborated with clinicians to study the interstitium.

Credit
Elly Park/Reuters

Doctors and researchers had been looking at this tissue for years, often by removing samples from the body to examine under a microscope, but that process collapsed the latticework into something that looked crackly and dense.

“Several things happen to a surgical specimen when you take it out of the body. It completely structurally changes, and all the water is lost,” Dr. Benias said. “You’re missing a lot of the story there, and that’s the problem.”

But the newer technology revealed an interstitial network that was “extensive” and more than worthy of being considered an organ, he added, calling it “an entire system that is interfacing between the vascular system and the lymphatic.”

James M. Williams, the director of the Human Anatomy Laboratory at Rush University, was not involved in the study but said the researchers’ work and the technology they used to see the interstitium was exciting and could change the way doctors treat cancers and other diseases.

But the words “new organ” attached to the study were a distraction, he said.

“The only new organs that are being made these days are those that appear onstage and make music,” Dr. Williams said, adding that he was looking forward to delving deeper into the research.

So is Dr. Benias, who said more study of the interstitium could lead to breakthroughs in cancer treatment. He added that the study involved clinicians, pathologists, bioengineers and others.

“A lot of research happens in a bubble, unfortunately,” he said. “People miss the forest for the trees.”



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