Isomoto Hajime, Wang Aiping, Mizuta Yohei, Akazawa Yuko, Ohba Kazuo, Omagari Katsuhisa, Miyazaki Masanobu, Murase Kunihiko, Hayashi Tomayoshi, Inoue Kenichiro, Murata Ikuo, Kohno Shigeru
Second Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto, Nagasaki, Japan.
Am J Gastroenterol. 2003 Mar;98(3):551-6. doi: 10.1111/j.1572-0241.2003.07303.x.
Chemokines play a key role in the pathogenesis of various inflammatory conditions. However, there is little information on their profile in reflux esophagitis (RE). We sought to study esophageal mucosa levels of chemokines in RE.
A total of 32 outpatients with RE and 13 normal controls were studied. Endoscopic severity of RE was classified according to the Los Angeles grading system. Paired biopsy specimens were taken from the esophagus 3 cm above the gastroesophageal junction; one biopsy was snap frozen for measurement of mucosal levels of interleukin 8 (IL-8), monocyte chemoattractant protein 1 (MCP-1), regulated on activation normal T-cell expressed and presumably secreted (RANTES), and IL-1 beta by enzyme linked immunosorbent assays, while the other was formalin-fixed for histopathological evaluation.
IL-8, MCP-1, and RANTES levels were significantly higher in esophageal mucosa of RE patients than those of the controls. IL-8 levels correlated significantly with the endoscopic severity of RE. Basal zone hyperplasia and papillary elongation, histopathological hallmarks of RE, were both associated with higher levels of IL-8 and MCP-1. The presence of intraepithelial neutrophils and eosinophils, which also indicate RE, was associated with high levels of IL-8 and RANTES, respectively. There were no significant differences in IL-1 beta levels between the RE and control groups, but IL-1 beta levels correlated significantly with the IL-8 production. Again, the IL-8 levels were significantly decreased after lansoprazole treatment.
Our results indicate that chemokines produced locally in the esophageal mucosa may be involved in the development and progression of RE.
趋化因子在多种炎症性疾病的发病机制中起关键作用。然而，关于其在反流性食管炎（RE）中的情况却知之甚少。我们旨在研究RE患者食管黏膜中趋化因子的水平。
共研究了32例RE门诊患者和13名正常对照者。RE的内镜严重程度根据洛杉矶分级系统进行分类。从胃食管交界处上方3 cm处的食管获取配对活检标本；一份活检标本速冻用于通过酶联免疫吸附测定法测量黏膜中白细胞介素8（IL-8）、单核细胞趋化蛋白1（MCP-1）、活化正常T细胞表达和可能分泌的调节因子（RANTES）以及IL-1β的水平，另一份用福尔马林固定用于组织病理学评估。
RE患者食管黏膜中的IL-8、MCP-1和RANTES水平显著高于对照组。IL-8水平与RE的内镜严重程度显著相关。RE的组织病理学特征——基底区增生和乳头延长，均与较高水平的IL-8和MCP-1相关。同样提示RE的上皮内中性粒细胞和嗜酸性粒细胞的存在，分别与高水平的IL-8和RANTES相关。RE组和对照组之间的IL-1β水平无显著差异，但IL-1β水平与IL-8的产生显著相关。此外，兰索拉唑治疗后IL-8水平显著降低。
我们的结果表明，食管黏膜局部产生的趋化因子可能参与了RE的发生和发展。
