Yoshida N, Uchiyama K, Kuroda M, Sakuma K, Kokura S, Ichikawa H, Naito Y, Takemura T, Yoshikawa T, Okanoue T
Molecular Gastroenterology and Hepatology, Department of Legal Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Scand J Gastroenterol. 2004 Sep;39(9):816-22. doi: 10.1080/00365520410006729.
It has been reported that inflammatory cell infiltration can be detected in patients with endoscopically negative gastroesophageal reflux disease (GERD) as well as those with erosive reflux esophagitis. In this study, we examined the expression of mRNA for interleukin (IL)-8, a potent chemokine for neutrophils, in the esophageal mucosa of patients with GERD and compared the results with their endoscopic findings and symptoms.
Biopsy samples were obtained from 80 patients. Endoscopic diagnosis was performed according to the Los Angeles classification. Patients with typical symptoms such as heartburn despite normal endoscopic findings were classified as the non-erosive GERD group. Total cellular RNA was extracted from the biopsy samples and IL-8 mRNA was quantified by real-time polymerase chain reaction (PCR). Localization of IL-8 protein in the esophageal mucosa was done by immunostaining.
Expression of IL-8 mRNA was correlated with the endoscopic grade of esophagitis or with inflammatory cell infiltration, but not with the symptoms of the patients. Expression of IL-8 mRNA was also detected in all patients with non-erosive GERD. The level of IL-8 expression in non-erosive GERD was low compared with that in erosive GERD, but was higher than that in normal controls. IL-8 immunostaining was found in the basal layers of the esophageal mucosa. Administration of lansoprazole, a proton-pump inhibitor, decreased both IL-8 mRNA and protein levels in the esophageal mucosa.
These results suggest that IL-8 in the esophageal mucosa may be involved in the pathogenesis of esophageal inflammation, including non-erosive GERD.
据报道，在内镜检查阴性的胃食管反流病（GERD）患者以及糜烂性反流性食管炎患者中均可检测到炎症细胞浸润。在本研究中，我们检测了GERD患者食管黏膜中白细胞介素（IL）-8（一种对中性粒细胞有强效趋化作用的细胞因子）的mRNA表达，并将结果与其内镜检查结果和症状进行了比较。
从80例患者中获取活检样本。根据洛杉矶分类法进行内镜诊断。内镜检查结果正常但有烧心等典型症状的患者被归类为非糜烂性GERD组。从活检样本中提取总细胞RNA，并通过实时聚合酶链反应（PCR）对IL-8 mRNA进行定量。通过免疫染色确定食管黏膜中IL-8蛋白的定位。
IL-8 mRNA的表达与食管炎的内镜分级或炎症细胞浸润相关，但与患者的症状无关。在所有非糜烂性GERD患者中也检测到了IL-8 mRNA的表达。与糜烂性GERD相比，非糜烂性GERD中IL-8的表达水平较低，但高于正常对照组。在食管黏膜的基底层发现了IL-8免疫染色。质子泵抑制剂兰索拉唑的给药降低了食管黏膜中IL-8 mRNA和蛋白水平。
这些结果表明，食管黏膜中的IL-8可能参与了包括非糜烂性GERD在内的食管炎症的发病机制。
