Digestion. 2018;98(2):95-103. doi: 10.1159/000487708. Epub 2018 Apr 26.
Although basic research has shown that certain cytokines affect gastrointestinal motility, the clinical evidence is lacking. The objective of this study was to explore the association between mucosally expressed cytokines and the esophageal motility function in humans.
We enrolled a total of 57 patients with suspected esophageal motility disorders (EMDs) who underwent high-resolution manometry.
The diagnoses of the patients were as follows: normal esophageal motility (n = 25), ineffective esophageal motility (n = 5), esophagogastric junction outflow obstruction (EGJOO; n = 10), distal esophageal spasm (n = 5), achalasia (n = 10), absent contractility (n = 1), and jackhammer esophagus (n = 1). The expression of tumor necrosis factor (TNF)-α in the esophagogastric junction (EGJ) was significantly higher in EGJOO (14.6, 14.0-15.8, n = 10) than in normal esophageal motility (13.3, 12.8-14.1, n = 25); however, there was no difference in the expression of TNF-α between achalasia (13.4, 13.0-14.1, n = 10) and normal esophageal motility (13.3, 12.8-14.1, n = 25). EGJOO was discriminated from achalasia/normal by a linear discriminant analysis (AUC = 0.917). A multivariable regression analysis revealed that interleukin (IL)-13 and IL-23A were predictive of the distal contractile integral, whereas TNF-α and IL-6 were predictive of the basal EGJ pressure.
The esophageal motility was associated with mucosally expressed cytokines in humans; these cytokines could be useful targets for the diagnosis and treatment of EMDs.
虽然基础研究表明某些细胞因子会影响胃肠道蠕动,但临床证据不足。本研究旨在探讨人类黏膜表达细胞因子与食管动力功能的关系。
共纳入 57 例疑似食管动力障碍(EMD)患者,行高分辨率测压。
患者诊断如下:正常食管动力(n=25)、无效食管动力(n=5)、食管胃结合部流出道梗阻(EGJOO;n=10)、远端食管痉挛(n=5)、贲门失弛缓症(n=10)、无收缩力(n=1)、贲门痉挛(n=1)。EGJOO 中肿瘤坏死因子(TNF)-α在食管胃结合部(EGJ)的表达明显高于正常食管动力(14.6,14.0-15.8,n=10)(13.3,12.8-14.1,n=25);然而,贲门失弛缓症(13.4,13.0-14.1,n=10)与正常食管动力(13.3,12.8-14.1,n=25)之间 TNF-α的表达无差异。线性判别分析(AUC=0.917)将 EGJOO 与贲门失弛缓症/正常区分开来。多变量回归分析显示,白细胞介素(IL)-13 和 IL-23A 可预测远端收缩积分,而 TNF-α和 IL-6 可预测基础 EGJ 压力。
人类食管动力与黏膜表达细胞因子相关;这些细胞因子可能是 EMD 诊断和治疗的有用靶点。