Zavala-Solares Mónica R, Fonseca-Camarillo Gabriela, Valdovinos Miguel, Granados Julio, Grajales-Figueroa Guido, Zamora-Nava Luis, Aguilar-Olivos Nancy, Valdovinos-García Luis R, Yamamoto-Furusho Jesús K
Programa de Doctorado en Ciencias Médicas, Unidad de Posgrado, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15. Col. Sección XVI, CP 14000, México City, D.F., Mexico.
BMC Gastroenterol. 2021 May 3;21(1):201. doi: 10.1186/s12876-021-01707-7.
BACKGROUND: The clinical endoscopic phenotypes of gastroesophageal reflux disease (GERD) are classified as Barrett's esophagus (BE), erosive esophagitis (EE) and non-erosive gastroesophageal reflux disease (NERD). NERD is subclassified as abnormal acid exposure (AAE) and normal acid exposure (NAE) based on pH monitoring study results. The aim of this study was to characterize genes involved in the pathophysiology and immune response of GERD. METHODS: This is an observational and cross-sectional study. All patients with BE, EE, AAE, and NAE and a control group were subjected to superior endoscopy (with biopsies of esophageal mucosa). Relative mRNA quantification of cytokine and target genes was conducted by quantitative Polymerase Chain Reaction (RT-qPCR). Changes in the expression of genes associated with inflammation were assessed for each disease phenotype. Statistical analysis of differential gene expression was performed using the Mann-Whitney U non-parametric test. A p value < 0.05 was considered significant. RESULTS: A total of 82 patients were included and were divided into the following groups: Group BE, 16 (19.51%); Group EE, 23 (28.04%); Group AAE, 13 (15.86%); NAE 13 (15.86%); and Control Group, 17 (20.73%). Compared with the control group, patients with BE exhibited increased IL-8 expression (p < 0.05) and increased levels of IL-10, MMP-3, and MMP-9. Patients with EE exhibited increased levels of IL-1B, IL-6 and IL-10 (p < 0.05), and patients with AAE exhibited increased expression of IL-1B, IL-6, IFN-γ and TNF-α (p < 0.05). AAE exhibited increased IL-1B and TNF-α expression compared with NAE (p < 0.05). CONCLUSION: This study demonstrates the differential expression of mediators of inflammation in the esophageal mucosa of patients with different GERD endoscopic phenotypes. IL-1B and TNF-α could be useful to differentially diagnose AAE and NAE in the non-erosive phenotype using endoscopic biopsies.
背景:胃食管反流病(GERD)的临床内镜表型分为巴雷特食管(BE)、糜烂性食管炎(EE)和非糜烂性胃食管反流病(NERD)。根据pH监测研究结果,NERD又分为酸暴露异常(AAE)和酸暴露正常(NAE)。本研究的目的是鉴定参与GERD病理生理学和免疫反应的基因。 方法:这是一项观察性横断面研究。所有BE、EE、AAE和NAE患者以及一个对照组均接受上消化道内镜检查(取食管黏膜活检)。通过定量聚合酶链反应(RT-qPCR)进行细胞因子和靶基因的相对mRNA定量。评估每种疾病表型中与炎症相关基因表达的变化。使用曼-惠特尼U非参数检验对差异基因表达进行统计分析。p值<0.05被认为具有统计学意义。 结果:共纳入82例患者,分为以下几组:BE组16例(19.51%);EE组23例(28.04%);AAE组13例(15.86%);NAE组13例(15.86%);对照组17例(20.73%)。与对照组相比,BE患者的IL-8表达增加(p<0.05),IL-10、MMP-3和MMP-9水平升高。EE患者的IL-1B、IL-6和IL-10水平升高(p<0.05),AAE患者的IL-1B、IL-6、IFN-γ和TNF-α表达增加(p<0.05)。与NAE相比,AAE的IL-1B和TNF-α表达增加(p<0.05)。 结论:本研究证明了不同GERD内镜表型患者食管黏膜中炎症介质的差异表达。IL-1B和TNF-α可用于通过内镜活检对非糜烂性表型中的AAE和NAE进行鉴别诊断。
Neurogastroenterol Motil. 2010-5-6
Scand J Gastroenterol. 2004-9
J Gastrointest Surg. 2008-8
Front Med (Lausanne). 2025-2-19
J Gastroenterol. 2024-3
Gastroenterology. 2017-10-14
Neurogastroenterol Motil. 2017-2
Gastroenterol Res Pract. 2013-7-11
Am J Physiol Gastrointest Liver Physiol. 2013-5-2
J Gastroenterol. 2011-5-18