Morozov Sergey, Sentsova Tatyana
Department of Gastroenterology, Hepatology and Nutrition, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow 115446, Russia.
Department of Hospital Pediatrics No. 2, Russian National Research Medical University named after N.I. Pirogov, Moscow 117997, Russia.
World J Clin Cases. 2022 Sep 16;10(26):9254-9263. doi: 10.12998/wjcc.v10.i26.9254.
BACKGROUND: Gene expression of inflammatory cytokines may take part in the pathophysiology of different forms of gastroesophageal reflux disease (GERD). AIM: To explore gene expression of inflammatory cytokines in esophageal mucosa in patients with erosive esophagitis (EE) and non-erosive forms of GERD (NERD) and its association with data of esophageal multichannel intraluminal impedance-pH (MII-pH) measurements. METHODS: This was a single-center prospective study. Esophageal mucosa samples were taken from the lower part of the esophagus during endoscopy. Expression of interleukin ()-, , , tumor necrosis factor α (), toll-like receptor 4 (), GATA binding protein 3 (), differentiation cluster 68 () and β-2 microglobulin genes in esophageal mucosa was assessed with ImmunoQuantex assays. MII-pH measurements were performed on all the participants. Diagnosis of GERD was confirmed by the results of the MII-pH data. Based on the endoscopy, patients were allocated to the groups of EE and NERD. The control group consisted of non-symptomatic subjects with normal endoscopy and MII-pH results. We used nonparametric statistics to compare the differences between the groups. Association of expression of the mentioned genes with the results of the MII-pH data was assessed with Spearman's rank method. RESULTS: Data from 60 patients with GERD and 10 subjects of the control group were available for the analysis. Higher expression of (5.89 ± 0.4 5.28 ± 1.1, = 0.04) and (2.92 ± 0.86 2.23 ± 0.96, = 0.03) was found in the EE group compared to NERD. Expression of , , , and was lower ( < 0.05) in the control group compared to EE and NERD. Esophageal acid exposure correlated with the expression of (Spearman's rank = 0.29), ( = 0.31), ( = 0.35), ( = 0.34), ( = 0.29), and ( = 0.37). Mean esophageal рН correlated inversely with the expression of , , , , and . No association of gene expression with the number of gastroesophageal refluxes was found. CONCLUSION: In patients with EE, local expression of and was higher compared to subjects with NERD. Esophageal acid exposure correlated directly with expression of , , , , , and β-2 microglobulin genes. Inverse correlation was revealed between expression of , , , , and and mean esophageal pH.
背景：炎症细胞因子的基因表达可能参与不同形式胃食管反流病（GERD）的病理生理过程。 目的：探讨糜烂性食管炎（EE）和非糜烂性GERD（NERD）患者食管黏膜中炎症细胞因子的基因表达及其与食管多通道腔内阻抗-pH（MII-pH）测量数据的关联。 方法：这是一项单中心前瞻性研究。在内镜检查时从食管下段获取食管黏膜样本。采用免疫定量检测法评估食管黏膜中白细胞介素（）-、、、肿瘤坏死因子α（）、Toll样受体4（）、GATA结合蛋白3（）、分化簇68（）和β-2微球蛋白基因的表达。对所有参与者进行MII-pH测量。根据MII-pH数据结果确诊GERD。根据内镜检查结果，将患者分为EE组和NERD组。对照组由内镜检查和MII-pH结果正常的无症状受试者组成。我们使用非参数统计方法比较组间差异。采用Spearman秩相关法评估上述基因表达与MII-pH数据结果的关联。 结果：共有60例GERD患者和10例对照组受试者的数据可用于分析。与NERD组相比，EE组中（5.89±0.4对5.28±1.1，=0.04）和（2.92±0.86对2.23±0.96，=0.03）的表达更高。与EE组和NERD组相比，对照组中、、、和的表达较低（<0.05）。食管酸暴露与、、、、和的表达相关（Spearman秩=0.29、=0.31、=0.35、=0.34、=0.29、=0.37）。平均食管pH值与、、、、和的表达呈负相关。未发现基因表达与胃食管反流次数之间存在关联。 结论：与NERD患者相比，EE患者中及的局部表达更高。食管酸暴露与、、、、和β-2微球蛋白基因的表达直接相关。在、、、和的表达与平均食管pH值之间发现了负相关。
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