Sugihartono Titong, Hidayat Amal Arifi, Alfaray Ricky Indra, Lusida Michael Austin Pradipta, Mahmudah Isna, Aftab Hafeza, Vilaichone Ratha-Korn, Yamaoka Yoshio, Malaty Hoda M, Miftahussurur Muhammad
Division of Gastroenterology-Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.
J Clin Med. 2024 Sep 29;13(19):5832. doi: 10.3390/jcm13195832.
The diverse clinical characteristics of erosive esophagitis (EE) and symptom perception in patients with gastroesophageal reflux disease (GERD) remain a major challenge in understanding their underlying pathogenesis. This study aimed to investigate the association between the levels of IL-8, TNF-α, and IL-17 in serum and the presence of erosive esophagitis and symptoms related to GERD. We enrolled 65 subjects presenting with GERD symptoms. Based on the findings of upper endoscopy, the subjects were categorized into two groups: (1) erosive esophagitis (EE LA grades B-D) and (2) non-erosive esophagitis (normal-EE LA grade A). Symptom perception was assessed via GERD questionnaire (GERD-Q) and the frequency scale for the symptoms of GERD (FSSG). The enzyme-linked immunosorbent assay (ELISA) method was used to analyze serum levels of IL-8, TNF-α, and IL-17. Analysis of cytokine levels between different symptoms severity was performed using the Kruskal-Wallis H test. Median serum IL-8 levels were significantly higher in the erosive esophagitis group compared to those with non-erosive esophagitis (20.2 (IQR 16.9-32.2) vs. 17.7 (IQR 15.2-19.6), < 0.05). The study found a significant association between IL-8 levels and the presence of globus symptoms (median IL8 level 46.961 (38.622-92.644) in subjects with globus vs. 18.06 (16.68-20.49) in those without globus; < 0.05). Similarly, TNF-α levels were associated with the frequency of regurgitation symptoms (H index = 10.748; dr = 3; < 0.05). We observed a significant correlation between IL-17 levels and the frequency of heartburn and early satiety symptoms. IL-8 may play a role in the development of mucosal erosion in GERD. IL-8, TNF- α, and IL-17 might be involved in the development of globus symptoms, the frequency of regurgitation, and the frequency of heartburn and early satiety, respectively. The diverse symptom phenotypes observed in patients with GERD symptoms may be mediated by distinct profiles of proinflammatory cytokines.
糜烂性食管炎(EE)的多样临床特征以及胃食管反流病(GERD)患者的症状感知,仍是理解其潜在发病机制的一项重大挑战。本研究旨在调查血清中白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)和白细胞介素-17(IL-17)水平与糜烂性食管炎的存在以及与GERD相关症状之间的关联。我们纳入了65名有GERD症状的受试者。根据上消化道内镜检查结果,将受试者分为两组:(1)糜烂性食管炎(EE LA分级B - D级)和(2)非糜烂性食管炎(正常 - EE LA分级A级)。通过GERD问卷(GERD - Q)和GERD症状频率量表(FSSG)评估症状感知。采用酶联免疫吸附测定(ELISA)方法分析血清中IL-8、TNF-α和IL-17的水平。使用Kruskal - Wallis H检验对不同症状严重程度之间的细胞因子水平进行分析。与非糜烂性食管炎组相比,糜烂性食管炎组血清IL-8水平中位数显著更高(20.2(四分位间距16.9 - 32.2)对17.7(四分位间距15.2 - 19.6),<0.05)。研究发现IL-8水平与咽部异物感症状的存在之间存在显著关联(有咽部异物感的受试者中IL-8水平中位数为46.961(38.622 - 92.644),无咽部异物感的受试者中为18.06(16.68 - 20.49);<0.05)。同样,TNF-α水平与反流症状的频率相关(H指数 = 10.748;自由度 = 3;<0.05)。我们观察到IL-17水平与烧心和早饱症状的频率之间存在显著相关性。IL-8可能在GERD的黏膜糜烂发展中起作用。IL-8、TNF-α和IL-17可能分别参与咽部异物感症状的发展、反流频率以及烧心和早饱频率。GERD症状患者中观察到的多样症状表型可能由促炎细胞因子的不同谱介导。