Diversity in the oesophageal phenotypic response to gastro-oesophageal reflux: immunological determinants
| Autor: | I T Saeed, Benjamin A. Onwuegbusi, Michael J.G. Farthing, W R Burnham, Rebecca C. Fitzgerald, Mona Bajaj-Elliott |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Cellular immunity medicine.medical_specialty Pathology Adolescent medicine.medical_treatment Inflammation Biology digestive system Gastroenterology Proinflammatory cytokine Barrett Esophagus Th2 Cells Internal medicine Gastro-Oesophageal Reflux medicine Esophagitis Humans Prospective Studies RNA Messenger Aged Aged 80 and over Reverse Transcriptase Polymerase Chain Reaction Esophageal disease digestive oral and skin physiology Reflux Interleukin Middle Aged medicine.disease Immunohistochemistry digestive system diseases Phenotype Cytokine Gastroesophageal Reflux Cytokines Female medicine.symptom |
| Zdroj: | Gut. 50:451-459 |
| ISSN: | 0017-5749 |
| DOI: | 10.1136/gut.50.4.451 |
| Popis: | Background and aims: Approximately 10% of adults experience gastro-oesophageal reflux symptoms with a variable oesophageal response. A total of 60% have no endoscopic abnormality, 30% have oesophagitis, and 10% have Barrett9s oesophagus. We investigated whether the inflammatory cell infiltrate and cytokine profiles of these clinical phenotypes merely vary in severity or are fundamentally different. Methods: Patients with reflux symptoms and a normal oesophagus (n=18), oesophagitis (n=26), and Barrett9s oesophagus (n=22 newly diagnosed, n=28 surveillance) were recruited. Endoscopic and histopathological degrees of inflammation were scored. Cytokine expression was determined by competitive reverse transcriptase-polymerase chain reaction and immunohistochemistry. Results: In oesophagitis, endoscopic and histopathological grades of inflammation correlated highly. mRNA expression of proinflammatory interleukin (IL)-1β, IL-8, and interferon γ (IFN-γ) were increased 3–10-fold compared with non-inflamed squamous or Barrett9s oesophageal samples. There was a modest increase in anti-inflammatory IL-10 but no increase in IL-4. In Barrett9s oesophagus, 29/50 had no endoscopic evidence of inflammation and histopathological inflammation was mild in 17/50 and moderate in 24/50, independent of acid suppressants. Expression of IL-1β, IL-8, and IFN-γ was similar to non-inflamed squamous mucosa. IL-10 was increased 1.6-fold similar to oesophagitis. IL-4 was increased fourfold, with 100-fold increase in IL-4/T cell receptor expression, compared with squamous oesophagus or oesophagitis. Conclusions: Barrett9s oesophagus is characterised by a distinct Th-2 predominant cytokine profile compared with the proinflammatory nature of oesophagitis. The specific oesophageal immune responses may influence disease development and progression. |
| Databáze: | OpenAIRE |
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