The refractory form of gastroesophageal reflux disease: clinical and endoscopical, functional and morphofunctional criteria
Abstract
Aim of investigation. To estimate activity of cells of diffuse endocrine system of the esophagus at patients with refractory form of gastroesophageal reflux disease (GERD).
Material and methods. Twenty three patients with the refractory form of gastroesophageal reflux disease (RFGERD), 100 patients of GERD who responded to treatment, including 60 of those with non-erosive form of endoscopically positive GERD (NFGERD), 40 — with erosive form of GERD (EFGERD) and 14 patients with Barret’s esophagus (BE) were investigated. Groups of comparison included 30 patients with chronic H. pyloriassociated gastritis and 20 generally healthy patients. Contents of nephro-endocrine cells in mucosa of the esophagus, producing nitric oxide synthase, endothelin-1, melatonin, neurotensin and р53 was determined by immunehistochemical method.
Results. In contrast to NFGERD and EFGERD, at RFGERD higher grade of hyperplasia of esophageal neuroendocrine cells secreting neurotensin, and esophageal epithelial cells expressing р53 was observed.
Conclusions. Disorders of functional activity of neuroendocrinal cells of esophageal mucosa, producing neurotensin, and epithelial cells of the esophagus expressing р53, can act as a factor promoting development of refractory forms of GERD.
About the Authors
M. A. OsadchukRussian Federation
A. M. Osadchuk
Russian Federation
D. V. Balashov
Russian Federation
I. M. Kvetnoy
Russian Federation
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Review
For citations:
Osadchuk M.A., Osadchuk A.M., Balashov D.V., Kvetnoy I.M. The refractory form of gastroesophageal reflux disease: clinical and endoscopical, functional and morphofunctional criteria. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2011;21(2):30-36. (In Russ.)
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