Distinct afferent innervation patterns within the human proximal and distal esophageal mucosa.
Distinct afferent innervation patterns within the human proximal and distal esophageal mucosa.
复制标题
DOI：
10.1152/ajpgi.00175.2014
复制
发表时间：
2015-03-15
期刊：
影响因子：
--
通讯作者：
Sifrim D
中科院分区：
文献类型：
--
作者：
Woodland P;Aktar R;Mthunzi E;Lee C;Peiris M;Preston SL;Blackshaw LA;Sifrim D
关于近端人食管的粘膜表型知之甚少。有证据表明，与远端相比，近端食管对化学和机械刺激更敏感。这可能具有生理相关性（例如，防止胃食管反流物的吸入），而且还具有病理学相关性（例如，在反流知觉或吞咽困难中）。这种敏感性增加的原因尚不清楚，但可能包括粘膜屏障完整性受损或感觉神经支配的变化。我们评估了健康志愿者食管近端和远端的粘膜屏障完整性和传入神经分布。在10名健康志愿者的基线近端和远端食管阻抗测量体内。从远端和近端食管进行食管粘膜活检，并在Ussing室中测量基线跨上皮电阻（TER）。活检组织进行化学检查降钙素基因相关肽（CGRP）免疫反应神经纤维的存在和位置。在另外四名健康志愿者中，我们研究了神经纤维中CGRP和蛋白基因产物（PGP）9.5免疫反应性的共定位。食管近端的基线阻抗高于远端[2，936 Ω（SD 578）vs. 2，229 Ω（SD 821）; P = 0.03]，但是，两者之间的基线TER无显著差异。在近端和远端食管的上皮中均发现了粘液CGRP免疫反应性神经，但与远端粘膜相比，近端粘膜中的CGRP免疫反应性神经位于更浅的位置[11.5（SD 7）vs. 21.7（SD 5）管腔细胞层，P = 0.002]，近端和远端粘膜中19%和10%的PGP免疫反应性纤维与CGRP共定位。食管近端的PGP免疫反应阳性纤维也比远端更接近管腔表面（P < 0.001）。我们得出结论，粘膜屏障的完整性是相似的近端和远端食管，但近端粘膜传入神经是在一个更浅的位置。对近端食管反流诱发症状的敏感性增强很可能有解剖学基础。
Little is known about the mucosal phenotype of the proximal human esophagus. There is evidence to suggest that the proximal esophagus is more sensitive to chemical and mechanical stimulation compared with the distal. This may have physiological relevance (e.g., in prevention of aspiration of gastroesophageal refluxate), but also pathological relevance (e.g., in reflux perception or dysphagia). Reasons for this increased sensitivity are unclear but may include impairment in mucosal barrier integrity or changes in sensory innervation. We assessed mucosal barrier integrity and afferent nerve distribution in the proximal and distal esophagus of healthy human volunteers. In 10 healthy volunteers baseline proximal and distal esophageal impedance was measured in vivo. Esophageal mucosal biopsies from the distal and proximal esophagus were taken, and baseline transepithelial electrical resistance (TER) was measured in Ussing chambers. Biopsies were examined immunohistochemically for presence and location of calcitonin gene-related peptide (CGRP)-immunoreactive nerve fibers. In a further four healthy volunteers we investigated for colocalization of CGRP and protein gene product (PGP) 9.5 immunoreactivity in nerve fibers. Baseline impedance was higher in the proximal than in the distal esophagus [2,936 Ω (SD578) vs. 2,229 Ω (SD821); P = 0.03], however, baseline TER was not significantly different between them. Mucosal CGRP-immunoreactive nerves were found in the epithelium of both proximal and distal esophagus, but were located more superficially in the proximal mucosa compared with the distal [11.5 (SD7) vs. 21.7 (SD5) cell layers from lumen, P = 0.002] 19% of proximal, and 10% of distal mucosal PGP-immunoreactive fibers colocalized with CGRP. PGP-immunoreactive fibers were also significantly closer to the luminal surface in the proximal compared with the distal esophagus (P < 0.001). We conclude that mucosal barrier integrity is similar in proximal and distal esophagus, but proximal mucosal afferent nerves are in a more superficial location. The enhanced sensitivity to reflux-evoked symptoms of the proximal esophagus most likely has an anatomical basis.
登录
查看更多内容
影响因子：
9.8
作者：
Kessing, Boudewijn F.;Bredenoord, Albert J.;Smout, A. J. P. M.
通讯作者：
Smout, A. J. P. M.
影响因子：
24.5
作者：
Bredenoord, AJ;Weusten, BLAM;Smout, AJPM
通讯作者：
Smout, AJPM
DOI：
10.1152/ajpgi.2000.279.2.g262
发表时间：
2000-08-01
影响因子：
4.5
作者：
Torrico, S;Kern, M;Shaker, R
通讯作者：
Shaker, R
影响因子：
24.5
作者：
Newton, M;Kamm, MA;Burnstock, G
通讯作者：
Burnstock, G
影响因子：
2.5
作者：
Wank, M;Neuhuber, WL
通讯作者：
Neuhuber, WL