Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease.
Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease.
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DOI：
10.5056/jnm16178
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发表时间：
2017-10-30
影响因子：
3.4
通讯作者：
Xiao YL
中科院分区：
文献类型：
--
作者：
Li YW;Sifrim D;Xie C;Chen M;Xiao YL
唾液胃蛋白酶增加可能表明胃食管反流增加，但之前的研究未能证明唾液胃蛋白酶浓度与 24 小时食管酸暴露之间的相关性。本研究旨在检测唾液胃蛋白酶并评估不同胃食管反流病表型患者唾液胃蛋白酶浓度与细胞间隙（IS）之间的关系。本研究共纳入 45 名患者和 11 名健康志愿者。所有受试者均接受上消化道内镜检查、24小时动态多通道阻抗-pH（MII-pH）监测，并在24小时MII-pH监测期间的3个时间点进行唾液采样。 IS通过透射电子显微镜测量，唾液胃蛋白酶浓度通过酶联免疫吸附测定法测定。食管炎 (EE)、非糜烂性反流病 (NERD) 和过敏性食管 (HO) 组的 IS 测量值高于功能性胃灼热 (FH) 组和健康志愿者组，并且存在显着差异。与 FH 患者相比，NERD 和 HO 患者的平均胃蛋白酶浓度较高。在 NERD 患者中，IS 和唾液胃蛋白酶之间存在弱相关性（r = 0.669，P = 0.035）。我们证实 NERD 患者唾液胃蛋白酶水平高于 FH 患者。 NERD 组的唾液胃蛋白酶浓度与粘膜完整性受损的严重程度相关。我们建议，在 NERD 患者中，唾液胃蛋白酶水平较低有助于识别 FH 患者，此外胃蛋白酶浓度越高，IS 扩张的严重程度可能越高。
Increased salivary pepsin could indicate an increase in gastro-esophageal reflux, however, previous studies failed to demonstrate a correlation between salivary pepsin concentrations and 24-hour esophageal acid exposure. This study aims to detect the salivary pepsin and to evaluate the relationship between salivary pepsin concentrations and intercellular spaces (IS) in different gastroesophageal reflux disease phenotypes in patients. A total of 45 patients and 11 healthy volunteers were included in this study. All subjects underwent upper gastrointestinal endoscopy, 24-hour ambulatory multichannel impedance-pH (MII-pH) monitoring, and salivary sampling at 3-time points during the 24-hour MII-pH monitoring. IS were measured by transmission electron microscopy, and salivary pepsin concentrations were determined by enzyme-linked immunosorbent assay. The IS measurements were greater in the esophagitis (EE), non-erosive reflux disease (NERD), and hypersensitive esophagus (HO) groups than in the functional heartburn (FH) and healthy volunteer groups, and significant differences were indicated. Patients with NERD and HO had higher average pepsin concentrations compared with FH patients. A weak correlation was determined between IS and salivary pepsin among patients with NERD (r = 0.669, P = 0.035). We confirmed the presence of a higher level of salivary pepsin in patients with NERD than in patients with FH. Salivary pepsin concentrations correlated with severity of mucosal integrity impairment in the NERD group. We suggest that in patients with NERD, low levels of salivary pepsin can help identify patients with FH, in addition the higher the pepsin concentration, the more likely the severity of dilated IS.
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影响因子：
7.3
作者：
HOPWOOD, D;MILNE, G;LOGAN, KR
通讯作者：
LOGAN, KR
影响因子：
2.6
作者：
Knight, J;Lively, MO;Koufman, JA
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影响因子：
29.4
作者：
Tobey, NA;Carson, JL;Orlando, RC
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Orlando, RC
影响因子：
2.9
作者：
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通讯作者：
Orlando, Roy C.
DOI：
10.1016/j.bpg.2013.06.007
发表时间：
2013-06-01
影响因子：
3.2
作者：
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通讯作者：
Vakil, Nimish