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A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms

BACKGROUND/AIMS: Eosinophilic esophagitis (EoE) is often erroneously diagnosed as gastroesophageal reflux disease (GERD). The aim of this study is to investigate the prevalence of EoE and the expression of tight junction (TJ) proteins in patients with GERD symptoms. METHODS: One hundred patients wit...

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Autores principales: Okimoto, Kenichiro, Arai, Makoto, Ishigami, Hideaki, Saito, Keiko, Minemura, Shoko, Maruoka, Daisuke, Matsumura, Tomoaki, Nakagawa, Tomoo, Katsuno, Tatsuro, Suzuki, Masaki, Nakatani, Yukio, Yokosuka, Osamu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial Office of Gut and Liver 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753681/
https://www.ncbi.nlm.nih.gov/pubmed/29032661
http://dx.doi.org/10.5009/gnl16600
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author Okimoto, Kenichiro
Arai, Makoto
Ishigami, Hideaki
Saito, Keiko
Minemura, Shoko
Maruoka, Daisuke
Matsumura, Tomoaki
Nakagawa, Tomoo
Katsuno, Tatsuro
Suzuki, Masaki
Nakatani, Yukio
Yokosuka, Osamu
author_facet Okimoto, Kenichiro
Arai, Makoto
Ishigami, Hideaki
Saito, Keiko
Minemura, Shoko
Maruoka, Daisuke
Matsumura, Tomoaki
Nakagawa, Tomoo
Katsuno, Tatsuro
Suzuki, Masaki
Nakatani, Yukio
Yokosuka, Osamu
author_sort Okimoto, Kenichiro
collection PubMed
description BACKGROUND/AIMS: Eosinophilic esophagitis (EoE) is often erroneously diagnosed as gastroesophageal reflux disease (GERD). The aim of this study is to investigate the prevalence of EoE and the expression of tight junction (TJ) proteins in patients with GERD symptoms. METHODS: One hundred patients with GERD symptoms and 10 healthy controls were prospectively studied. Sixty-two patients had symptoms refractory to proton pump inhibitors (PPI). All patients underwent esophageal biopsy. Patients were diagnosed with EoE if the number of eosinophil granulocytes per high-power field was ≥15. Immunohistochemical analysis of TJ proteins (claudin-1, claudin-4, occludin, and zonula occludin-1 [ZO-1]) was performed. RESULTS: EoE was diagnosed in six of 100 patients (6%) with GERD symptoms and in six patients (9.7%) of 62 patients with PPI-refractory GERD. Only one had typical EoE endoscopic findings. The proportion of ZO-1-positive cells was significantly lower in the lower than in the middle esophagus (56.0%±14.0% vs 66.0%±11.5%, p<0.05). There were no significant correlations between TJ protein expression and GERD symptoms. CONCLUSIONS: The prevalence of EoE among patients with PPI-refractory GERD is approximately 10%. Regardless of endoscopic findings, esophageal biopsy is crucial in diagnosing EoE. The disruption of ZO-1 expression in the lower esophagus is significantly associated with GERD symptoms.
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spelling pubmed-57536812018-01-19 A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms Okimoto, Kenichiro Arai, Makoto Ishigami, Hideaki Saito, Keiko Minemura, Shoko Maruoka, Daisuke Matsumura, Tomoaki Nakagawa, Tomoo Katsuno, Tatsuro Suzuki, Masaki Nakatani, Yukio Yokosuka, Osamu Gut Liver Original Article BACKGROUND/AIMS: Eosinophilic esophagitis (EoE) is often erroneously diagnosed as gastroesophageal reflux disease (GERD). The aim of this study is to investigate the prevalence of EoE and the expression of tight junction (TJ) proteins in patients with GERD symptoms. METHODS: One hundred patients with GERD symptoms and 10 healthy controls were prospectively studied. Sixty-two patients had symptoms refractory to proton pump inhibitors (PPI). All patients underwent esophageal biopsy. Patients were diagnosed with EoE if the number of eosinophil granulocytes per high-power field was ≥15. Immunohistochemical analysis of TJ proteins (claudin-1, claudin-4, occludin, and zonula occludin-1 [ZO-1]) was performed. RESULTS: EoE was diagnosed in six of 100 patients (6%) with GERD symptoms and in six patients (9.7%) of 62 patients with PPI-refractory GERD. Only one had typical EoE endoscopic findings. The proportion of ZO-1-positive cells was significantly lower in the lower than in the middle esophagus (56.0%±14.0% vs 66.0%±11.5%, p<0.05). There were no significant correlations between TJ protein expression and GERD symptoms. CONCLUSIONS: The prevalence of EoE among patients with PPI-refractory GERD is approximately 10%. Regardless of endoscopic findings, esophageal biopsy is crucial in diagnosing EoE. The disruption of ZO-1 expression in the lower esophagus is significantly associated with GERD symptoms. Editorial Office of Gut and Liver 2018-01 2017-10-17 /pmc/articles/PMC5753681/ /pubmed/29032661 http://dx.doi.org/10.5009/gnl16600 Text en Copyright © 2018 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Okimoto, Kenichiro
Arai, Makoto
Ishigami, Hideaki
Saito, Keiko
Minemura, Shoko
Maruoka, Daisuke
Matsumura, Tomoaki
Nakagawa, Tomoo
Katsuno, Tatsuro
Suzuki, Masaki
Nakatani, Yukio
Yokosuka, Osamu
A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms
title A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms
title_full A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms
title_fullStr A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms
title_full_unstemmed A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms
title_short A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms
title_sort prospective study of eosinophilic esophagitis and the expression of tight junction proteins in patients with gastroesophageal reflux disease symptoms
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753681/
https://www.ncbi.nlm.nih.gov/pubmed/29032661
http://dx.doi.org/10.5009/gnl16600
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