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Lansoprazole-induced improvement of esophageal submucosal injury.

Mine S, Tanaka Y - J Clin Biochem Nutr (2007)

Bottom Line: The proton pumpvinhibitor, lansoprazole, is reported to have acid secretion inhibiting effect as well as anti-inflammatory effects such as inhibition of cytokine secretion from inflammatory cells.At baseline (before treatment), EUS showed abnormalities in the mucosa, submucosa and muscularis propria caused by inflammation, thickening of the entire esophageal wall and changes in the contractile properties of esophageal smooth muscles reflecting the effects of inflammation on the entire wall of the lower esophagus in reflux esophagitis regardless of whether it is erosive or endoscopically-negative.Treatment with lansoprazole resulted in normalization of esophageal wall structure and improvement of motility, suggesting that lansoprazole improves not only mucosal inflammation but also submucosal inflammation in GERD.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hagiwara Central Hospital, 1-10-1 Hagiwara Yahatanishi-ku, Kitakyushu 806-0059, Japan.

ABSTRACT
The proton pumpvinhibitor, lansoprazole, is reported to have acid secretion inhibiting effect as well as anti-inflammatory effects such as inhibition of cytokine secretion from inflammatory cells. Clinically, excellent efficacy of lansoprazole is reported for not only gastric ulcer but also gastroesophageal reflux disease (GERD). Since GERD is categorized endoscopically into erosive esophagitis and non-erosive reflux disease, it is important to make accurate assessment of any improvement in the inflammatory process when using endoscopic ultrasonography (EUS) capable of visualizing the submucosal structure. We report here our experience in assessing the effect of treatment with lansoprazole on esophageal wall structure using EUS in patients with GERD. At baseline (before treatment), EUS showed abnormalities in the mucosa, submucosa and muscularis propria caused by inflammation, thickening of the entire esophageal wall and changes in the contractile properties of esophageal smooth muscles reflecting the effects of inflammation on the entire wall of the lower esophagus in reflux esophagitis regardless of whether it is erosive or endoscopically-negative. Treatment with lansoprazole resulted in normalization of esophageal wall structure and improvement of motility, suggesting that lansoprazole improves not only mucosal inflammation but also submucosal inflammation in GERD.

No MeSH data available.


Related in: MedlinePlus

Endoscopic ultrasonographic images of the esophageal wall. Comparison of submucosal and muscular layers between normal subjects (A) and patients with reflux esophagitis (B). Note the marked thickening of the submucosal and muscular layers in (B) with changes in echo density. Reprinted with permission [21].
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Related In: Results  -  Collection


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Figure 1: Endoscopic ultrasonographic images of the esophageal wall. Comparison of submucosal and muscular layers between normal subjects (A) and patients with reflux esophagitis (B). Note the marked thickening of the submucosal and muscular layers in (B) with changes in echo density. Reprinted with permission [21].

Mentions: On EUS, the esophageal wall is seen to consist of five layers of different echogenicities, roughly corresponding to the anatomic layers. We and others have reported that the thickness of the esophageal wall ranges between 2.43 mm and 0.16 mm at the gastroesophageal junction in normal subjects [20, 21]. In GERD, EUS can visualize changes in the layer structure with localized or diffuse thickening (Fig. 1) [21]. In our study, the total thicknesses of the lower esophageal wall, submucosal layer and muscularis propria layer measured by EUS in 20 normal adults (13 males and 7 females, age: 55 ± 20 years) were 2.44 ± 0.4, 1.03 ± 0.2, and 0.98 ± 0.2 mm (mean ± SD), respectively. The respective mean total wall thickness and submucosal thickness were significantly greater in 25 patients with EE and NERD (14 males and 11 females, age: 65 ± 13 years, Table 1) [21]. A number of investigators have reported that such changes in the esophageal wall are associated with not only irreversible fibrosis [22], but also reversible edema and inflammatory cell infiltration [23].


Lansoprazole-induced improvement of esophageal submucosal injury.

Mine S, Tanaka Y - J Clin Biochem Nutr (2007)

Endoscopic ultrasonographic images of the esophageal wall. Comparison of submucosal and muscular layers between normal subjects (A) and patients with reflux esophagitis (B). Note the marked thickening of the submucosal and muscular layers in (B) with changes in echo density. Reprinted with permission [21].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2170952&req=5

Figure 1: Endoscopic ultrasonographic images of the esophageal wall. Comparison of submucosal and muscular layers between normal subjects (A) and patients with reflux esophagitis (B). Note the marked thickening of the submucosal and muscular layers in (B) with changes in echo density. Reprinted with permission [21].
Mentions: On EUS, the esophageal wall is seen to consist of five layers of different echogenicities, roughly corresponding to the anatomic layers. We and others have reported that the thickness of the esophageal wall ranges between 2.43 mm and 0.16 mm at the gastroesophageal junction in normal subjects [20, 21]. In GERD, EUS can visualize changes in the layer structure with localized or diffuse thickening (Fig. 1) [21]. In our study, the total thicknesses of the lower esophageal wall, submucosal layer and muscularis propria layer measured by EUS in 20 normal adults (13 males and 7 females, age: 55 ± 20 years) were 2.44 ± 0.4, 1.03 ± 0.2, and 0.98 ± 0.2 mm (mean ± SD), respectively. The respective mean total wall thickness and submucosal thickness were significantly greater in 25 patients with EE and NERD (14 males and 11 females, age: 65 ± 13 years, Table 1) [21]. A number of investigators have reported that such changes in the esophageal wall are associated with not only irreversible fibrosis [22], but also reversible edema and inflammatory cell infiltration [23].

Bottom Line: The proton pumpvinhibitor, lansoprazole, is reported to have acid secretion inhibiting effect as well as anti-inflammatory effects such as inhibition of cytokine secretion from inflammatory cells.At baseline (before treatment), EUS showed abnormalities in the mucosa, submucosa and muscularis propria caused by inflammation, thickening of the entire esophageal wall and changes in the contractile properties of esophageal smooth muscles reflecting the effects of inflammation on the entire wall of the lower esophagus in reflux esophagitis regardless of whether it is erosive or endoscopically-negative.Treatment with lansoprazole resulted in normalization of esophageal wall structure and improvement of motility, suggesting that lansoprazole improves not only mucosal inflammation but also submucosal inflammation in GERD.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hagiwara Central Hospital, 1-10-1 Hagiwara Yahatanishi-ku, Kitakyushu 806-0059, Japan.

ABSTRACT
The proton pumpvinhibitor, lansoprazole, is reported to have acid secretion inhibiting effect as well as anti-inflammatory effects such as inhibition of cytokine secretion from inflammatory cells. Clinically, excellent efficacy of lansoprazole is reported for not only gastric ulcer but also gastroesophageal reflux disease (GERD). Since GERD is categorized endoscopically into erosive esophagitis and non-erosive reflux disease, it is important to make accurate assessment of any improvement in the inflammatory process when using endoscopic ultrasonography (EUS) capable of visualizing the submucosal structure. We report here our experience in assessing the effect of treatment with lansoprazole on esophageal wall structure using EUS in patients with GERD. At baseline (before treatment), EUS showed abnormalities in the mucosa, submucosa and muscularis propria caused by inflammation, thickening of the entire esophageal wall and changes in the contractile properties of esophageal smooth muscles reflecting the effects of inflammation on the entire wall of the lower esophagus in reflux esophagitis regardless of whether it is erosive or endoscopically-negative. Treatment with lansoprazole resulted in normalization of esophageal wall structure and improvement of motility, suggesting that lansoprazole improves not only mucosal inflammation but also submucosal inflammation in GERD.

No MeSH data available.


Related in: MedlinePlus