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Role of saliva in esophageal defense: implications in patients with nonerosive reflux disease.

Yandrapu H, Marcinkiewicz M, Poplawski C, Han K, Zbroch T, Goldin G, Sarosiek I, Namiot Z, Sarosiek J - Am. J. Med. Sci. (2015)

Bottom Line: Salivary EGF secretion was higher in patients with NERD during mechanical stimulation (P < 0.05).Patients with NERD demonstrated a significantly stronger salivary secretory response in terms of volume, bicarbonate, glycoconjugate, protein, EGF and TGF-α than asymptomatic controls.This enhanced salivary esophagoprotection is potentially mediating resistance to the development of endoscopic mucosal changes by gastroesophageal reflux.

View Article: PubMed Central - PubMed

Affiliation: Molecular Medicine Research Laboratory (HY, MM, KH, GG, IS, JS), Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas; Nicolaus Copernicus University of Torun (CP), Torun, Poland; University of Virginia Health Sciences Center (KH, GG), Charlottesville, VA; and Medical University of Bialystok (TZ, ZN), Bialystok, Poland.

ABSTRACT

Background: It has been previously demonstrated that patients with reflux esophagitis exhibit a significant impairment in the secretion of salivary protective components versus controls. However, the secretion of salivary protective factors in patients with nonerosive reflux disease (NERD) is not explored. The authors therefore studied the secretion of salivary volume, pH, bicarbonate, nonbicarbonate glycoconjugate, protein, epidermal growth factor (EGF), transforming growth factor alpha (TGF-α) and prostaglandin E2 in patients with NERD and compared with the corresponding values in controls (CTRL).

Methods: Salivary secretion was collected during basal condition, mastication and intraesophageal mechanical (tubing, balloon) and chemical (initial saline, acid, acid/pepsin, final saline) stimulations, respectively, mimicking the natural gastroesophageal reflux.

Results: Salivary volume, protein and TGF-α outputs in patients with NERD were significantly higher than CTRL during intraesophageal mechanical (P < 0.05) and chemical stimulations (P < 0.05). Salivary bicarbonate was significantly higher in NERD than CTRL group during intraesophageal stimulation with both acid/pepsin (P < 0.05) and saline (P < 0.01). Salivary glycoconjugate secretion was significantly higher in the NERD group than the CTRL group during chewing (P < 0.05), mechanical (P < 0.05) and chemical stimulation (P < 0.01). Salivary EGF secretion was higher in patients with NERD during mechanical stimulation (P < 0.05).

Conclusions: Patients with NERD demonstrated a significantly stronger salivary secretory response in terms of volume, bicarbonate, glycoconjugate, protein, EGF and TGF-α than asymptomatic controls. This enhanced salivary esophagoprotection is potentially mediating resistance to the development of endoscopic mucosal changes by gastroesophageal reflux.

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Related in: MedlinePlus

Salivary bicarbonate output in the control group (CTRL) and patients with nonerosive reflux disease (NERD) (*P < 0.05 and **P < 0.01, which is significant). Salivary bicarbonate secretion is significantly higher in patients with NERD during chemical stimulation with HCl/Pepsin (acid/pepsin) and final NaCl (final saline).
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Figure 2: Salivary bicarbonate output in the control group (CTRL) and patients with nonerosive reflux disease (NERD) (*P < 0.05 and **P < 0.01, which is significant). Salivary bicarbonate secretion is significantly higher in patients with NERD during chemical stimulation with HCl/Pepsin (acid/pepsin) and final NaCl (final saline).

Mentions: Salivary volume in patients with NERD was significantly higher than control group (CTRL) during mechanical stimulation with balloons (4.67 ± 1.16 mL/min versus 3.16 ± 0.32 mL/min, P < 0.05) and chemical stimulation with HCl/pepsin and final saline (4.12 ± 0.38 mL/min versus 2.83 ± 0.33 mL/min, P < 0.05 and 4.39 ± 0.54 mL/min versus 2.75 ± 0.33 mL/min, P < 0.05, respectively), as shown in Figure 1. The bicarbonate output in the NERD group was significantly higher than the CTRL group during chemical stimulation with HCl/pepsin (103.80 ± 15.30 μEq/min versus 59.00 ± 11.98 μEq/min, P < 0.05) and final saline (129.70 ± 25.40 μEq/min versus 48.40 ± 10.39 μEq/min, P < 0.01), as shown in Figure 2 (Table 1).


Role of saliva in esophageal defense: implications in patients with nonerosive reflux disease.

Yandrapu H, Marcinkiewicz M, Poplawski C, Han K, Zbroch T, Goldin G, Sarosiek I, Namiot Z, Sarosiek J - Am. J. Med. Sci. (2015)

Salivary bicarbonate output in the control group (CTRL) and patients with nonerosive reflux disease (NERD) (*P < 0.05 and **P < 0.01, which is significant). Salivary bicarbonate secretion is significantly higher in patients with NERD during chemical stimulation with HCl/Pepsin (acid/pepsin) and final NaCl (final saline).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4418785&req=5

Figure 2: Salivary bicarbonate output in the control group (CTRL) and patients with nonerosive reflux disease (NERD) (*P < 0.05 and **P < 0.01, which is significant). Salivary bicarbonate secretion is significantly higher in patients with NERD during chemical stimulation with HCl/Pepsin (acid/pepsin) and final NaCl (final saline).
Mentions: Salivary volume in patients with NERD was significantly higher than control group (CTRL) during mechanical stimulation with balloons (4.67 ± 1.16 mL/min versus 3.16 ± 0.32 mL/min, P < 0.05) and chemical stimulation with HCl/pepsin and final saline (4.12 ± 0.38 mL/min versus 2.83 ± 0.33 mL/min, P < 0.05 and 4.39 ± 0.54 mL/min versus 2.75 ± 0.33 mL/min, P < 0.05, respectively), as shown in Figure 1. The bicarbonate output in the NERD group was significantly higher than the CTRL group during chemical stimulation with HCl/pepsin (103.80 ± 15.30 μEq/min versus 59.00 ± 11.98 μEq/min, P < 0.05) and final saline (129.70 ± 25.40 μEq/min versus 48.40 ± 10.39 μEq/min, P < 0.01), as shown in Figure 2 (Table 1).

Bottom Line: Salivary EGF secretion was higher in patients with NERD during mechanical stimulation (P < 0.05).Patients with NERD demonstrated a significantly stronger salivary secretory response in terms of volume, bicarbonate, glycoconjugate, protein, EGF and TGF-α than asymptomatic controls.This enhanced salivary esophagoprotection is potentially mediating resistance to the development of endoscopic mucosal changes by gastroesophageal reflux.

View Article: PubMed Central - PubMed

Affiliation: Molecular Medicine Research Laboratory (HY, MM, KH, GG, IS, JS), Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas; Nicolaus Copernicus University of Torun (CP), Torun, Poland; University of Virginia Health Sciences Center (KH, GG), Charlottesville, VA; and Medical University of Bialystok (TZ, ZN), Bialystok, Poland.

ABSTRACT

Background: It has been previously demonstrated that patients with reflux esophagitis exhibit a significant impairment in the secretion of salivary protective components versus controls. However, the secretion of salivary protective factors in patients with nonerosive reflux disease (NERD) is not explored. The authors therefore studied the secretion of salivary volume, pH, bicarbonate, nonbicarbonate glycoconjugate, protein, epidermal growth factor (EGF), transforming growth factor alpha (TGF-α) and prostaglandin E2 in patients with NERD and compared with the corresponding values in controls (CTRL).

Methods: Salivary secretion was collected during basal condition, mastication and intraesophageal mechanical (tubing, balloon) and chemical (initial saline, acid, acid/pepsin, final saline) stimulations, respectively, mimicking the natural gastroesophageal reflux.

Results: Salivary volume, protein and TGF-α outputs in patients with NERD were significantly higher than CTRL during intraesophageal mechanical (P < 0.05) and chemical stimulations (P < 0.05). Salivary bicarbonate was significantly higher in NERD than CTRL group during intraesophageal stimulation with both acid/pepsin (P < 0.05) and saline (P < 0.01). Salivary glycoconjugate secretion was significantly higher in the NERD group than the CTRL group during chewing (P < 0.05), mechanical (P < 0.05) and chemical stimulation (P < 0.01). Salivary EGF secretion was higher in patients with NERD during mechanical stimulation (P < 0.05).

Conclusions: Patients with NERD demonstrated a significantly stronger salivary secretory response in terms of volume, bicarbonate, glycoconjugate, protein, EGF and TGF-α than asymptomatic controls. This enhanced salivary esophagoprotection is potentially mediating resistance to the development of endoscopic mucosal changes by gastroesophageal reflux.

Show MeSH
Related in: MedlinePlus