M1829 Chronic Inflammation of the Cardia in Gastroesophageal Reflux Disease (GERD) Is Not Regulated By FOXP3 Expressing Regulatory T Cells

2009 ◽  
Vol 136 (5) ◽  
pp. A-426-A-427
Author(s):  
Arne Kandulski ◽  
Thomas Wex ◽  
Doerthe Kuester ◽  
Klaus Mönkemüller ◽  
Lucia C. Fry ◽  
...  
Author(s):  
Robin Moiseff ◽  
Nicholas Olson ◽  
Arief A. Suriawinata ◽  
Richard I. Rothstein ◽  
Mikhail Lisovsky

Context.— Published reports have suggested an association of lymphocytic esophagitis (LyE) with gastroesophageal reflux disease (GERD) and primary motility disorders and have also shown that GERD and motility disorders frequently overlap. These findings make it difficult to determine the true relationship between LyE and GERD, which may be confounded by the presence of motility disorders with LyE. Objective.— To characterize patterns of lymphocytic inflammation in patients with GERD that have no motility abnormalities. Design.— We identified 161 patients seen at our institution from 1998 to 2014, who were diagnosed with GERD, had normal esophageal motility, and available esophageal biopsies. LyE was defined as peripapillary lymphocytosis with rare or absent granulocytes. CD4 and CD8 immunophenotype of lymphocytes was evaluated using immunohistochemistry. Results.— We found increased intraepithelial lymphocytes in 13.7% of patients with GERD. Two major patterns and 1 minor pattern of lymphocytic inflammation were observed as follows: (1) LyE (in 6.8% [11 of 161] of patients and typically focal), (2) dispersed lymphocytes in an area of reflux esophagitis (in 5.6% [9 of 161] and typically diffuse), and (3) peripapillary lymphocytes in an area of reflux esophagitis (in 1.2% [2 of 161]). CD8 T cells significantly outnumbered CD4 T cells in 91% of patients with lymphocytic esophagitis and 100% of patients with dispersed lymphocytes (9 of 9) or peripapillary lymphocytes (2 of 2) in the area of reflux esophagitis. Conclusions.— These findings suggest that LyE is one of the major patterns of lymphocytic inflammation in GERD. CD8 T-cell–predominant immunophenotype may be useful as a marker of GERD in the differential diagnosis of LyE.


2009 ◽  
Vol 54 (9) ◽  
pp. 1940-1946 ◽  
Author(s):  
Arne Kandulski ◽  
Thomas Wex ◽  
Doerthe Kuester ◽  
Klaus Mönkemüller ◽  
Ulrich Peitz ◽  
...  

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.


2001 ◽  
Vol 120 (5) ◽  
pp. A480-A480
Author(s):  
F GRANDERATH ◽  
U SCHWEIGER ◽  
T KAMOLZ ◽  
T BAMMER ◽  
M PASIUT ◽  
...  

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