Peculiarities of the Pathology of Gastrointestinal Tract in Patients with Gastroesophageal Reflux Disease on the Background of Hypothyroidism

The article identifies the features of the pathology of the gastrointestinal tract in patients with gastroesophageal reflux disease on the background of hypothyroidism. The frequency of gastroesophageal reflux disease and the severity of this disease increase with age and the presence of comorbid pathology. In the elderly, the frequency of the typical esophageal manifestations decreases, and the erosive esophagitis with atypical symptoms is more common. The growing number of cases of combined thyroid dysfunction with gastropathology requires in-depth study of the reasons for the relationship between these processes. Pathological changes in the gastrointestinal tract in these patients make their condition severer, contributing to the development and progression of metabolic disorders. An important aggravating effect on the regulatory mechanisms of esophageal kinetics has a pathological functioning of the thyroid gland on the background of iodine deficiency. Results and discussion. In patients with gastroesophageal reflux disease with hypothyroidism, all changes in gastric and duodenal function are associated with a decrease in the acid-forming function of the gastric mucosa, due to its atrophy, decreased tone and contractility of the stomach. This in turn leads to a slowing of gastric and duodenal evacuation, dysfunction of the closing capacity of the cardia and, as a consequence, the development of duodenogastroesophageal reflux. The esophageal contents are not so pronounced, so patients with non-erosive forms of esophagitis predominate (46.2%) against 16% of patients in the second group (patients with gastroesophageal reflux disease). At the same time, erosive forms predominate among patients in the control group with predominant acid reflux. It should be noted that there is a clear relationship between the frequency of erosive changes in the esophageal mucosa and the duration of the disease. Thus, among patients of the main group with a 5-year history of the disease, the number of erosive forms of gastroesophageal reflux disease was minimal. The number of erosive changes in the esophageal mucosa increased sharply in patients with a 10-year history and reached its maximum after 15 years from the onset of the disease. Conclusion. The delay in gastric evacuation is more pronounced in patients with gastroesophageal reflux disease on the background of hypothyroidism. It can be explained by a decrease in gastric motility and the presence of duodenostasis. The slowing of gastric evacuation was more pronounced in patients with gastroesophageal reflux disease on the background of reduced thyroid function. In patients with gastroesophageal reflux disease on the background of hypothyroidism there is an alkaline duodenogastroesophageal reflux as a consequence of reduced acid-forming function of the gastric mucosa and reduced contractility of the stomach and duodenum

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Gene Expression Profiling of Inflammatory Cytokines in Esophageal Biopsies of Different Phenotypes of Gastroesophageal Reflux Disease: a cross-sectional study.

10.21203/rs.3.rs-16050/v2 ◽

2020 ◽

Author(s):

Monica Zavala-Solares ◽

Gabriela Fonseca-Camarillo ◽

Miguel Valdovinos ◽

Julio Granados ◽

Guido Grajales-Figueroa ◽

...

Keyword(s):

Gene Expression ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Cross Sectional Study ◽

Control Group ◽

Esophageal Mucosa ◽

Cross Sectional ◽

Tnf Α ◽

And Control

Abstract Background: Patients clinical endoscopic phenotypes in gastroesophageal reflux disease (GERD) are classified as: Barrett's esophagus (BE), erosive esophagitis (EE) and non-erosive gastroesophageal reflux disease (NERD). NERD are subclassified in Abnormal acid exposure (AAE) and Normal acid exposure (NAE) according to pH monitoring study. The aim of this study was to characterize genes involved in the pathophysiology and immune response of GERD.Methods: This is an observational and cross-sectional study. All patients with BE, EE, AAE, NAE and control group were subjected to a superior endoscopy (with biopsies of esophageal mucosa). The cytokine mRNA relative quantification of target genes was conducted by RT-PCR. Changes in gene expression were assessed of the genes associated with inflammation in each disease phenotype. Statistical analysis of differential gene expression was performed by using Dunn's Multiple Comparison non-parametric test. A p value < 0.05 was considered as significant. Results: A total of 82 patients were included and they were divided into the following groups: Group BE 16 (19.51%), Group EE 23 (28.04%), Group AAE 13 (15.86%), NAE (15.86%) and Control Group 17 (20.73%). When comparing with control group we found: patients with BE showed an increased expression of IL-8 (P<0.005) and higher levels of: IL-10 and MMP-3, MMP-9 as well; patients with EE had higher levels of IL-1B, IL-6 and IL-10 (P<0.005), patients with AAE showed an increased expression of Il-1B, Il-6, IFN-γ and TNF-α (P<0.005). AAE had a higher expression of Il-1B and TNF-α than NAE (P<0.005). Conclusions: This study demonstrates the differential expression of mediators of inflammation in the esophageal mucosa of patients in GERD endoscopic phenotypes. MMP3 could be implicated in damage to esophageal mucosa. IL-1B and TNF-α could be a differential diagnosis between AAE and NAE in the non-erosive phenotype from endoscopic biopsies.

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The role of interleukin 1β and interleukin 1 receptor antagonist polymorphism genes, Helicobacter pylori infection and the state of the gastric mucosa in the development and progression of gastroesophageal reflux disease

Pacific Medical Journal ◽

10.34215/1609-1175-2020-4-44-48 ◽

2020 ◽

pp. 44-48

Author(s):

A. A. Zhilina ◽

N. V. Lareva ◽

E. V. Luzina

Keyword(s):

Helicobacter Pylori ◽

High Risk ◽

Gastroesophageal Reflux Disease ◽

Gastric Mucosa ◽

Gastroesophageal Reflux ◽

Receptor Antagonist ◽

Reflux Disease ◽

Local Level ◽

Erosive Esophagitis ◽

Esophagus Cancer

The mechanisms of the gastroesophageal reflux disease (GERD) development and its complications are analyzed on the tissue and cell levels. That’s why studying polymorphism of interleukin (IL) genes is important. Genotypes IL1β-511Т/Т, IL1β31С/С and IL1RN2/2 (receptor antagonist IL1) associate with high risk of complicated course of GERD disease. Researching genes polymorphism of the pro-inflammatory cytokines of the patients having gastroesophageal reflux disease and changes in gastric mucosa it was determined that genotype IL1β-511Т/Т is associated with the deeper local level of IL1β. Meanwhile the patients having erosive esophagitis had lover level of IL1β. It was determined that genotype IL1RN2/2 and haplotype IL1RN*2 /IL1В-31*Т are connected with the high risk of esophagus cancer of patients having Helicobacter pylori. Genotype IL1β-511Т/Т and haplotype IL1β-511Т/Т /IL1RN1/1 of the patients having GERD are associated with the low risk of the esophagus cancer. So, the allele IL1RN*2 and genotype IL1RN2/2 can combine by independent predictors of GERD progression. The study of this field should be continued taking into account not only changes in gastric mucosa, presence of helicobacteriosis, but also the nature of gastroesophageal reflux.

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Influence of some hormones and collagen metabolism on gastroesophageal reflux disease pathogenesis in children

Kazan medical journal ◽

10.17816/kmj1456 ◽

2014 ◽

Vol 95 (1) ◽

pp. 54-58

Author(s):

N V Butorina ◽

Ya M Vakhrushev ◽

A M Zaprudnov

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Insulin Level ◽

Collagen Metabolism ◽

Control Group ◽

Blood Levels ◽

Esophageal Mucosa ◽

Adaptation Mechanisms ◽

Low Levels

Aim. To study the collagen metabolism and secretion of hormones, and estimate their association in gastroesophageal reflux disease (GERD). Methods. 62 children with gastroesophageal reflux disease were examined. Control group included 32 children. Insulin and cortisol blood levels were determined by electro-chemiluminescence immunoassay (ECLIA), gastrin and somatostatin blood levels were determined by ELISA. Hydroxyproline and sialic acids levels were measured in gastric juice. Results. Esophageal mucosa lesions of different stages were diagnosed in all children with GERD: 36 (58%) children had I stage of esophagitis, 24 (38.7 %) children - II stage, 2 (3.2%) children - III stage. It was revealed that children with GERD demonstrated increased collagen breakdown level in esophageal and gastric mucosa, confirmed by high free hydroxyproline levels (29.6±3.2 μmol/L; p 0,05) and peptin-associated hydroxyproline (25.5±2.1 μmol /L; p 0.01). This collagen breakdown might be possible due to high cortisol level (389±15.5 nmol/L versus 204.4±12.1 nmol/L in control group, р 0.05). Increased insulin level (28.5±3.2 μU/ml vs 9.3±2.5 μU/ml; р 0,05) in patients with GERD might be a compensatory reaction to catabolic processes. Increased level of somatostatin (0.457±0.14 nmol/L; р 0.001) associated with low levels of gastrin (7.2±1.4 nmol/L) was discovered in children with GERD aged 9-12 years. On the contrary, children older than 12 years demonstrated high gastrin levels (18.72±3.2 nmol/L) associated with low levels of somatostatin (0.129±0.09 nmol/L). Conclusion. Influence of cortisol increased blood level on mucosa results in disbalance between aggressive and protective gastroduodenal factors in children with GERD, resulting in collagen breakdown. Increased insulin level signs the stimulation of the protective and adaptation mechanisms in children with GERD.

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Gene Expression Profiling of Inflammatory Cytokines in Esophageal Biopsies of Different Phenotypes of Gastroesophageal Reflux Disease: a cross-sectional study

10.21203/rs.3.rs-16050/v3 ◽

2020 ◽

Author(s):

Monica Zavala-Solares ◽

Gabriela Fonseca-Camarillo ◽

Miguel Valdovinos ◽

Julio Granados ◽

Guido Grajales-Figueroa ◽

...

Keyword(s):

Gene Expression ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Cross Sectional Study ◽

Control Group ◽

Esophageal Mucosa ◽

Cross Sectional ◽

Tnf Α ◽

And Control

Abstract Background: Patients clinical endoscopic phenotypes in gastroesophageal reflux disease (GERD) are classified as: Barrett's esophagus (BE), erosive esophagitis (EE) and non-erosive gastroesophageal reflux disease (NERD). NERD are subclassified in Abnormal acid exposure (AAE) and Normal acid exposure (NAE) according to pH monitoring study. The aim of this study was to characterize genes involved in the pathophysiology and immune response of GERD. Methods: This is an observational and cross-sectional study. All patients with BE, EE, AAE, NAE and control group were subjected to a superior endoscopy (with biopsies of esophageal mucosa). The cytokine mRNA relative quantification of target genes was conducted by RT-PCR. Changes in gene expression were assessed of the genes associated with inflammation in each disease phenotype. Statistical analysis of differential gene expression was performed by using Dunn's Multiple Comparison non-parametric test. A p value < 0.05 was considered as significant. Results: A total of 82 patients were included and they were divided into the following groups: Group BE 16 (19.51%), Group EE 23 (28.04%), Group AAE 13 (15.86%), NAE (15.86%) and Control Group 17 (20.73%). When comparing with control group we found: patients with BE showed an increased expression of IL-8 (P<0.005) and higher levels of: IL-10 and MMP-3, MMP-9 as well; patients with EE had higher levels of IL-1B, IL-6 and IL-10 (P<0.005), patients with AAE showed an increased expression of Il-1B, Il-6, IFN-γ and TNF-α (P<0.005). AAE had a higher expression of Il-1B and TNF-α than NAE (P<0.005). Conclusions: This study demonstrates the differential expression of mediators of inflammation in the esophageal mucosa of patients in GERD endoscopic phenotypes. MMP3 could be implicated in damage to esophageal mucosa. IL-1B and TNF-α could be a differential diagnosis between AAE and NAE in the non-erosive phenotype from endoscopic biopsies.

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Gastroesophageal reflux disease and salivary pepsin in patients with heterotopic gastric mucosa in the upper esophagus

Diseases of the Esophagus ◽

10.1093/dote/doab074 ◽

2021 ◽

Author(s):

Xin Xiong ◽

Suyu He ◽

Fei Xu ◽

Zhihong Xu ◽

Xiumei Zhang ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastric Mucosa ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Acid Reflux ◽

Heterotopic Gastric Mucosa ◽

Control Group ◽

Reflux Symptom Index ◽

Symptom Index ◽

Demeester Score

Summary Background Heterotopic gastric mucosa in the upper esophagus (HGMUE) is reported to be related to gastroesophageal reflux disease (GERD). This study investigated the prevalence of GERD and the use of salivary pepsin to diagnose gastroesophageal reflux, especially proximal reflux, in HGMUE patients. Methods One hundred and fifty-three HGMUE patients and 50 healthy volunteers were studied. All subjects took a reflux symptom index questionnaire (RSI); underwent endoscopy, barium esophagogram, high-resolution manometry (HRM), and 24-hour multichannel intraluminal impedance-pH-metry (MII-pH); and salivary pepsin test. Results Ninety-five (62.1%) HGMUE patients but no control subjects were diagnosed with GERD. The salivary pepsin concentration, RSI score, DeMeester score, acid exposure time (AET), total reflux episodes, proximal acidic reflux episodes, and proximal weakly acidic reflux episodes were significantly higher in the HGMUE group than in the control group (P < 0.05). The salivary pepsin test showed a sensitivity of 85.9% and specificity of 56.9% for diagnosing GERD using the optimal cut-off value of 75 ng/mL. One hundred and seven (69.9%) and 46 (30.1%) HGMUE patients were categorized as pepsin (+) and pepsin (−), respectively when 75 ng/mL was used as a cut-off value. Male sex, RSI, AET, and proximal acid reflux episodes were positive predictive factors for the occurrence of pepsin (+) in HGMUE patients. Conclusions GERD, especially GERD with proximal acid reflux and related symptoms, was common in HGMUE patients. The salivary pepsin test could be an additional useful test for testing reflux in HGMUE patients, but it will not replace the MII-pH.

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CLINICAL AND ULTRASOUND PARALLELS IN DIAGNOSIS OF GASTROESOPHAGEAL REFLUX DISEASE AND AUTOIMMUNE THYROIDITIS

EUREKA Health Sciences ◽

10.21303/2504-5679.2020.001520 ◽

2020 ◽

pp. 69-73

Author(s):

Aleksey Oparin ◽

Natalia Yarantseva ◽

Anatoliy Oparin

Keyword(s):

Gastrointestinal Tract ◽

Thyroid Gland ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Thyroid Hormones ◽

Reflux Disease ◽

Ultrasound Examination ◽

Clinical Course ◽

Control Group ◽

Secretory Function

The aim of the work: to study the relationship of ultrasound parameters of the thyroid gland with the clinical course, the level of thyroid hormones and indicators of the motor-secretory function of the gastrointestinal tract in patients with gastroesophageal reflux disease (GERD) and autoimmune thyroiditis (AIT). Materials and methods. The study involved three groups of patients. The first group consisted of 22 patients with isolated GERD. The second group included 20 patients suffering from GERD in combination with AIT in the hypothyroid stage. And the third group included 20 patients suffering from isolated AIT in the hypothyroid stage. The control group consisted of 15 apparently healthy individuals of the same age and sex. All patients underwent a comprehensive examination, which included the necessary set of clinical, laboratory and instrumental research methods in accordance with the local treatment protocols such as collection of complaints and anamnesis, patient examination, physical examination, clinical and biochemical analyzes, ECG, EGD, intragastric pH-metry. The patients underwent ultrasound examination of the motor-evacuation function of the esophagus and stomach with water load and an ultrasound examination of thyroid gland. The functional activity of thyroid gland was assessed by determining the level of thyroid hormones (TSH, T4 free, T3) by ELISA and the presence of antibodies to. Results. The study involved three groups of patients: patients with isolated gastroesophageal reflux disease, patients with a combined course of GERD and AIT in the hypothyroid stage and patients with isolated AIT in the hypothyroid stage. The most pronounced complaints, a higher level of thyroid-stimulating hormone and the most pronounced ultrasound changes are noted in patients with combined pathology. Ultrasound examination of the lower third of esophagus and stomach in patients of all three groups showed the presence of regurgitation, expansion of the lumen of the lower third of esophagus and an increase in the diameter of esophageal opening of diaphragm in varying degrees, in contrast to patients in the control group. Thus according to the results of thyroid sonography and ultrasound examination of the motor function of the lower third of esophagus and stomach, the most pronounced changes were found in the second group of patients who had a combined course of GERD and AIT. Conclusions. 1. A clear correlation was established between the clinical course, an increase in the level of thyroid hormones and ultrasound picture of thyroid gland and indicators of the motor-secretory function of the gastrointestinal tract in patients with GERD and AIT; It was shown that disorders in the activity of thyroid hormones affect the formation of motor-secretory disorders in patients with GERD with concomitant AIT which mutually aggravates the course of this comorbid pathology; Ultrasound diagnostics can be used as an evaluative method in this category of patients.

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Non-dental oral cavity findings in gastroesophageal reflux disease: a systematic review and meta-analysis

Journal of Mind and Medical Sciences ◽

10.22543/7674.81.p6070 ◽

2021 ◽

Vol 8 (1) ◽

pp. 60-70

Author(s):

Madalina-Gabriela Indre ◽

Darius Sampelean ◽

Vlad Taru ◽

Angela Cozma ◽

Dorel Sampelean ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Oral Cavity ◽

Reflux Disease ◽

Functional Limitation ◽

Gastrointestinal Symptoms ◽

Erosive Esophagitis ◽

The United States ◽

Esophageal Mucosa ◽

Oral Manifestations

Gastroesophageal reflux disease (GERD) is known as the most prevalent gastrointestinal disorder in the United States, leading to substantial morbidity, although associated mortality is rare. Based on the appearance of esophageal mucosa on upper endoscopy, GERD is divided into erosive esophagitis (ERD) and nonerosive reflux disease (NERD). Heartburn and acid regurgitation are the typical symptoms of the disease, although some patients may present atypical manifestations such as epigastric pain, nausea, asthma, chronic cough, pharyngitis, laryngitis, sleep disturbances, otitis, and sinusitis. Other signs, such as oral mucosal lesions may result from GERD by direct acid or acidic vapor contact in the oral cavity. Oral manifestations such as tooth erosion, periodontitis, gingivitis, palatal erythema, ulceration, glossitis, oral acid burning sensation, halitosis, xerostomia have recently been reported in GERD patients. A considerable percentage of the patients are affected by oral manifestations before the onset of gastrointestinal symptoms, although in most cases the gastrointestinal signs and symptoms dominate the clinical picture. The injured oral mucosa negatively impacts the quality of life, especially functional limitation, physical inability and psychological disabilities, thus leading to social isolation. There is plenty of non-standardized information on the oral mucosal changes in GERD. In this context, we aimed at synthesizing and analyzing the current available evidence on non-dental oral cavity lesions and complaints that are present in patients diagnosed with GERD.

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Gene expression profiling of inflammatory cytokines in esophageal biopsies of different phenotypes of gastroesophageal reflux disease: a cross-sectional study

BMC Gastroenterology ◽

10.1186/s12876-021-01707-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mónica R. Zavala-Solares ◽

Gabriela Fonseca-Camarillo ◽

Miguel Valdovinos ◽

Julio Granados ◽

Guido Grajales-Figueroa ◽

...

Keyword(s):

Gene Expression ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Cross Sectional Study ◽

Control Group ◽

Esophageal Mucosa ◽

Sectional Study ◽

Cross Sectional ◽

Tnf Α

Abstract Background The clinical endoscopic phenotypes of gastroesophageal reflux disease (GERD) are classified as Barrett's esophagus (BE), erosive esophagitis (EE) and non-erosive gastroesophageal reflux disease (NERD). NERD is subclassified as abnormal acid exposure (AAE) and normal acid exposure (NAE) based on pH monitoring study results. The aim of this study was to characterize genes involved in the pathophysiology and immune response of GERD. Methods This is an observational and cross-sectional study. All patients with BE, EE, AAE, and NAE and a control group were subjected to superior endoscopy (with biopsies of esophageal mucosa). Relative mRNA quantification of cytokine and target genes was conducted by quantitative Polymerase Chain Reaction (RT-qPCR). Changes in the expression of genes associated with inflammation were assessed for each disease phenotype. Statistical analysis of differential gene expression was performed using the Mann–Whitney U non-parametric test. A p value < 0.05 was considered significant. Results A total of 82 patients were included and were divided into the following groups: Group BE, 16 (19.51%); Group EE, 23 (28.04%); Group AAE, 13 (15.86%); NAE 13 (15.86%); and Control Group, 17 (20.73%). Compared with the control group, patients with BE exhibited increased IL-8 expression (p < 0.05) and increased levels of IL-10, MMP-3, and MMP-9. Patients with EE exhibited increased levels of IL-1B, IL-6 and IL-10 (p < 0.05), and patients with AAE exhibited increased expression of IL-1B, IL-6, IFN-γ and TNF-α (p < 0.05). AAE exhibited increased IL-1B and TNF-α expression compared with NAE (p < 0.05). Conclusion This study demonstrates the differential expression of mediators of inflammation in the esophageal mucosa of patients with different GERD endoscopic phenotypes. IL-1B and TNF-α could be useful to differentially diagnose AAE and NAE in the non-erosive phenotype using endoscopic biopsies.

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Combination of Symptom Profile, Endoscopic Findings, and Esophageal Mucosal Histopathology Helps to Differentiate Achalasia from Refractory Gastroesophageal Reflux Disease

Diagnostics ◽

10.3390/diagnostics11122347 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2347

Author(s):

Chia-Chu Yeh ◽

Chia-Tung Shun ◽

Liang-Wei Tseng ◽

Tsung-Hsien Chiang ◽

Jia-Feng Wu ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Erosive Esophagitis ◽

Esophageal Mucosa ◽

Cell Hyperplasia ◽

Eckardt Score ◽

Symptom Profile ◽

Reflux Symptoms ◽

Food Retention

: Achalasia, a rare primary esophageal motility disorder, is often misdiagnosed as refractory gastroesophageal reflux disease (GERD). This study is aimed to identify the clinical and histopathologic features that may help to differentiate these two entities. Patients with untreated achalasia and those with refractory reflux symptoms despite ≥8 weeks of proton-pump inhibitor treatment were enrolled prospectively. All patients underwent validated symptom questionnaires, esophagogastroduodenoscopy with biopsy, and high-resolution impedance manometry (HRIM). Histopathology of esophageal mucosa was compared based on four pre-determined histological criteria: basal cell hyperplasia or papillae elongation, eosinophilic infiltration, petechiae formation, and hypertrophy of the muscularis mucosae (MM). Compared with the GERD patients, patients with achalasia had similar reflux symptoms, but higher Eckardt scores, fewer erosive esophagitis and hiatal hernia, more esophageal food retention on endoscopy, and higher prevalence of hypertrophy of the MM and petechiae formation on histopathology. Multivariate logistic regression based on Eckardt score ≥4, normal esophagogastric junction morphology or esophageal food retention, and coexistence of petechiae formation and hypertrophy of the MM, established the best prediction model for achalasia. Therefore, combination of routinely accessible variables, including Eckardt score, endoscopic features, and histopathology obtained via esophageal mucosal biopsy, may provide an earlier identification of achalasia.

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Gene Expression Profiling of Inflammatory Cytokines in Esophageal Biopsies of Different Phenotypes of Gastroesophageal Reflux Disease: a cross-sectional study

10.21203/rs.3.rs-16050/v1 ◽

2020 ◽

Author(s):

Monica Zavala-Solares ◽

Gabriela Fonseca-Camarillo ◽

Miguel Valdovinos ◽

Julio Granados ◽

Guido Grajales-Figueroa ◽

...

Keyword(s):

Gene Expression ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Cross Sectional Study ◽

Control Group ◽

Esophageal Mucosa ◽

Sectional Study ◽

Cross Sectional ◽

Differential Gene

Abstract Background: Patients clinical phenotypes in gastroesophageal reflux disease (GERD) are classified as: Barrett's esophagus (BE), erosive esophagitis (EE) and non-erosive gastroesophageal reflux disease (NERD). The aim of this study was to characterize genes involved in the pathophysiology and immune response of GERD.Methods: This is an observational and cross-sectional study. All patients with BE, EE, NERD and the control group were subjected to a superior endoscopy (with biopsies of esophageal mucosa). The cytokine mRNA relative quantification of target genes was conducted by RT-PCR. Changes in gene expression were assessed of the genes associated with inflammation in each disease phenotype. Statistical analysis of differential gene expression was performed by using Dunn's Test for Multiple Comparisons. A p value < 0.05 was considered as significant. Results: A Total of 98 patients were included and they were divided into the following groups: Group BE 16 (16.33%), Group EE 23 (23.47%), Group NERD 42 (42.86%) and Control Group 17 (17.35%). When comparing with control group we found: patients with BE showed an increased expression of IL-8 (P<0.005) and higher levels of: IL-1β, NF-κβ, IL-10 and MMP-3, MMP-9 as well; patients with EE had higher levels of IL-1B, IL-6, IL-8 and IL-10 (P<0.005) and patients with NERD showed a differential gene expression of cytokines Th1, particularly TNF-α and IL-1B (P<0.005) and decreased gene expression of Th2 cytokines such as IL-10, IL-8 and MMP9. Conclusions: This study demonstrates the differential expression of mediators of inflammation in the esophageal mucosa of patients with the EE and BE phenotype.

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