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World J Gastroenterol. May 28, 2008; 14(20): 3218-3223
Published online May 28, 2008. doi: 10.3748/wjg.14.3218
Reactive oxygen species and chemokines: Are they elevated in the esophageal mucosa of children with gastroesophageal reflux disease?
Engin Tutar, Deniz Ertem, Goksenin Unluguzel, Sevda Tanrikulu, Goncagul Haklar, Cigdem Celikel, Evin Ademoglu, Ender Pehlivanoglu
Engin Tutar, Deniz Ertem, Ender Pehlivanoglu, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Marmara University School of Medicine, Altunizade, İstanbul 81190, Turkey
Goksenin Unluguzel, Goncagul Haklar, Department of Biochemistry, Marmara University School of Medicine, Altunizade, İstanbul 81190, Turkey
Sevda Tanrikulu, Evin Ademoglu, Department of Biochemistry, Istanbul University Istanbul Faculty of Medicine, Çapa, İstanbul 34390, Turkey
Cigdem Celikel, Department of Pathology, Marmara University School of Medicine, Altunizade, İstanbul 81190, Turkey
Author contributions: Tutar E, Ertem D designed the study, recruited the study population, performed endoscopies and wrote the paper, Pehlivanoglu E involved in the study design, Tanrikulu S and Ademoglu E performed biochemical parameters, Unluguzel G and Haklar G involved in measurements of reactive oxygen species, Celikel C performed histopathological examinations.
Correspondence to: Deniz Ertem, MD, Associate Professor of Pediatrics, Marmara University School of Medicine, Divisiong of Pediatric Gastroenterology, Hepatology and Nutrition, Tophanelioglu Cd. 13-15, Altunizade, İstanbul 81190, Turkey. denizertem@marmara.edu.tr
Telephone: +90-216-3266639
Fax: +90-216-3269578
Received: December 15, 2007
Revised: March 20, 2008
Accepted: March 27, 2008
Published online: May 28, 2008
Abstract

AIM: To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood reflux esophagitis.

METHODS: A total of 59 subjects who had complaints suggesting GERD underwent esophagogastroduodenoscopy. Endoscopic and histopathologic diagnosis of reflux esophagitis was established by Savary-Miller and Vandenplas grading systems, respectively. Esophageal biopsy specimens were taken from the esophagus 20% proximal above the esophagogastric junction for conventional histopathological examination and the measurements of ROS and cytokine levels. ROS were measured by chemiluminescence, whereas IL-8 and MCP-1 levels were determined with quantitative immunometric ELISA on esophageal tissue. Esophageal tissue ROS, IL-8 and MCP-1 levels were compared among groups with and without endoscopic/histo-pathologic esophagitis.

RESULTS: Of 59 patients 28 (47.5%) had normal esophagus whereas 31 (52.5%) had endoscopic esophagitis. In histopathological evaluation, almost 73% of the cases had mild and 6.8% had moderate degree of esophagitis. When ROS and chemokine levels were compared among groups with and without endoscopic esophagitis, statistical difference could not be found between patients with and without esophagitis. Although the levels of ROS, IL-8 and MCP-1 were found to be higher in the group with histopathological reflux esophagitis, this difference was not statistically significant.

CONCLUSION: These results suggest that the grade of esophagitis is usually mild or moderate during childhood and factors apart from ROS, IL-8 and MCP-1 may be involved in the pathogenesis of reflux esophagitis in children.

Keywords: Gastroesophageal reflux disease; Reflux esophagitis; Reactive oxygen species; Interleukine-8; Monocyte chemoattractant protein-1