Role Of SP,CGRP And Inflammatory Cytokines In The Occurences Of Non Erosive Esophagitis

Objective: To explore the mechanism of substance P(SP),calcitonin gene-related peptide(CGRP)and inflammatory cytokines(IL-1β,IL-6,IFN-γ,TNF-α)in the development of non erosive reflux disease.Methods: A total of 25 NERD patients and 10 normal controls were enrolled.All the subjects underwent GERDQ score,24 h pH monitoring,high resolution esophageal manometry monitoring and endoscopic removal of the local mucosa at 3 cm of the esophageal dentate line as specimens.The expression of SP,CGRP and inflammatory cytokines(IL-1β,IL-6,IFN-γ,TNF-α)was detected by HE staining and RT-PCR.Results: 24 h esophageal pH monitoring showed that the number of weak acid reflux(4<pH<7),acid reflux(pH≤4),acid reflux(%)in proximal esophagus and DeMeester score in NERD group were significantly higher than in control group(P<0.05).H&E staining showed that there were obvious neutrophil infiltration and pre-inflammatory reaction in esophageal mucosa of NERD group,and the score of inflammation injury was significantly higher than that of control group(P<0.01).The relative expression of SP and CGRP in NERD group was significantly higher than that in control group(P<0.01).In NERD group,the relative expressions of IL-1β,IL-6,IFN-γand TNF-α in esophageal mucosa were significantly increased(P<0.01).Pearson correlation analysis showed that the acid reflux score(DeMeester)in NERD group was positively correlated with the expression of SP,CGRP and inflammatory cytokines(IL-1β,IL-6,IFN-γ,TNF-α)respectively(P<0.01),the correlation coefficients were r=0.678 、0.686、0.390、0.482、0.374、0.415,respectively.Conclusion: The expression of SP,CGRP and inflammatory cytokines(IL-1β,IL-6,IFN-γ,TNF-α)in NERD patients increased significantly,which may be closely related to the increase of esophageal acid sensitivity caused by acid reflux and the occurrence of inflammation.