Associations between the severity of reflux esophagitis in children and changes in oxidative stress, serum inflammation, vasoactive intestinal peptide and motilin

Abstract

Changes in the levels of serum oxidative stress indexes, gastrointestinal hormones and inflammatory factors in children with different severity of reflux esophagitis (RE) were detected. Sixty child patients diagnosed with gastroesophageal reflux disease (GERD) via gastroscopy were selected and divided into non-erosive reflux disease group (NERD group, n=12) and RE group (n=48) according to whether there was esophageal mucosal injury. In RE group, the patients were further divided into grade I RE group (n=15), grade II RE group (n=18) and grade III RE group (n=15) based on the severity of mucosal injury. None of the child patients took PPI and domperidone within 2 weeks before enrollment. The content of malondialdehyde (MDA) and total superoxide dismutase (T-SOD) in the esophageal mucosa was detected. The changes in the levels of serum vasoactive intestinal peptide (VIP), motilin, interleukin-1β (IL-1β), IL-8 and tumor necrosis factor-α (TNF-α) were determined. The DeMeester score was the highest in grade III RE group, followed by grade II RE group, grade I RE group and NERD group (P<0.05). The content of MDA in the esophageal mucosa was higher in RE group than that in NERD group, and the T-SOD activity declined with the increased severity of injury (P<0.05). In the three RE groups, the level of plasma VIP was significantly higher, while the motilin level was remarkably lower than those in NERD group (P<0.05). With the increased severity of disease, the expression levels of serum IL-1β, IL-8 and TNF-α in RE group were gradually raised (P<0.05). RE patients have strong oxidative stress and inflammatory response, an increased level of serum VIP, a regulator of gastrointestinal motility, and a decreased level of motilin. Controlling the changes in the above factors using effective treatment means can improve the development of GERD.

Protective Effects of Inflammation of Curcumae Longae Rhizoma 30% EtOH Extract on Acute Reflux Esophagitis Rats

“…In this experiment, we confirmed the inhibitory effect of CLR on oxidative stress in ARE model. It is known that in ARE, ROS is produced in mucosal epithelial cells stimulated by reflux of gastric contents, which increases esophageal mucosal damage [ 42 ]. As a result of confirming the levels of ROS and ONOO − , biomarkers of oxidative stress in serum, it was significantly decreased in CM and CH, and TBARS levels, lipid peroxides in serum and tissue, were also significantly decreased in CM and CH (Figures 4 and 5 ).…”

The Relationship between Serum Total Oxidant Status, Total Antioxidant Status, and Oxidative Stress Index with Severity Levels of Gastroesophageal Reflux Disease: A Literature Review

“…Deng et al [6] investigated the association between the severity of reflux esophagitis (GERD group and ER group) in children and changes in OS, serum inflammation, vasoactive intestinal peptide (VIP), and motilin. The study concluded that patients with reflux esophagitis had OS (by measuring changes in MDA levels, total SOD, VIP, motilin, IL-1β, IL-8, and TNF) and elevated robust inflammatory response serum VIP (motility regulators), gastrointestinal tract, and decreased motilin levels.…”

“…High gastric acid stimulates oesophageal epithelial cells to create reactive oxygen species (ROS) and cause oxidative stress (OS) by activating macrophages, Proteinase-Activated Receptor 2 (PAR 2), and Platelet-Activating Factor [5]. The inflammatory process will be aided by OS, eventually resulting in mucosal damage [6].…”

Total Antioxidant Activity and Manganese Superoxide Dismutase in Comorbidity of Gastroesophageal Reflux Disease and Autoimmune Thyroiditis in Student Population

“…Excessive concentrations of free oxygen radicals in conditions of a lack of antioxidants such as reduced glutathione and SOD damage DNA and promote the development of esophageal adenocarcinoma [21]. There is a dependence of lipid peroxidation processes on the severity of GERD: the malonyldialdehyde content in the esophageal mucosa of patients with reflux esophagitis exceeded that in patients with non-erosive GERD, and the decrease in total SOD activity is inversely proportional to the severity of damage to the esophageal mucosa [22]. Oxidative stress accompanies thyroid diseases, while the mechanisms of its implementation depend on the functional state of the gland: in hyperthyroidism, the leading link is the overproduction of ROS, and in hypothyroidism, the low availability of antioxidants [23].…”