Role Of MDA In The Pathogenesis Of GERD Esophagus Mucosal Inflammatory Injury

Objective: To investigate the expression of MDA in esophageal mucosa of different types of GERD patients and its role in the esophageal inflammation.Methods: According to the inclusion and exclusion criteria,42 patients hospitalized in the the Xinjiang Uygur Autonomous Region People’s Hospital from December 2017 to October 2018 were selected as the research group.8 healthy subjects completed physical examination were set up as healthy control group.GERD completed GERDQ score,24 h pH monitoring,and taken 3cm on the dentate line of the esophagus as a specimen.The study group was divided into Non-erosive reflux disease(NERD)group(17 cases)and Erosive reflux disease(RE)group(25 cases).Then HE staining,immunohistochemistry,RT-PCR,ELISA methods were used to detect inflammation,oxidative stress(MDA),antioxidant enzyme(Mn SOD,GSH,CAT),and proinflammatory cytokines(MCP-1,IL-8,TNF-alpha).Results: There was no significant difference in Body mass index(BMI)between the three groups(P>0.05).24 h pH monitoring of esophagus showed that the indexes of weak acid reflux(4<pH<7),acid reflux(pH < 4),esophageal near end acid reflux(%)and DeMeester score in group RE were significantly higher than those in group NERD,and there was statistical significance between the groups(P<0.05).There was no significant difference in esophageal pressure between high resolution groups(P>0.05).In group RE,the infiltration of immune cells(neutrophils,eosinophils),nipple lengthening,edema and other inflammatory changes were found in the esophageal mucosa,and the inflammation score reached the peak,which was significantly higher than that in NERD group,with statistical significance(P<0.001).The positive expression of MDA in the two groups(NERD,RE)was higher than that in the control group,and the MDA expression in the group RE was almost covered with the full layer esophagus,and the serum MDA concentration in the NERD and RE groups was significantly that than higher in control the group(P < 0.001),but the MDA concentration in the RE group reached the peak.Compared with the NERD group,the serum MDA was statistically significant(P<0.01).The relative expression of mRNA(Mn SOD,GSH and CAT)in NERD group and RE group was significantly decreased,and was there difference a significant between the three groups(P<0.001).Compared with group NERD,RE group significantly decreased mRNA Mn SOD and CAT level expression(P<0.01).The expression of relative mRNA(MCP-1,IL-8,TNF-alpha)increased significantly in the two groups(NERD,RE),There were three groups differences among the significant in statistics(P<0.001).Compared with the NERD group,the RE group significantly increased the expression of its inflammatory factors(P<0.01).Conclusion: The expression level of MDA in different types of GERD is significantly higher,which may be closely related to esophageal inflammation induced by acid reflux.