| Objective: Two subtypes of gastroesophageal reflux disease(gerd)[non-erosive reflux disease(nerd)and reflux esophagitis(re)] were compared with those in healthy controls.The expression of related tj(tight junction)protein,To investigate the role of these proteins in the course of gerd and the mechanism of their expression.Methods: According to strict inclusion and exclusion criteria,45 patients admitted to hospital during the set period of time were selected as the subjects.Include healthy subjects(N9)who came to the medical examination.All the subjects completed the gerdq score first,then the re group and the nerd group underwent esophageal acid manometry,and the local mucosa of the esophageal dentate line on the esophageal dentate line was taken as the specimen of the laboratory study under endoscopy,and then the he staining was used in the follow-up,and then the esophageal acid manometry was performed in the re group and the nerd group.Immunohistochemistry,rt-pcr and elisa were used to detect the oxidative stress related indexes(nox-4),antioxidant protein(nrf-2,ho-1)and tj protein [occlusal protein coccludin0,closure protein-1(claudin-1)].The relative expression levels of closure protein-4(claudin-4)and cytoplasmic tight adhesion protein-1(zonula occludens-1,zo-1)were detected.Photo-taking under microscope and image processing software were used to measure esophageal mucosal epithelial cell space digitally.Then,the relationship between the expression of tj protein and the change of cell space in each group was analyzed.To investigate the effect of excessive production of esophageal ros(nox-4)on tight protein in esophageal mucosa.Results: The age range of 45 subjects included in the study was between 18 and 65 years old.There was no significant difference in body mass index(body mass index,bmi)between control group,nerd group and re group(p > 0.05),re group was older than control group,the difference was statistically significant).Esophageal 24 h ph monitoring showed that the number of acid reflux(ph ? 4)and demeester score in re group were significantly higher than those in nerd group(p < 0.05),and the times of weak acid reflux(4 < ph < 7)and all reflux times in).Re group were slightly higher than those in nerd group.However,there was no significant difference between the two groups(p > 0.05).The distance between esophageal epithelial cells in re group was significantly wider than that in nerd group,and there was significant difference between the three groups(p < 0.05).The results of immunohistochemistry showed that.nox-4 immunohistochemistry,The positive expression of nox-4 in esophagus of nerd group and re group was significantly higher than that of normal control group.The expression multiple of nox-4 mrna and serum concentration in nerd group and re group were significantly higher than those in control group(p < 0.01).The expression of nox-4 mrna and the concentration of serum nox-4 in re group were the highest,which were significantly higher than those in nerd group(p < 0.01).The results of mrna assay of antioxidant protein showed that the mrna transcription level of nuclear factor nf-e2 related factor and downstream lycopene oxygenase-1 in nerd group and re group was significantly lower than that in control group,and there was significant difference among the three groups(p < 0.01).The results of mrna test of esophageal epithelial tight junction protein in each group showed that the mrna transcription level of occlusal protein,closed protein-1,closed protein-4 and cytoplasmic tight adhesion protein-1 decreased gradually in nerd group and re group.It was significantly lower than that of the healthy control group,and there was significant difference among the three groups(p < 0.01).In addition,compared with nerd group,re group decreased the expression of occludin,claudin-1,claudin-4 and zo-1 mrna.Conclusion: The results were as follows:(1)the expression of tj protein was significantly decreased in patients with different subtypes of gerd.The decreased expression of tj protein may be related to the widening of(dis).(2)Widened cell space may lead to clinical symptoms,and the low expression of tj protein may be related to the excessive production of esophageal nox-4 caused by acid reflux. |
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