title: Differences in ERK activation in squamous mucosa in patients who have gastroesophageal reflux disease with and without Barrett's esophagus.
abstract: OBJECTIVE
  In some patients with gastroesophageal reflux disease (GERD), the reflux-damaged esophageal squamous epithelium heals through the process of intestinal metaplasia (resulting in Barrett's esophagus) rather than through the regeneration of more squamous cells. We hypothesized that squamous epithelium in Barrett's esophagus might have abnormalities in activation of the extracellular-regulated kinases 1 and 2 (ERK1/2) signaling pathway that may facilitate esophageal repair through metaplasia in response to acid-induced injury.
  
  
  METHODS
  Endoscopic biopsies were taken from distal esophageal squamous mucosa in patients who had GERD with and without Barrett's esophagus and in controls, before and after esophageal perfusion with 0.1 N HCl acid. Basal ERK1/2 phosphorylation, acid-induced ERK1/2 activity and phosphorylation, and localization of phosphorylated ERK1/2 were determined using immunoblotting, Western blotting, and immunohistochemistry.
  
  
  RESULTS
  Compared to patients with Barrett's esophagus, patients with GERD exhibited significantly lower baseline levels of phosphorylated ERK1/2 expression (35 +/- 4%vs 90 +/- 21% control, p= 0.01) Acid exposure significantly increased ERK1/2 activity (346.6 +/- 51.90 to 446.8 +/- 62.44 RIU, p= 0.02) and phosphorylation (3.55 +/- 1.26 to 4.49 +/- 1.25 [ratio phospho/total ERK], p= 0.01) in the squamous mucosa of GERD patients, but not in those with Barrett's esophagus or in controls.
  
  
  CONCLUSIONS
  Between patients with Barrett's esophagus and patients with uncomplicated GERD, there are significant differences in baseline levels and in acid-induced activation of ERK1/2 in esophageal squamous epithelium. To our knowledge, this is the first description of a molecular, phenotypic feature that distinguishes the esophageal squamous mucosa of GERD patients with and without Barrett's esophagus.
authors.affiliation: Department of Medicine, Dallas VA Medical Center, University of Texas-Southwestern Medical School, Dallas, Texas, USA.
authors.forename: Rhonda F
authors.initials: RF
authors.lastname: Souza
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Shewmake
authors.forename: Yuenan
authors.initials: Y
authors.lastname: Shen
authors.forename: Ruben D
authors.initials: RD
authors.lastname: Ramirez
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Bullock
authors.forename: Christa L
authors.initials: CL
authors.lastname: Hladik
authors.forename: Edward L
authors.initials: EL
authors.lastname: Lee
authors.forename: Lance S
authors.initials: LS
authors.lastname: Terada
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Spechler
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications / Q000201:enzymology*; D001706:Biopsy; D015153:Blotting, Western; D004789:Enzyme Activation; D005260:Female; D005764:Gastroesophageal Reflux / Q000201:enzymology*; D006801:Humans; D015151:Immunoblotting; D007150:Immunohistochemistry; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D019950:Mitogen-Activated Protein Kinase 1 / Q000378:metabolism*; D048052:Mitogen-Activated Protein Kinase 3 / Q000378:metabolism*; D009092:Mucous Membrane / Q000201:enzymology; D010766:Phosphorylation; D015398:Signal Transduction / Q000502:physiology; D014018:Tissue Distribution
chemical_list: D019950:Mitogen-Activated Protein Kinase 1; D048052:Mitogen-Activated Protein Kinase 3