title: Reduction of interleukin 8 gene expression in reflux esophagitis and Barrett's esophagus with antireflux surgery.
abstract: OBJECTIVE
  Chronic inflammation of esophageal mucosa secondary to refluxed gastric juice increases gene expression of interleukin 8 (IL-8). Antireflux surgery can reduce this overexpression.
  
  
  METHODS
  Prospective analysis of archival paraffin-embedded tissue.
  
  
  METHODS
  Academic tertiary medical center.
  
  
  METHODS
  One hundred eight patients with reflux symptoms were classified according to pH monitoring and endoscopic and histologic findings. Twenty patients did not have reflux or mucosal injury; 47 had reflux disease (16 esophagitis and 31 Barrett's esophagus), 20 had dysplasia, and 21 had adenocarcinoma. Microdissection was performed to exclude inflammatory cells and stromal tissue. After RNA isolation and reverse transcription, IL-8 messenger RNA expression was measured using quantitative real-time polymerase chain reaction. All patients with reflux disease had Nissen fundoplication with biopsies at matched levels within the esophagus preoperation and postoperation.
  
  
  RESULTS
  Expression of IL-8 was increased in patients with reflux compared with those without reflux. Patients with the highest IL-8 expression were those with Barrett's dysplasia and adenocarcinoma (P<.001). In patients with reflux, Nissen fundoplication led to significantly decreased IL-8 expression compared with preoperative levels in esophagitis (P = .01) and Barrett's esophagus (P = .03).
  
  
  CONCLUSIONS
  Interleukin 8 messenger RNA expression increases during the progression of reflux disease from normal squamous mucosa to esophageal adenocarcinoma. Elimination of reflux with Nissen fundoplication significantly reduces IL-8 expression in both squamous and Barrett's mucosa. These results demonstrate that effective antireflux surgery can modulate the gene expression of esophageal mucosa and may impact the natural history of reflux disease.
authors.affiliation: Department of Cardiothoracic Surgery, University of Southern California, 1510 San Pablo Street, Los Angeles, CA 90033, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Oh
authors.forename: Steven R
authors.initials: SR
authors.lastname: DeMeester
authors.forename: Daniel
authors.initials: D
authors.lastname: Vallbohmer
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Mori
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kuramochi
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Hagen
authors.forename: John
authors.initials: J
authors.lastname: Lipham
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Danenberg
authors.forename: Peter V
authors.initials: PV
authors.lastname: Danenberg
authors.forename: Parakrama
authors.initials: P
authors.lastname: Chandrasoma
authors.forename: Tom R
authors.initials: TR
authors.lastname: DeMeester
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D001471:Barrett Esophagus / Q000209:etiology / Q000378:metabolism* / Q000601:surgery; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy; D004942:Esophagitis, Peptic / Q000209:etiology / Q000378:metabolism* / Q000601:surgery; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000150:complications / Q000378:metabolism / Q000601:surgery; D006801:Humans; D016209:Interleukin-8 / Q000235:genetics / Q000378:metabolism*; D012333:RNA, Messenger / Q000378:metabolism
chemical_list: D016209:Interleukin-8; D012333:RNA, Messenger