Gastroesophageal reflux patients' defective antioxidative capacity in the proximal esophageal mucosa before antireflux surgery and also after 4-year follow-up.
BACKGROUND
Oxidative stress has a role in the pathogenesis of gastroesophageal reflux disease (GERD).


OBJECTIVE
To investigate the redox balance in proximal esophagus before and 6 and 48 months after antireflux surgery.


METHODS
In 20 GERD patients and 9 controls oxidative stress by myeloperoxidase activity (MPO activity) and antioxidative capacity of esophageal mucosa by superoxide dismutase activity (SOD), and glutathione content (GSH) was measured from proximal esophageal samples.


RESULTS
In proximal esophagus of GERD patients compared to controls', antioxidative capacity appearing as GSH level was significantly decreased (P < 0.001) at all time points and as SOD levels preoperatively (P < 0.001) and 4 years postoperatively (P = 0.01). MPO activity of patients was significantly lower than controls' preoperatively, and 6 months and 4 years postoperatively (P < 0.05). MPO activity remained lower than that of the distal esophagus at 6 months and 4 years (P < 0.01 for both).


CONCLUSIONS
In GERD patients, proximal esophageal mucosal antioxidative defense is defective before and after antireflux surgery. Antireflux surgery seems not to change the level of oxidative stress in proximal esophagus, suggesting that defective mucosal antioxidative capacity plays a role in development of oxidative damage to the esophageal mucosa in GERD.
Räsänen
Jari V
JV
Division of General Thoracic and Esophageal Surgery, Department of Cardiothoracic Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Sihvo
Eero I T
EI
Rantanen
Tuomo K
TK
Ahotupa
Markku O
MO
Färkkilä
Martti A
MA
Harjula
Ari
A
Salo
Jarmo A
JA
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004945:Esophagoscopy; D004947:Esophagus / Q000201:enzymology / Q000378:metabolism* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000201:enzymology / Q000378:metabolism* / Q000601:surgery*; D005978:Glutathione / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D018384:Oxidative Stress; D009195:Peroxidase / Q000378:metabolism; D013482:Superoxide Dismutase / Q000378:metabolism; D016896:Treatment Outcome
D009195:Peroxidase; D013482:Superoxide Dismutase; D005978:Glutathione