Reactive oxygen species and chemokines: are they elevated in the esophageal mucosa of children with gastroesophageal reflux disease?
OBJECTIVE
To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood reflux esophagitis.


METHODS
A total of 59 subjects who had complaints suggesting GERD underwent esophagogastroduodenoscopy. Endoscopic and histopathologic diagnosis of reflux esophagitis was established by Savary-Miller and Vandenplas grading systems, respectively. Esophageal biopsy specimens were taken from the esophagus 20% proximal above the esophagogastric junction for conventional histopathological examination and the measurements of ROS and cytokine levels. ROS were measured by chemiluminescence, whereas IL-8 and MCP-1 levels were determined with quantitative immunometric ELISA on esophageal tissue. Esophageal tissue ROS, IL-8 and MCP-1 levels were compared among groups with and without endoscopic/histo-pathologic esophagitis.


RESULTS
Of 59 patients 28 (47.5%) had normal esophagus whereas 31 (52.5%) had endoscopic esophagitis. In histopathological evaluation, almost 73% of the cases had mild and 6.8% had moderate degree of esophagitis. When ROS and chemokine levels were compared among groups with and without endoscopic esophagitis, statistical difference could not be found between patients with and without esophagitis. Although the levels of ROS, IL-8 and MCP-1 were found to be higher in the group with histopathological reflux esophagitis, this difference was not statistically significant.


CONCLUSIONS
These results suggest that the grade of esophagitis is usually mild or moderate during childhood and factors apart from ROS, IL-8 and MCP-1 may be involved in the pathogenesis of reflux esophagitis in children.
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Marmara University School of Medicine, Altunizade, Istanbul 81190, Turkey.
Engin
E
Tutar
Deniz
D
Ertem
Goksenin
G
Unluguzel
Sevda
S
Tanrikulu
Goncagul
G
Haklar
Cigdem
C
Celikel
Evin
E
Ademoglu
Ender
E
Pehlivanoglu
D000293:Adolescent; D018932:Chemokine CCL2 / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System; D004797:Enzyme-Linked Immunosorbent Assay; D004947:Esophagus / Q000737:chemistry* / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000378:metabolism*; D006801:Humans; D007223:Infant; D016209:Interleukin-8 / Q000032:analysis*; D008163:Luminescent Measurements; D009092:Mucous Membrane / Q000737:chemistry; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000032:analysis*; D012720:Severity of Illness Index; D015854:Up-Regulation
C111835:CCL2 protein, human; D018932:Chemokine CCL2; D016209:Interleukin-8; D017382:Reactive Oxygen Species