title: Chronic mucosal inflammation of the gastric cardia in gastroesophageal reflux disease is not regulated by FOXP3-expressing T cells.
abstract: BACKGROUND
  Chronic inflammation at the cardia occurs in gastroesophageal reflux disease (GERD), as well as in the presence of Helicobacter pylori. Regulatory T cells have been demonstrated for H. pylori-induced gastritis, whereas their role has not been studied in GERD.
  
  
  METHODS
  We prospectively analyzed the expression of FOXP3, a marker of various regulatory T cells, as well as the mucosal transcript levels of TGF-beta1 and IL-10. RNA and protein levels have been determined in cardiac biopsies of 70 patients stratified according to GERD (n = 22), controls (n = 17), and H. pylori (n = 31).
  
  
  RESULTS
  GERD presented with chronic inflammation and reduced FOXP3-mRNA in the cardiac mucosa (-84%), whereas H. pylori-positive patients revealed a 25.1-fold increase of FOXP3 gene expression. These results were verified by the regulatory cytokines IL-10 and TGF-beta1, and by the immunohistochemical detection of intramucosal FOXP3-expressing T cells.
  
  
  CONCLUSIONS
  Chronic inflammation at the cardia associated with either GERD or H. pylori differs concerning the presence of FOXP3-expressing T cells. In contrast to H. pylori, FOXP3-expressing T cells are not associated with GERD-associated carditis.
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg 39120, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Kandulski
authors.forename: Thomas
authors.initials: T
authors.lastname: Wex
authors.forename: Doerthe
authors.initials: D
authors.lastname: Kuester
authors.forename: Klaus
authors.initials: K
authors.lastname: Mönkemüller
authors.forename: Ulrich
authors.initials: U
authors.lastname: Peitz
authors.forename: Albert
authors.initials: A
authors.lastname: Roessner
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000328:Adult; D000368:Aged; D002299:Cardia / Q000378:metabolism* / Q000473:pathology; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism*; D005753:Gastric Mucosa / Q000276:immunology / Q000378:metabolism; D005756:Gastritis / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000150:complications / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D015870:Gene Expression; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*; D053773:Transforming Growth Factor beta1 / Q000378:metabolism; D055815:Young Adult
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D053773:Transforming Growth Factor beta1; D016753:Interleukin-10