title: Impact of the composition of gastric reflux bile acids on Barrett's oesophagus.
abstract: BACKGROUND
  The effect of the composition of reflux bile acids, especially the ratio of hydrophobic to hydrophilic ones, on the development of Barrett's oesophagus has not been fully investigated in human studies.
  
  
  OBJECTIVE
  To evaluate the influence of the bile acid composition of gastric juice on Barrett's oesophagus, a prospective study was designed.
  
  
  METHODS
  Fifty patients with and 100 patients without Barrett's oesophagus were enrolled. For all enrolled patients, gastric juice was collected by the endoscopic procedure for bile acid analysis. The ratio of hydrophobic to hydrophilic bile acids (bile hydrophobicity ratio, BHR) was calculated from 6 kinds of bile acids analysed in gastric juice. The relationship between the ratio and clinico-pathological factors of Barrett's oesophagus was investigated.
  
  
  RESULTS
  The mean of BHR of patients with Barrett's oesophagus was significantly higher than that of patients without Barrett's oesophagus (0.26 ± 0.05 vs. 0.08 ± 0.02, p<0.05). In multivariate analysis, a high BHR value was a predictor for the presence of Barrett's oesophagus (OR 5.74, p<0.001). In patients with Barrett's oesophagus, the BHR correlated with COX-2 protein expression and with accelerated cellular proliferation.
  
  
  CONCLUSIONS
  Patients with Barrett's oesophagus had a higher BHR in the gastric juice than those without.
authors.affiliation: Second Department of Internal Medicine, Shimane University, Faculty of Medicine, Izumo, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Amano
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yuki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mishima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tamagawa
authors.forename: Goichi
authors.initials: G
authors.lastname: Uno
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishimura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sato
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology*; D001655:Bile Reflux / Q000150:complications*; D055415:Bone Morphogenetic Protein 4 / Q000378:metabolism; D002793:Cholic Acids / Q000032:analysis*; D051546:Cyclooxygenase 2 / Q000378:metabolism; D005260:Female; D005750:Gastric Juice / Q000737:chemistry*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000378:metabolism; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D055415:Bone Morphogenetic Protein 4; D002793:Cholic Acids; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human