title: Role of saliva in esophageal defense: implications in patients with nonerosive reflux disease.
abstract: BACKGROUND
  It has been previously demonstrated that patients with reflux esophagitis exhibit a significant impairment in the secretion of salivary protective components versus controls. However, the secretion of salivary protective factors in patients with nonerosive reflux disease (NERD) is not explored. The authors therefore studied the secretion of salivary volume, pH, bicarbonate, nonbicarbonate glycoconjugate, protein, epidermal growth factor (EGF), transforming growth factor alpha (TGF-α) and prostaglandin E2 in patients with NERD and compared with the corresponding values in controls (CTRL).
  
  
  METHODS
  Salivary secretion was collected during basal condition, mastication and intraesophageal mechanical (tubing, balloon) and chemical (initial saline, acid, acid/pepsin, final saline) stimulations, respectively, mimicking the natural gastroesophageal reflux.
  
  
  RESULTS
  Salivary volume, protein and TGF-α outputs in patients with NERD were significantly higher than CTRL during intraesophageal mechanical (P < 0.05) and chemical stimulations (P < 0.05). Salivary bicarbonate was significantly higher in NERD than CTRL group during intraesophageal stimulation with both acid/pepsin (P < 0.05) and saline (P < 0.01). Salivary glycoconjugate secretion was significantly higher in the NERD group than the CTRL group during chewing (P < 0.05), mechanical (P < 0.05) and chemical stimulation (P < 0.01). Salivary EGF secretion was higher in patients with NERD during mechanical stimulation (P < 0.05).
  
  
  CONCLUSIONS
  Patients with NERD demonstrated a significantly stronger salivary secretory response in terms of volume, bicarbonate, glycoconjugate, protein, EGF and TGF-α than asymptomatic controls. This enhanced salivary esophagoprotection is potentially mediating resistance to the development of endoscopic mucosal changes by gastroesophageal reflux.
authors: Molecular Medicine Research Laboratory (HY, MM, KH, GG, IS, JS), Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas; Nicolaus Copernicus University of Torun (CP), Torun, Poland; University of Virginia Health Sciences Center (KH, GG), Charlottesville, VA; and Medical University of Bialystok (TZ, ZN), Bialystok, Poland.
authors: Harathi
authors: H
authors: Yandrapu
authors: Marek
authors: M
authors: Marcinkiewicz
authors: Cezary
authors: C
authors: Poplawski
authors: Kyung
authors: K
authors: Han
authors: Tomasz
authors: T
authors: Zbroch
authors: George
authors: G
authors: Goldin
authors: Irene
authors: I
authors: Sarosiek
authors: Zbigniew
authors: Z
authors: Namiot
authors: Jerzy
authors: J
authors: Sarosiek
mesh_terms: D000328:Adult; D015232:Dinoprostone / Q000378:metabolism; D004815:Epidermal Growth Factor / Q000378:metabolism; D005260:Female; D005764:Gastroesophageal Reflux / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D010812:Physical Stimulation; D012463:Saliva / Q000378:metabolism; D065787:Salivary Elimination; D012469:Salivary Glands / Q000378:metabolism / Q000503:physiopathology; D012965:Sodium Chloride / Q000378:metabolism; D013268:Stimulation, Chemical; D016211:Transforming Growth Factor alpha / Q000378:metabolism
chemical_list: D016211:Transforming Growth Factor alpha; D012965:Sodium Chloride; D004815:Epidermal Growth Factor; D015232:Dinoprostone