title: Contribution of immunomodulators to gastroesophageal reflux disease and its complications: stromal cells, interleukin 4, and adiponectin.
abstract: Gastroesophageal reflux disease (GERD) has become the most commonly seen gastrointestinal disorder in outpatient clinics. In the United States, around 20% of the general population experience heartburn on a weekly basis. Although clinical complaints can be mild or moderate, patients with GERD may develop further complications, such as peptic strictures, Barrett's esophagus (BE), and even esophageal adenocarcinoma. Pathologically, GERD is developed as a result of chronic and enhanced exposure of the esophageal epithelium to noxious gastric refluxate. In this review article, we provide an overview of GERD and then focus on the roles of stromal cells, interleukin 4, and adiponectin in GERD and BE. The importance of inflammation and immunomodulators in GERD pathogenesis is highlighted. Targeting the immunomodulators or inflammation in general may improve the therapeutic outcome of GERD, in particular, in those refractory to proton pump inhibitors.
authors.affiliation: Department of Thoracic Surgery, Ningxia Medical University General Hospital, Yinchuan, Ningxia, China.|Cancer Research Program, JLC-BBRI, North Carolina Central University, Durham, North Carolina.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Cancer Research Program, JLC-BBRI, North Carolina Central University, Durham, North Carolina. lchen@nccu.edu.|Center for Esophageal Disease and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. lchen@nccu.edu.
authors.forename: Xiaoxin Luke
authors.initials: XL
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California. ashaker@usc.edu.
authors.forename: Anisa
authors.initials: A
authors.lastname: Shaker
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. t-oshima@hyo-med.ac.jp.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Jing
authors.initials: J
authors.lastname: Shan
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
authors.affiliation: Department of Gastroenterology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China. fc.188@stu.xjtu.edu.cn.
authors.forename: Cheng
authors.initials: C
authors.lastname: Feng
authors.affiliation: Department of Gastroenterology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D052242:Adiponectin / Q000037:antagonists & inhibitors / Q000378:metabolism*; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007155:Immunologic Factors / Q000037:antagonists & inhibitors / Q000378:metabolism*; D015847:Interleukin-4 / Q000037:antagonists & inhibitors / Q000378:metabolism*; D017154:Stromal Cells / Q000187:drug effects / Q000378:metabolism; D050916:TRPV Cation Channels / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D000893:Anti-Inflammatory Agents; C508598:IL4 protein, human; D007155:Immunologic Factors; D050916:TRPV Cation Channels; C494482:TRPV1 protein, human; D015847:Interleukin-4
keywords: Barrett's esophagus; adiponectin; gastroesophageal reflux disease; interleukin 4; stromal cells