Dynamics of prostaglandin E2 in the surgical treatment of gastroesophageal reflux disease
DOI:
https://doi.org/10.14739/2310-1237.2023.1.273146Keywords:
gastroesophageal reflux disease, hiatal hernia, prostaglandin E2Abstract
Gastroesophageal reflux disease (GERD) is one of the most common gastroenterological diseases. Therefore, the issues of diagnosis and the most effective treatment of GERD are extremely relevant. Achieving a stable positive result of treatment is impossible without taking into account the pathogenetic mechanisms of the development of GERD. Particularly relevant are the little-studied issues of the influence of humoral factors on the development of GERD in the course of treatment. One of the interesting biologically active substances is prostaglandin E2, the possible involvement of which in the mechanisms of the development of GERD is insufficiently reported.
The aim of the study is to evaluate the effect of antireflux surgery on the level of prostaglandin E2 in blood serum and to verify that its changes after surgical treatment are associated with the decrease of gastroesophageal reflux and esophageal inflammation.
Materials and methods. 35 patients were examined with GERD who underwent laparoscopic total antireflux fundoplication. There were 26 women (74.3 %) and 9 men (25.7 %). Their age is 55.3 ± 11.3. The control group consisted of 20 practically healthy people (women – 14 (70.0 %), men – 6 (30.0 %), average age – 56.7 ± 10.6).
Immunoenzymatic analysis of prostaglandin E2 was performed in blood plasma, which was obtained according to a standard method. Determination of prostaglandin E2 (Prostaglandin E2 ELISA, KGE004B, RnD Systems) was carried out by the immunoenzymatic method based on the use of the “sandwich“ variant of the solid-phase immunoenzymatic analysis. The procedure was carried out on the immunoenzyme complex ImmunoChem-2100 (USA) at the Department of Clinical Laboratory Diagnostics in Zaporizhzhia State Medical University. Research on the level of prostaglandin E2 in the main group was carried out before surgical treatment and 2–3 months after surgery by taking venous blood and using the above test systems. Statistical evaluation of the research results was performed using the Statistica for Windows 13 software package (StatSoft Inc., No. JPZ804I382130ARCN10-J).
Results. The level of prostaglandin E2 in the blood of practically healthy people was 16.7 ± 6.1 pg/ml. In the main group, the values of prostaglandin E2 before surgical treatment were 25.8 ± 5.7 pg/ml, after surgical treatment, they decreased to 13.5 ± 5.3 pg/ml. The detailed analysis of patients in the main group showed that the level of prostaglandin E2 did not differ statistically in different erosive forms of esophagitis, or CLE and NERD. But it is statistically different from the level of prostaglandin E2 in practically healthy individuals of the control group. The conducted correlation analysis indicated that the level of prostaglandin E2 did not depend on the duration of acid exposure in the esophagus, as well as on the severity of esophagitis or the presence of CLE.
Conclusions. With effective surgical treatment of gastroesophageal reflux disease, a decrease in the level of prostaglandin E2 after surgery is determined compared to preoperative data to the level obtained in a group of practically healthy patients. The obtained dynamics of the level of prostaglandin E2 indicates the possibility of this hormone influencing the tone of the lower esophageal sphincter and active participation in the pathogenesis of GERD, which confirms the possibility of its use as an additional diagnostic marker of inflammation in the esophagus and a marker of the effectiveness of surgical treatment.
References
Bai, X., Ihara, E., Otsuka, Y., Tsuruta, S., Hirano, K., Tanaka, Y., Ogino, H., Hirano, M., Chinen, T., Akiho, H., Nakamura, K., Oda, Y., & Ogawa, Y. (2019). Involvement of different receptor subtypes in prostaglandin E2-induced contraction and relaxation in the lower esophageal sphincter and esophageal body. European journal of pharmacology, 857, 172405. https://doi.org/10.1016/j.ejphar.2019.172405
Soma, T., Shimada, Y., Kawabe, A., Kaganoi, J., Kondo, K., Imamura, M., & Uemoto, S. (2007). Induction of prostaglandin E synthase by gastroesophageal reflux contents in normal esophageal epithelial cells and esophageal cancer cells. Diseases of the esophagus, 20(2), 123-129. https://doi.org/10.1111/j.1442-2050.2007.00657.x
Sarosiek, J., & McCallum, R. W. (2000). Mechanisms of oesophageal mucosal defence. Bailliere’s best practice & research. Clinical gastroenterology, 14(5), 701-717. https://doi.org/10.1053/bega.2000.0119
Costa, P. M., & Fernandes, F. V. (1985). Efeito do betanecol e das prostaglandinas E2 sobre o refluxo gastroesofágico e o esvaziamento esofágico, em doentes com esofagite de refluxo, propostos para terapêutica cirúrgica [Effect of bethanecol and prostaglandin E2 on gastroesophageal reflux and esophageal emptying, in patients with reflux esophagitis proposed for surgical therapy]. Acta medica portuguesa, 6(2), 83-94. [in Portuguese].
Giuli, R., Siewert, J. R., Couturier, D., & Scarpignato, C. (Eds.) (2003). Barrettʼs esophagus. Columnar lined esophagus. 250 questions – 250 answers (Vol. 1). John Libbey Eurot ext.
Sadatomi, D., Kono, T., Mogami, S., & Fujitsuka, N. (2020). Weak acids induce PGE2 production in human oesophageal cells: novel mechanisms underlying GERD symptoms. Scientific reports, 10(1), 20775. https://doi.org/10.1038/s41598-020-77495-z
Namiot, Z., Yu, Z. J., Piascik, R., Hetzel, D. P., McCallum, R. W., & Sarosiek, J. (1997). Modulatory effect of esophageal intraluminal mechanical and chemical stressors on salivary prostaglandin E2 in humans. The American journal of the medical sciences, 313(2), 90-98. https://doi.org/10.1097/00000441-199702000-00004
Long, J. D., & Orlando, R. C. (1997). Eicosanoids and the esophagus. Digestive diseases, 15(3), 145-154. https://doi.org/10.1159/000171595
Kondo, T., Sei, H., Yamasaki, T., Tomita, T., Ohda, Y., Oshima, T., Fukui, H., Watari, J., & Miwa, H. (2017). A novel prostanoid EP1 receptor antagonist, ONO-8539, reduces acid-induced heartburn symptoms in healthy male volunteers: a randomized clinical trial. Journal of gastroenterology, 52(10), 1081-1089.
Triadafilopoulos, G., Kaczynska, M., & Iwane, M. (1996). Esophageal mucosal eicosanoids in gastroesophageal reflux disease and Barrett’s esophagus. The American journal of gastroenterology, 91(1), 65-74.
Ottignon, Y., Alber, D., Moussard, C., Deschamps, J. P., Carayon, P., & Henry, J. C. (1987). Esophageal mucosal prostaglandin E2 levels in health and in gastroesophageal reflux disease. Prostaglandins, leukotrienes, and medicine, 29(2-3), 141-151.
Sarosiek, J., Yu, Z., Namiot, Z., Rourk, R. M., Hetzel, D. P., & McCallum, R. W. (1994). Impact of acid and pepsin on human esophageal prostaglandins. The American journal of gastroenterology, 89(4), 588-594.
Richter, J. E., & Rubenstein, J. H. (2018). Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology, 154(2), 267-276.
Sandhu, D. S., & Fass, R. (2018). Current Trends in the Management of Gastroesophageal Reflux Disease. Gut and liver, 12(1), 7-16.
Katzka, D. A., & Kahrilas, P. J. (2020). Advances in the diagnosis and management of gastroesophageal reflux disease. BMJ (Clinical research ed.), 371, m3786.
Fass, R., Boeckxstaens, G. E., El-Serag, H., Rosen, R., Sifrim, D., & Vaezi, M. F. (2021). Gastro-oesophageal reflux disease. Nature reviews. Disease primers, 7(1), 55.
Slater, B. J., Dirks, R. C., McKinley, S. K., Ansari, M. T., Kohn, G. P., Thosani, N., Qumseya, B., Billmeier, S., Daly, S., Crawford, C., P Ehlers, A., Hollands, C., Palazzo, F., Rodriguez, N., Train, A., Wassenaar, E., Walsh, D., Pryor, A. D., & Stefanidis, D. (2021). SAGES guidelines for the surgical treatment of gastroesophageal reflux (GERD). Surgical endoscopy, 35(9), 4903-4917.
Yadlapati, R., Gyawali, C. P., & Pandolfino, J. E. (2022). Personalized Approach to the Evaluation and Management of Gastroesophageal Reflux Disease. Clinical gastroenterology and hepatology, S1542-3565(22)00079-9. Advance online publication.
Fuchs, K. H., Lee, A. M., Breithaupt, W., Varga, G., Babic, B., & Horgan, S. (2021). Pathophysiology of gastroesophageal reflux disease-which factors are important?. Translational gastroenterology and hepatology, 6, 53.
Fuchs, K. H., & Meining, A. (2021). Current Insights in the Pathophysiology of Gastroesophageal Reflux Disease. Chirurgia (Bucharest, Romania : 1990), 116(5), 515-523.
Chen, S., Du, F., Zhong, C., Liu, C., Wang, X., Chen, Y., Wang, G., Gao, X., Zhang, L., Li, L., & Wu, W. (2021). Gastroesophageal reflux disease: recent innovations in endoscopic assessment and treatment. Gastroenterology report, 9(5), 383-391.
Allan, V. J. (2000). Basic immunofluorescence. In V. J. Allan (ed.), Protein localization by fluorescent microscopy. A practical approach. Oxford University Press.
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