Morphofunctional State of Esophageal Mucosa in Patients with Gastroesophageal Reflux Disease Depending on the Nutritional Status of Patients

Abstract

We have studied morphofunctional state of esophageal mucosa in 57 patients with gastroesophageal reflux disease (GERD) with normal (body mass index (BMI) — 18.5–24.9 kg/m2) and excessive (BMI over 25 kg/m2) body weight. A histologic and morphometric study of esophageal mucosa, immunohistochemical analysis of the expression of apoptosis marker CD95 and inflammatory marker cyclooxygenase-2 (COX-2) were carried out. In reflux esophagitis, most characteristic are changes in multilayered epithelium — hyperkeratosis, parakeratosis, proliferation of basal cells and acanthosis. At that, significant differences in morphometric characteristics of patients with normal BMI and overweight were not found. The development of reflux esophagitis was associated with violations of pro-apoptotic ability of esophageal mucosa cells and increased expression of COX-2, most significant in patients with high BMI. Detected disorders may determine the mechanisms of complicated course of GERD in these patients.

Keywords

• gastroesophageal reflux disease
• esophageal mucosa
• markers of apoptosis
• cyclooxygenase-2