Features of the blood cytokine profile in gastroesophageal reflux disease in schoolchildren with gastritis and family history of peptic ulcer

Abstract

Gastroesophageal reflux disease (GERD) is a common acid-dependent disease among the population, including children, with multifactorial genesis. It, like many other acid-dependent diseases (peptic ulcer, etc.) is associated with a family predisposition to the disease. Of interest is the study of the role of cytokines in the regulation of pathology in childhood, depending on the severity of a family history of peptic ulcer disease. Aim: to evaluate the levels of cytokines in the blood serum in case of family history of ulcerative diseases in schoolchildren with gastritis associated with GERD. In the course of a scientific study, 142 children with gastroenterological complaints aged 7-17 years were examined. The diagnosis of GERD was made in the presence of weekly heartburn in accordance with the global consensus on pathology in children. All subjects underwent gastroscopy with taking biopsy material from the gastric mucosa and morphological confirmation of their diagnosis of gastritis in accordance with the Sydney classification. The concentration of cytokines in blood serum (IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, IL-1β, IFNα, TNFα) was obtained by enzyme immunoassay. During statistical processing, the χ2 and Mann–Whitney tests were used. The studies were approved by the ethics committee and informed consents of patients and their parents were obtained prior to the start of the study. The results of the study did not show significant differences in the concentration of cytokines in schoolchildren depending on the presence of GERD. In children with a family burden of peptic ulcer, GERD was detected more often (p = 0.054), which is probably a consequence of their increased acid formation. Changes in the cytokine profile of the blood were noted. During GERD, with aggravation of peptic ulcer, there was an increase in the replication of IL-4 (p = 0.027) and IFNα (p = 0.001). The increase in blood IFNα in children with GERD with family burden is obviously aimed at enhancing immune responses involving the whole body to damage. This is due to its functional role – participation in the immune response. Increased replication of IL-4, obviously, provides an increase in metabolic, immune processes in the body aimed at optimizing the course of proliferative processes in the esophageal mucosa under conditions of increased secretion of hydrochloric acid in the stomach. Thus, when a family history of peptic ulcer is aggravated in schoolchildren with gastritis associated with GERD, a number of links in the cytokine network (IL-4, IFNα) move to the systemic level of regulation.

Keywords

• cytokines
• children
• gastroesophageal reflux disease
• gastritis
• peptic ulcer
• family predisposition