Esophageal motility disorder and high CD206 expression in patients with gastroesophageal reflux disease

Abstract

Objective. To study the immune response and esophageal motility in patients with non-erosive reflux disease (NERD), gastroesophageal reflux disease (GERD) complicated by intestinal-type cylindrical cell metaplasia (CCM), and Barrett’s esophagus (BE). Patients and methods. The study included 30 patients: 10 patients with NERD, 10 patients with GERD complicated by intestinaltype CCM, and 10 patients with BE. All patients underwent high-resolution esophageal manometry. The expression levels of surface receptors CD25, CD80 (Th1-type immune response) and CD163, CD206 (Th2-type immune response) were analyzed. Results. The analysis revealed high CD206 expression in patients with NERD and GERD complicated by intestinal-type CCM compared to BE (р = 0.011, р = 0.075, respectively). In patients with NERD, median distal contractile integral (DCI) was 920 [178; 2033] mmHg⋅s⋅cm; in patients with GERD complicated by intestinal-type CCM, it was 1046 [223; 3759] mmHg⋅s⋅cm; in patients with BE – 276 [1; 1870] mmHg⋅s⋅cm. Patients with BE had ineffective esophageal motility more often than patients with NERD and GERD complicated by intestinal-type CCM (р = 0.06, р = 0.052, respectively). Lower esophageal sphincter pressure was 22.5 [8; 40] mmHg in patients with NERD, 18.0 [7.0; 36.0] mmHg in patients with GERD complicated by intestinal-type CCM, and 14.5 [1.0; 30.0] mmHg in patients with BE. The positive correlation between high CD206 expression and DCI (r = 0.317, р = 0.077) was determined. Conclusion. The role of esophageal motility disorder and immune response in patients with GERD should be further studied to assess their impact on the course of the disease. Key words: gastroesophageal reflux disease, immune response, high-resolution esophageal manometry, metaplasia