A distinct salivary secretory response mediated by the esophago-salivary reflex in patients with Barrett's esophagus: Its potential pathogenetic implications |
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| Affiliation: | 1. Molecular Medicine Research Laboratory, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA;2. Department of Medicine, Columbia County Health System, Dayton, WA, USA;3. Department of Endoscopy, University Hospital 1, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Torun, Bydgoszcz, Poland;4. Department of Physiology, Medical University of Bialystok, Bialystok, Poland;5. Department of Reproduction and Gynecological Endocrinology, University Clinical Hospital, Bialystok, Poland;1. Department of Surgery, Hamad Medical Corporation, Doha, Qatar;2. Trauma Surgery Section, Hamad General Hospital, Doha, Qatar;3. Clinical Research, Hamad General Hospital, Doha, Qatar;4. Weill Cornell Medical College, Doha, Qatar;5. Department of Surgery, Arizona University, Tucson, AZ, United States;1. Department of Clinical Pathomorphology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland;2. Department of Otolaryngology and Clinical Oncology Chair and Clinic of Otolaryngology and Department of Pathophysiology of Hearing and Balance System Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland;3. Department of Oncologic Pathology, Poznan University of Medical Sciences and Greater Poland Oncology Center, Poznan, Poland;1. Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan, Taiwan;2. Department of Medicine, Taipei Medical University, Taipei, Taiwan;3. Department of Sport Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan;4. Department of Biological Sciences and Technology, National University of Tainan, Taiwan;5. Department of Biotechnology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan;6. Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan;7. Department of Obstetrics & Gynecology, National Cheng Kung University Hospital, Tainan, Taiwan;8. Department of Biotechnology, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan;9. Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan;10. Department of Biological Science, National Sun Yat-sen University, Kaohsiung, Taiwan |
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| Abstract: | PurposeA significantly compromised epidermal growth factor (EGF) secretion by basal parotid saliva may contribute to the development of Barrett's esophagus (BE). The rate of secretion of EGF as well as a wide spectrum of protective factors in total basal and stimulated saliva in BE patients remains to be explored. We therefore studied the rate of secretion of salivary buffers, glycoconjugate, protein, EGF, transforming growth factor α (TGFα) and prostaglandin E2 (PGE2), evoked by esophago-salivary reflex, in patients with BE and controls (CTRL).Material/methodsSalivary secretion was collected during basal condition, mastication, and intraesophageal mechanical and chemical stimulations respectively, mimicking the natural gastroesophageal reflux scenario.ResultsSalivary pH in BE was significantly lower than in controls during mechanical (p < 0.001) and chemical stimulations (p < 0.001). Bicarbonate and protein outputs in BE were significantly lower during mechanical (p < 0.05) and chemical stimulations (p < 0.01). The non-bicarbonate and glycoconjugate outputs in BE were lower during chemical stimulation (p < 0.05) and during mechanical (p < 0.05) and chemical stimulations (p < 0.05) respectively. The rate of salivary EGF output in BE was significantly lower during mechanical stimulation (p < 0.05). We observed a higher TGFα output during mastication (p < 0.05) and PGE2 secretion during basal and masticatory condition (p < 0.05) in BE.ConclusionsPatients with BE demonstrated significantly compromised salivary pH and rate of secretion of bicarbonate, non-bicarbonate, glycoconjugate, protein and EGF. This impairment could potentially predispose to the development of accelerated esophageal mucosal injury. Potential restoration of this impairment by masticatory stimulation of salivary secretion using sugarless chewing gum justifies further clinical exploration. |
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| Keywords: | Barrett's esophagus Salivary pH Bicarbonate Glycoconjugate EGF |
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