E-CADHERIN EXPRESSION IN ESOPHAGEAL MUCOSA IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE AND/OR OBSTRUCTIVE SLEEP APNEA/HYPOPNEA SYNDROME
Abstract
Background. Obstructive sleep apnea/hypopnea syndrome (OSAHS) seems to have a negative impact on the state of esophageal mucosa in patients with GERD, therefore it is significant to evaluate the structure of esophageal epithelium in patients with GERD and OSAHS.
Objective – to evaluate E-cadherin expression in the epithelium of the lower third of the esophagus in patients with GERD and/or OSAHS.
Materials and methods. 143 examined patients have undergone esophagogastroduodenoscopy with the biopsy of the lower third of the esophagus as well as respiratory monitoring. The patients were divided into 4 groups: group 1 – patients with GERD (n=35), group 2 – patients with GERD and OSAHS (n=40), group 3 – with OSAHS (n=38), group 4 – control group (n=30). There have been performed the identification of plasma concentration of N-terminal E-cadherin fragment and evaluation of E-cadherin expression in the epithelium of the lower third of the esophagus.
Results. The patients with GERD and OSAHS had statistically significant higher plasma concentration of N-terminal E-cadherin fragment in comparison to other groups. E-cadherin expression in the epithelium was statistically significantly lower in all studied groups in contrast to the control group. There has been revealed a negative correlation between plasma concentration of N-terminal E-cadherin fragment and E-cadherin expression in the epithelium as well as between apnea/hypopnea index and E-cadherin expression.
Conclusion. The patients with GERD and OSAHS are characterized by low E-cadherin expression in the epithelium of the lower third of the esophagus on the background of high plasma concentration of N-terminal E-cadherin fragment.
References
1. Tkachev AV, Tarasova GN, Smirnova EA, Sinelnik EA. Osobennosti gistoarhitektoniki slizistoj obolochki pishhevoda u pacientov s gastrojezofagealnoj refljuksnoj boleznju. Sovremennye problemy nauki i obrazovanija [Internet]. 2018;2. Available from: https://www.science-education.ru/ru/article/view?id=27461. (Russian).
2. Shaukovich YY, Shishko VI, Kolodzejskij YA. Kollagen IV tipa kak biomarker povrezhdenija slizistoj obolochki pishhevoda u pacientov s gastrojezofagealnoj refljuksnoj boleznju i sindromom obstruktivnogo apnoje/gipopnoje sna [Collagen type IV as biomarker of esophageal mucosa damage in patient with gastroesophageal reflux disease and obstructive sleep apnea/hypopnea syndrome]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta [Journal of the Grodno State Medical University]. 2019;17(2):159-163. doi: 10.25298/2221-8785-2019-17-2-159-163. (Russian).
3. Dzhulaj GS, Sekareva EV. Gastrojezofagealnaja refljuksnaja bolezn: sostojanie i perspektivy reshenija problem [Gastroesophageal reflux disease: state and prospects of solving the problem]. Moskva: ID «MEDPRAKTIKA-M»; 2010. 48 p. (Russian).
4. Shirahata T, Nakamura H, Nakajima T, Nakamura M, Chubachi S, Yoshida S, Tsuduki K, Mashimo S, Takahashi S, Minematsu N, Tateno H, Asano K, Fujishima S, Betsuyaku T. Plasma sE-cadherin and the plasma sE-cadherin/sVE-cadherin ratio are potential biomarkers for chronic obstructive pulmonary disease. Biomarkers. 2018;23(5):414-421. doi: 10.1080/1354750X.2018.1434682.
5. Shaukovich YY. Rol E-kadgerina v ocenke povrezhdenija slizistoj obolochki pishhevoda u pacientov s gastrojezofagealnoj refljuksnoj boleznju, associirovannoj s sindromom obstruktivnogo apnoje/gipopnoje sna [The Role of E-cadherin in the assessment of esophageal mucosal damage in patients with gastroesophageal reflux disease associated with obstructive sleep apnea/hypopnea syndrome]. Rossijskij zhurnal gastrojenterologii, gepatologii, koloproktologii [Russian Journal of Gastroenterology, Hepatology, Coloproctology]. 2019;29(3):25-32. doi: 10.22416/1382-4376-2019-29-3-25-32. (Russian).
6. Shishko VI, Petrulevich YY. Gastrojezofagealnaja refljuksnaja bolezn: klassifikacija, klinika, diagnostika, principy lechenija (obzor literatury, chast 2) [Gastroesophageal reflux disease: classification, clinic, diagnosis, principles of treatment (literature review, part 2)]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta [Journal of the Grodno State Medical University]. 2015;50(2):15-23. (Russian).
7. Savarino E, Bredenoord A, Fox M, Pandolfino J, Roman S, Gyawali C. Expert consensus document: Advances in the physiological assessment and diagnosis of GERD. Nature Reviews Gastroenterology & Hepatology. 2017;14(11):665-676. doi: 10.1038/nrgastro.2017.130.
8. Shtabinskaya ТТ, Basinsky VА, Lyalikov SА. Angiogenez v adenokarcinome tolstoj kishki [Colon Adenocarcinoma Angiogenesis]. Grodno: GrGMU; 2018. 132 p. (Russian).
9. Grzhibovskij AM. Analiz treh i bolee nezavisimyh grupp kolichestvennyh dannyh [Analysis of three or more independent groups of quantitative data]. Jekologija cheloveka [Human ecology]. 2008;(3):50-58. (Russian).
10. Jovov B, Que J, Tobey NA, Djukic Z, Hogan BL, Orlando RC. Role of E-cadherin in the Pathogenesis of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2011;106(6):1039-1047. doi: 10.1038/ajg.2011.102.
11. Jing S, Wang Y, Kuroda M, Su J, Sun G, Liu Q, Cheng Y, Yang C. HIF-1α contributes to hypoxia-induced invasion and metastasis of esophageal carcinoma via inhibiting E-cadherin and promoting MMP-2 expression. Acta Med Okayama. 2012;66(5):399-407. doi: 10.18926/AMO/48964.
12. Jing S, Wang Y, Chen L, Sang M, Zheng M, Sun G, Liu Q, Cheng Y, Yang C. Hypoxia suppresses E-cadherin and enhances matrix metalloproteinase-2 expression favoring esophageal carcinoma migration and invasion via hypoxia inducible factor-1 alpha activation. Dis Esophagus. 2013;26(1):75-83. doi: 10.1111/j.1442-2050.2011.01321.x.
