A Prospective Study of Eosinophilic Esophagitis and the Expression of Tight Junction Proteins in Patients with Gastroesophageal Reflux Disease Symptoms

• Published in: Gut and liver 2018-01, Vol.12 (1), p.30
• Main Authors: Kenichiro Okimoto, Makoto Arai, Hideaki Ishigami, Keiko Saito, Shoko Minemura, Daisuke Maruoka, Tomoaki Matsumura, Tomoo Nakagawa, Tatsuro Katsuno, Masaki Suzuki, Yukio Nakatani, Osamu Yokosuka
• Format: Article
• Language: Korean
• Subjects: Eosinophilic esophagitis; Gastroesophageal reflux; Proton pump inhibitor; Tight junctions; Zonula occludin-1
• ISSN: 1976-2283

Background/Aims: Eosinophilic esophagitis (EoE) is often erroneously diagnosed as gastroesophageal reflux disease (GERD). The aim of this study is to investigate the prevalence of EoE and the expression of tight junction (TJ) proteins in patients with GERD symptoms. Methods: One hundred patients with GERD symptoms and 10 healthy controls were prospectively studied. Sixty-two patients had symptoms refractory to proton pump inhibitors (PPI). All patients underwent esophageal biopsy. Patients were diagnosed with EoE if the number of eosinophil granulocytes per high-power field was ≥15. Immunohistochemical analysis of TJ proteins (claudin-1, claudin-4, occludin, and zonula occludin-1 [ZO-1]) was performed. Results: EoE was diagnosed in six of 100 patients (6%) with GERD symptoms and in six patients (9.7%) of 62 patients with PPI-refractory GERD. Only one had typical EoE endoscopic findings. The proportion of ZO-1-positive cells was significantly lower in the lower than in the middle esophagus (56.0%±14.0% vs 66.0%±11.5%, p