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Zhao H, Cheng Y, Kalra A, Ma K, Zheng Y, Ziman B, Tressler C, Glunde K, Shin EJ, Ngamruengphong S, Khashab M, Singh V, Anders RA, Jit S, Wyhs N, Chen W, Li X, Lin DC, Meltzer SJ. Generation and multiomic profiling of a TP53/CDKN2A double-knockout gastroesophageal junction organoid model. Sci Transl Med 2022; 14:eabq6146. [PMID: 36449602 PMCID: PMC10026384 DOI: 10.1126/scitranslmed.abq6146] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Inactivation of the tumor suppressor genes tumor protein p53 (TP53) and cyclin-dependent kinase inhibitor 2A (CDKN2A) occurs early during gastroesophageal junction (GEJ) tumorigenesis. However, because of a paucity of GEJ-specific disease models, cancer-promoting consequences of TP53 and CDKN2A inactivation at the GEJ have not been characterized. Here, we report the development of a wild-type primary human GEJ organoid model and a CRISPR-edited transformed GEJ organoid model. CRISPR-Cas9-mediated TP53 and CDKN2A knockout (TP53/CDKN2AKO) in GEJ organoids induced morphologic dysplasia and proneoplastic features in vitro and tumor formation in vivo. Lipidomic profiling identified several platelet-activating factors (PTAFs) among the most up-regulated lipids in CRISPR-edited organoids. PTAF/PTAF receptor (PTAFR) abrogation by siRNA knockdown or a pharmacologic inhibitor (WEB2086) reduced proliferation and other proneoplastic features of TP53/CDKN2AKO GEJ organoids in vitro and tumor formation in vivo. In addition, murine xenografts of Eso26, an established human esophageal adenocarcinoma cell line, were suppressed by WEB2086. Mechanistically, TP53/CDKN2A dual inactivation disrupted both the transcriptome and the DNA methylome, likely mediated by key transcription factors, particularly forkhead box M1 (FOXM1). FOXM1 activated PTAFR transcription by binding to the PTAFR promoter, further amplifying the PTAF-PTAFR pathway. Together, these studies established a robust model system for investigating early GEJ neoplastic events, identified crucial metabolic and epigenomic changes occurring during GEJ model tumorigenesis, and revealed a potential cancer therapeutic strategy. This work provides insights into proneoplastic mechanisms associated with TP53/CDKN2A inactivation in early GEJ neoplasia, which may facilitate early diagnosis and prevention of GEJ neoplasms.
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Affiliation(s)
- Hua Zhao
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Clinical Laboratory, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an 710061, Shaanxi, China
| | - Yulan Cheng
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Andrew Kalra
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Ke Ma
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Einstein Healthcare Network, Philadelphia, PA 19136, USA
| | - Yueyuan Zheng
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Benjamin Ziman
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
| | - Caitlin Tressler
- Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kristine Glunde
- Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Biological Chemistry, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Eun Ji Shin
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Saowanee Ngamruengphong
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Mouen Khashab
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Vikesh Singh
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Robert A. Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Simran Jit
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Nicolas Wyhs
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Wei Chen
- Clinical Laboratory, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an 710061, Shaanxi, China
| | - Xu Li
- Center for Translational Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China
| | - De-Chen Lin
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
| | - Stephen J. Meltzer
- Division of Gastroenterology and Hepatology, Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Bourgois A, Saurat D, De Araujo S, Boyard A, Guitard N, Renault S, Fargeau F, Frederic C, Peyret E, Flahaut E, Servonnet A, Favier AL, Lacroix G, François S, Dekali S. Nose-only inhalations of high-dose alumina nanoparticles/hydrogen chloride gas mixtures induce strong pulmonary pro-inflammatory response: a pilot study. Inhal Toxicol 2021; 33:308-324. [PMID: 34772293 DOI: 10.1080/08958378.2021.1996492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Solid composite propellants combustion, in aerospace and defense fields, can lead to complex aerosols emission containing high concentrations of alumina nanoparticles (Al2O3 NPs) and hydrogen chloride gas (HClg). Exposure to these mixtures by inhalation is thus possible but literature data toward their pulmonary toxicity are missing. To specify hazards resulting from these combustion aerosols, a pilot study was implemented. MATERIALS AND METHODS Male Wistar rats were nose-only exposed to Al2O3 NPs (primary size 13 nm, 10 g/L suspension leading to 20.0-22.1 mg/m3 aerosol) and/or to HClg aerosols (5 ppm target concentration) following two exposure scenarios (single exposures (SE) or repeated exposures (RE)). Bronchoalveolar lavage fluids (BALF) content and lungs histopathology were analyzed 24 h after exposures. RESULTS Repeated co-exposures increased total proteins and LDH concentrations in BALF indicating alveolar-capillary barrier permeabilization and cytolysis. Early pulmonary inflammation was induced after RE to Al2O3 NPs ± HClg resulting in PMN, TNF-α, IL-1β, and GRO/KC increases in BALF. Both exposure scenarios resulted in pulmonary histopathological lesions (vascular congestions, bronchial pre-exfoliations, vascular and interalveolar septum edemas). Lung oxidative damages were observed in situ following SE. CONCLUSION Observed biological effects are dependent on both aerosol content and exposure scenario. Results showed an important pro-inflammatory effect of Al2O3 NPs/HClg mixtures on the lungs of rat 24 h after exposure. This pilot study raises concerns toward potential long-term pulmonary toxicity of combustion aerosols and highlights the importance for further studies to be led in order to define dose limitations and exposure thresholds for risk management at the work place.
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Affiliation(s)
- Alexandra Bourgois
- Département EBR, Unité Risques Technologiques Emergents, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Dominique Saurat
- Département EBR, Unité Risques Technologiques Emergents, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Suzanne De Araujo
- Département EBR, Unité Risques Technologiques Emergents, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Alexandre Boyard
- Département EBR, Unité Risques Technologiques Emergents, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Nathalie Guitard
- Département EBR, Unité Radiobiologie, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Sylvie Renault
- Département Plateformes et Recherche Technologique, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Francisca Fargeau
- Département Plateformes et Recherche Technologique, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Christine Frederic
- Département Plateformes et Recherche Technologique, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Emmanuel Peyret
- Unité de toxicologie expérimentale, Institut National de l'Environnement Industriel et des RISques (INERIS), Verneuil-en-Halatte, France
| | - Emmanuel Flahaut
- CIRIMAT, Université de Toulouse, CNRS, INPT, UPS, UMR CNRS-UPS-INP No. 5085, Université Toulouse 3 Paul Sabatier, Toulouse cedex 9, France
| | - Aurélie Servonnet
- Département Plateformes et Recherche Technologique, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Anne-Laure Favier
- Département Plateformes et Recherche Technologique, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Ghislaine Lacroix
- Unité de toxicologie expérimentale, Institut National de l'Environnement Industriel et des RISques (INERIS), Verneuil-en-Halatte, France
| | - Sabine François
- Département EBR, Unité Radiobiologie, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
| | - Samir Dekali
- Département EBR, Unité Risques Technologiques Emergents, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge Cedex, France
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Rieder F, Nonevski I, Ma J, Ouyang Z, West G, Protheroe C, DePetris G, Schirbel A, Lapinski J, Goldblum J, Bonfield T, Lopez R, Harnett K, Lee J, Hirano I, Falk G, Biancani P, Fiocchi C. T-helper 2 cytokines, transforming growth factor β1, and eosinophil products induce fibrogenesis and alter muscle motility in patients with eosinophilic esophagitis. Gastroenterology 2014; 146:1266-77.e1-9. [PMID: 24486052 PMCID: PMC3992171 DOI: 10.1053/j.gastro.2014.01.051] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 01/10/2014] [Accepted: 01/22/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Patients with eosinophilic esophagitis (EoE) often become dysphagic from the combination of organ fibrosis and motor abnormalities. We investigated mechanisms of dysphagia, assessing the response of human esophageal fibroblasts (HEFs), human esophageal muscle cells (HEMCs), and esophageal muscle strips to eosinophil-derived products. METHODS Biopsy specimens were collected via endoscopy from the upper, middle, and lower thirds of the esophagus of 18 patients with EoE and 21 individuals undergoing endoscopy for other reasons (controls). Primary cultures of esophageal fibroblasts and muscle cells were derived from 12 freshly resected human esophagectomy specimens. Eosinophil distribution was investigated by histologic analyses of full-thickness esophageal tissue. Active secretion of EoE-related mediators was assessed from medium underlying mucosal biopsy cultures. We quantified production of fibronectin and collagen I by HEF and HEMC in response to eosinophil products. We also measured the expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 by, and adhesion of human eosinophils to, HEFs and HEMCs. Eosinophil products were tested in an esophageal muscle contraction assay. RESULTS Activated eosinophils were present in all esophageal layers. Significantly higher concentrations of eosinophil-related mediators were secreted spontaneously in mucosal biopsy specimens from patients with EoE than controls. Exposure of HEFs and HEMCs to increasing concentrations of eosinophil products or co-culture with eosinophils caused HEFs and HEMCs to increase secretion of fibronectin and collagen I; this was inhibited by blocking transforming growth factor β1 and p38 mitogen-activated protein kinase signaling. Eosinophil binding to HEFs and HEMCs increased after incubation of mesenchymal cells with eosinophil-derived products, and decreased after blockade of transforming growth factor β1 and p38 mitogen-activated protein kinase blockade. Eosinophil products reduced electrical field-induced contraction of esophageal muscle strips, but not acetylcholine-induced contraction. CONCLUSIONS In an analysis of tissues samples from patients with EoE, we linked the presence and activation state of eosinophils in EoE with altered fibrogenesis and motility of esophageal fibroblasts and muscle cells. This process might contribute to the development of dysphagia.
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Affiliation(s)
- Florian Rieder
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio; Department of Pathobiology, Lerner Research Institute, Cleveland, Ohio
| | - Ilche Nonevski
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio
| | - Jie Ma
- Rhode Island Hospital and Brown University, Providence, Rhode Island
| | - Zhufeng Ouyang
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio
| | - Gail West
- Department of Pathobiology, Lerner Research Institute, Cleveland, Ohio
| | - Cheryl Protheroe
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Giovanni DePetris
- Department of Laboratory Medicine/Pathology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Anja Schirbel
- Department of Pathobiology, Lerner Research Institute, Cleveland, Ohio
| | - James Lapinski
- Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - John Goldblum
- Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Tracey Bonfield
- Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio
| | - Rocio Lopez
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Karen Harnett
- Rhode Island Hospital and Brown University, Providence, Rhode Island
| | - James Lee
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Ikuo Hirano
- Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gary Falk
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio
| | - Piero Biancani
- Rhode Island Hospital and Brown University, Providence, Rhode Island
| | - Claudio Fiocchi
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio; Department of Pathobiology, Lerner Research Institute, Cleveland, Ohio.
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4
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Sofi MH, Gudi R, Karumuthil-Melethil S, Perez N, Johnson BM, Vasu C. pH of drinking water influences the composition of gut microbiome and type 1 diabetes incidence. Diabetes 2014; 63:632-44. [PMID: 24194504 PMCID: PMC3900548 DOI: 10.2337/db13-0981] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Nonobese diabetic (NOD) mice spontaneously develop type 1 diabetes (T1D), progression of which is similar to that in humans, and therefore are widely used as a model for understanding the immunological basis of this disease. The incidence of T1D in NOD mice is influenced by the degree of cleanliness of the mouse colony and the gut microflora. In this report, we show that the T1D incidence and rate of disease progression are profoundly influenced by the pH of drinking water, which also affects the composition and diversity of commensal bacteria in the gut. Female NOD mice that were maintained on acidic pH water (AW) developed insulitis and hyperglycemia rapidly compared with those on neutral pH water (NW). Interestingly, forced dysbiosis by segmented filamentous bacteria (SFB)-positive fecal transfer significantly suppressed the insulitis and T1D incidence in mice that were on AW but not in those on NW. The 16S rDNA-targeted pyrosequencing revealed a significant change in the composition and diversity of gut flora when the pH of drinking water was altered. Importantly, autoantigen-specific T-cell frequencies in the periphery and proinflammatory cytokine response in the intestinal mucosa are significantly higher in AW-recipient mice compared with their NW counterparts. These observations suggest that pH of drinking water affects the composition of gut microflora, leading to an altered autoimmune response and T1D incidence in NOD mice.
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Affiliation(s)
- M. Hanief Sofi
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC
| | - Radhika Gudi
- Department of Surgery, Medical University of South Carolina, Charleston, SC
| | | | - Nicolas Perez
- Department of Surgery, University of Illinois at Chicago, Chicago, IL
| | - Benjamin M. Johnson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC
| | - Chenthamarakshan Vasu
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC
- Department of Surgery, Medical University of South Carolina, Charleston, SC
- Corresponding author: Chenthamarakshan Vasu,
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Zhang S, Liu Z, Heldsinger A, Owyang C, Yu S. Intraluminal acid activates esophageal nodose C fibers after mast cell activation. Am J Physiol Gastrointest Liver Physiol 2014; 306:G200-7. [PMID: 24264049 PMCID: PMC3920110 DOI: 10.1152/ajpgi.00142.2013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Acid reflux in the esophagus can induce esophageal painful sensations such as heartburn and noncardiac chest pain. The mechanisms underlying acid-induced esophageal nociception are not clearly understood. In our previous studies, we characterized esophageal vagal nociceptive afferents and defined their responses to noxious mechanical and chemical stimulation. In the present study, we aim to determine their responses to intraluminal acid infusion. Extracellular single-unit recordings were performed in nodose ganglion neurons with intact nerve endings in the esophagus using ex vivo esophageal-vagal preparations. Action potentials evoked by esophageal intraluminal acid perfusion were compared in naive and ovalbumin (OVA)-challenged animals, followed by measurements of transepithelial electrical resistance (TEER) and the expression of tight junction proteins (zona occludens-1 and occludin). In naive guinea pigs, intraluminal infusion with either acid (pH = 2-3) or capsaicin did not evoke an action potential discharge in esophageal nodose C fibers. In OVA-sensitized animals, following esophageal mast cell activation by in vivo OVA inhalation, intraluminal acid infusion for about 20 min started to evoke action potential discharges. This effect is further confirmed by selective mast cell activation using in vitro tissue OVA challenge in esophageal-vagal preparations. OVA inhalation leads to decreased TEER and zona occludens-1 expression, suggesting an impaired esophageal epithelial barrier function after mast cell activation. These data for the first time provide direct evidence of intraluminal acid-induced activation of esophageal nociceptive C fibers and suggest that mast cell activation may make esophageal epithelium more permeable to acid, which subsequently may increase esophageal vagal nociceptive C fiber activation.
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Affiliation(s)
- Shizhong Zhang
- 1Division of Gastroenterology and Hepatology, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and
| | - Zhenyu Liu
- 2Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrea Heldsinger
- 1Division of Gastroenterology and Hepatology, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and
| | - Chung Owyang
- 1Division of Gastroenterology and Hepatology, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and
| | - Shaoyong Yu
- 2Johns Hopkins University School of Medicine, Baltimore, Maryland
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Ma J, Altomare A, Guarino M, Cicala M, Rieder F, Fiocchi C, Li D, Cao W, Behar J, Biancani P, Harnett KM. HCl-induced and ATP-dependent upregulation of TRPV1 receptor expression and cytokine production by human esophageal epithelial cells. Am J Physiol Gastrointest Liver Physiol 2012; 303:G635-45. [PMID: 22790593 PMCID: PMC3468560 DOI: 10.1152/ajpgi.00097.2012] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The pathogenesis of gastroesophageal reflux disease (GERD) remains elusive, but recent evidence suggests that early secretion of inflammatory cytokines and chemokines by the mucosa leads to influx of immune cells followed by tissue damage. We previously showed that exposure of esophageal mucosa to HCl causes ATP release, resulting in activation of acetyl-CoA:1-O-alkyl-sn-glycero-3-phosphocholine acetyltransferase (lyso-PAF AT), the enzyme responsible for the production of platelet-activating factor (PAF). In addition, HCl causes release of IL-8 from the esophageal mucosa. We demonstrate that esophageal epithelial cells secrete proinflammatory mediators in response to HCl and that this response is mediated by ATP. Monolayers of the human esophageal epithelial cell line HET-1A were exposed to acidified cell culture medium (pH 5) for 12 min, a total of seven times over 48 h, to simulate the recurrent acid exposure clinically occurring in GERD. HCl upregulated mRNA and protein expression for the acid-sensing transient receptor potential cation channel, subfamily vanilloid member 1 (TRPV1), lyso-PAF AT, IL-8, eotaxin-1, -2, and -3, macrophage inflammatory protein-1α, and monocyte chemoattractant protein-1. The chemokine profile secreted by HET-1A cells in response to repeated HCl exposure parallels similar findings in erosive esophagitis patients. In HET-1A cells, the TRPV1 agonist capsaicin reproduced these findings for mRNA of the inflammatory mediators lyso-PAF AT, IL-8, and eotaxin-1. These effects were blocked by the TRPV1 antagonists iodoresiniferatoxin and JNJ-17203212. These effects were imitated by direct application of ATP and blocked by the nonselective ATP antagonist suramin. We conclude that HCl/TRPV-induced ATP release upregulated secretion of various chemoattractants by esophageal epithelial cells. These chemoattractants are selective for leukocyte subsets involved in acute inflammatory responses and allergic inflammation. The data support the validity of HET-1A cells as a model of the response of the human esophageal mucosa in GERD.
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Affiliation(s)
- Jie Ma
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,2School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China;
| | - Annamaria Altomare
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,3Department of Digestive Disease of Campus Bio Medico University of Rome, Rome, Italy;
| | - Michele Guarino
- 3Department of Digestive Disease of Campus Bio Medico University of Rome, Rome, Italy;
| | - Michele Cicala
- 3Department of Digestive Disease of Campus Bio Medico University of Rome, Rome, Italy;
| | - Florian Rieder
- 4Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio; and
| | - Claudio Fiocchi
- 4Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio; and
| | - Dan Li
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Weibiao Cao
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,5Department of Pathology, Rhode Island Hospital and Brown University, Providence, Rhode Island
| | - Jose Behar
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Piero Biancani
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Karen M. Harnett
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
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Ma J, Altomare A, Rieder F, Behar J, Biancani P, Harnett KM. ATP: a mediator for HCl-induced TRPV1 activation in esophageal mucosa. Am J Physiol Gastrointest Liver Physiol 2011; 301:G1075-82. [PMID: 21960521 PMCID: PMC3233789 DOI: 10.1152/ajpgi.00336.2011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In esophageal mucosa, HCl causes TRPV1-mediated release of calcitonin gene-related peptide (CGRP) and substance P (SP) from submucosal neurons and of platelet-activating factor (PAF) from epithelial cells. CGRP and SP release was unaffected by PAF antagonists but reduced by the purinergic antagonist suramin. ATP caused CGRP and SP release from esophageal mucosa, confirming a role of ATP in the release. The human esophageal epithelial cell line HET-1A was used to identify epithelial cells as the site of ATP release. HCl caused ATP release from HET-1A, which was reduced by the TRPV1 antagonist 5-iodoresiniferatoxin. Real-time PCR demonstrated the presence of mRNA for several P2X and P2Y purinergic receptors in epithelial cells. HCl also increased activity of lyso-PAF acetyl-CoA transferase (lyso-PAF AT), the enzyme responsible for production of PAF. The increase was blocked by suramin. ATP caused a similar increase, confirming ATP as a mediator for the TRPV1-induced increase in enzyme activity. Repeated exposure of HET-1A cells to HCl over 2 days caused upregulation of mRNA and protein expression for lyso-PAF AT. Suramin blocked this response. Repeated exposure to ATP caused a similar mRNA increase, confirming ATP as a mediator for upregulation of the enzyme. Thus, HCl-induced activation of TRPV1 causes ATP release from esophageal epithelial cells that causes release of CGRP and SP from esophageal submucosal neurons and activation of lyso-PAF AT, the enzyme responsible for the production of PAF in epithelial cells. Repeated application of HCl or of ATP causes upregulation of lyso-PAF AT in epithelial cells.
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Affiliation(s)
- Jie Ma
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,2School of Pharmaceutical Sciences, Jilin University , Changchun, Jilin, China;
| | - Annamaria Altomare
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,3Department of Digestive Disease of Campus Bio Medico University of Rome, Rome, Italy; and
| | - Florian Rieder
- 4Departments of Pathobiology, Lerner Research Institute, and Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Jose Behar
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Piero Biancani
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Karen M. Harnett
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
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Abstract
Gastroesophageal reflux disease (GERD) affects 20-30% of the population in Western countries, and is one of the most common clinical problems in daily practice. GERD-associated functional and structural abnormalities are caused by recurrent exposure of the esophagus to acidic and nonacidic refluxate of gastric contents (containing duodenal and intestinal proteases as well as acid and gastric pepsin) from the stomach. Major progress has been made in the understanding of the molecular pathogenesis of GERD-associated mucosal inflammation, suggesting a complex and multifactorial pathogenesis and immune-mediated effects. This Review summarizes the complexity of mucosal pathogenesis, including microscopic changes, mucosal inflammation and GERD-specific molecular mediators, in the context of the clinical features and pathophysiological characteristics of GERD. The abnormal exposure of the esophagus to luminal contents leads to chronic mucosal inflammation that is characterized by the release of IL-8 specifically, as well as other proinflammatory mediators, from the esophageal mucosa. Evidence from animal studies indicates a stepwise inflammatory response by the epithelium, which attracts immune effector cells to infiltrate the mucosa. From bench to bedside, these novel molecular findings might provide new treatment options beyond current acid-suppressive therapy and the principle of inhibition of transient lower esophageal sphincter relaxation.
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Park SY, Lee YJ, Min Y, Kim HR, Jeong JH, Sohn UD. The mechanism of MAP kinase activation under acidic condition in feline esophageal smooth muscle cells. Arch Pharm Res 2011; 34:1759-68. [PMID: 22076776 DOI: 10.1007/s12272-011-1020-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 08/02/2011] [Accepted: 08/04/2011] [Indexed: 12/21/2022]
Abstract
Reflux esophagitis results from repeated exposure of the esophagus to acidic gastric juice or bile-containing duodenal contents. In Barrett's adenocarcinoma, acid increases proliferation via ERK and p38 MAPK activation. This study was focused on determination of the mechanism(s) underlying MAPKs (ERK 1/2, p38 MAPK, and JNK) activation induced by acidic medium at pH 4 in normal feline primary cultured esophageal smooth muscle cells (FESMCs). We detected ERK 1/2 and p38 MAPK phosphorylation after exposure to pH 4 or neutral media in the presence or absence of several inhibitors and quantified the MAPK levels using western blotting analysis and densitometry. Acidic medium markedly increased the phosphorylation of ERK 1/2 and p38 MAPK within 10 min. Acid-induced ERK 1/2 and p38 MAPK activation was inhibited by pertussis toxin (PTX-sensitive G(i/o) protein inhibitor), DEDA (phospholipase (PL) A(2) inhibitor), ρCMB (PLD inhibitor), GF109203X (protein kinase C (PKC) inhibitor) and D609 (phosphatidylcholine-specific PLC inhibitor). But, genistein (tyrosine kinase inhibitor), forskolin (adenylate cyclase activator) and U73122 (phosphatidylinositol-specific PLC inhibitor) had no effect on acid-induced ERK1/2 and p38 MAPK activation. These findings indicate that the activation of ERK 1/2 and p38 MAPK pathways by acidic conditions, at least in part, may be mediated by activation of the G(i/o) protein coupled receptors, PC-PLC, PLD, PLA(2), and PKC in FESMCs.
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Affiliation(s)
- Sun Young Park
- Department of Pharmacology, College of Pharmacy, Chung-Ang University, Seoul 156-756, Korea
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10
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Harnett KM, Rieder F, Behar J, Biancani P. Viewpoints on Acid-induced inflammatory mediators in esophageal mucosa. J Neurogastroenterol Motil 2010; 16:374-88. [PMID: 21103419 PMCID: PMC2978390 DOI: 10.5056/jnm.2010.16.4.374] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2010] [Revised: 08/18/2010] [Accepted: 08/21/2010] [Indexed: 12/13/2022] Open
Abstract
We have focused on understanding the onset of gastroesophageal reflux disease by examining the mucosal response to the presence of acid in the esophageal lumen. Upon exposure to HCl, inflammation of the esophagus begins with activation of the transient receptor potential channel vanilloid subfamily member-1 (TRPV1) in the mucosa, and production of IL-8, substance P (SP), calcitonin gene related peptide (CGRP) and platelet activating factor (PAF). Production of SP and CGRP, but not PAF, is abolished by the neural blocker tetrodotoxin suggesting that SP and CGRP are neurally released and that PAF arises from non neural pathways. Epithelial cells contain TRPV1 receptor mRNA and protein and respond to HCl and to the TRPV1 agonist capsaicin with production of PAF. PAF, SP and IL-8 act as chemokines, inducing migration of peripheral blood leukocytes. PAF and SP activate peripheral blood leukocytes inducing the production of H2O2. In circular muscle, PAF causes production of IL-6, and IL-6 causes production of additional H2O2, through activation of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidases. Among these, NADPH oxidase 5 cDNA is significantly up-regulated by exposure to PAF; H2O2 content of esophageal and lower esophageal sphincter circular muscle is elevated in human esophagitis, causing dysfunction of esophageal circular muscle contraction and reduction in esophageal sphincter tone. Thus esophageal keratinocytes, that constitute the first barrier to the refluxate, may also serve as the initiating cell type in esophageal inflammation, secreting inflammatory mediators and pro-inflammatory cytokines and affecting leukocyte recruitment and activity.
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Affiliation(s)
- Karen M Harnett
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, RI, USA
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11
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Ma J, Altomare A, de la Monte S, Tong M, Rieder F, Fiocchi C, Behar J, Shindou H, Biancani P, Harnett KM. HCl-induced inflammatory mediators in esophageal mucosa increase migration and production of H2O2 by peripheral blood leukocytes. Am J Physiol Gastrointest Liver Physiol 2010; 299:G791-8. [PMID: 20616304 PMCID: PMC2950690 DOI: 10.1152/ajpgi.00160.2010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Exposure of esophageal mucosa to hydrochloric acid (HCl) is a crucial factor in the pathogenesis of reflux disease. We examined supernatant of HCl-exposed rabbit mucosa for inflammatory mediators enhancing migration of leukocytes and production of H(2)O(2) as an indicator of leukocyte activation. A tubular segment of rabbit esophageal mucosa was tied at both ends to form a sac, which was filled with HCl-acidified Krebs buffer at pH 5 (or plain Krebs buffer as control) and kept oxygenated at 37 degrees C. The medium around the sac (supernatant) was collected after 3 h. Rabbit peripheral blood leukocytes (PBL) were isolated, and sac supernatant was used to investigate PBL migration and H(2)O(2) production. HCl-exposed esophageal mucosa released substance P (SP), CGRP, platelet-activating factor (PAF), and IL-8 into the supernatant. PBL migration increased in response to IL-8 or to supernatant of the HCl-filled mucosal sac. Supernatant-induced PBL migration was inhibited by IL-8 antibodies and by antagonists for PAF (CV3988) or neurokinin 1 (i.e., SP), but not by a CGRP antagonist. Supernatant of the HCl-filled mucosal sac increased H(2)O(2) release by PBL that was significantly reduced by CV3988 and by a SP antagonist but was not affected by IL-8 antibodies or by a CGRP antagonist. We conclude that IL-8, PAF, and SP are important inflammatory mediators released by esophageal mucosa in response to acid that promote PBL migration. In addition, PAF and SP induce production of H(2)O(2) by PBL. These findings provide a direct link between acid exposure and recruitment and activation of immune cells in esophageal mucosa.
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Affiliation(s)
- Jie Ma
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,2School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China;
| | - Annamaria Altomare
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,3Department of Digestive Disease of Campus Bio Medico University of Rome, Rome, Italy;
| | - Suzanne de la Monte
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Ming Tong
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Florian Rieder
- 4Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio; and
| | - Claudio Fiocchi
- 4Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio; and
| | - Jose Behar
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Hideo Shindou
- 5Department of Biochemistry and Molecular Biology, University of Tokyo, Tokyo, Japan
| | - Piero Biancani
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Karen M. Harnett
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
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12
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Rieder F, Biancani P, Harnett K, Yerian L, Falk GW. Inflammatory mediators in gastroesophageal reflux disease: impact on esophageal motility, fibrosis, and carcinogenesis. Am J Physiol Gastrointest Liver Physiol 2010; 298:G571-81. [PMID: 20299604 PMCID: PMC2867418 DOI: 10.1152/ajpgi.00454.2009] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Gastroesophageal reflux disease (GERD) is one of the most common problems in clinical practice today. It is widely believed that functional and structural abnormalities of the gastroesophageal junction as well as an abnormal exposure to gastroduodenal contents are the main contributors to its pathogenesis. Novel findings of the inflammatory process in GERD suggest a far more complex process involving multifaceted inflammatory mechanisms. This review summarizes knowledge about the expression of inflammatory mediators in GERD and their potential cellular sources and provides an integrated concept of disease pathogenesis. In addition we evaluate the contribution of inflammatory mediators to well-known complications of GERD, namely motility abnormalities, fibrosis, and carcinogenesis. Novel findings regarding the pathophysiology of esophageal inflammation should enhance our understanding of GERD and its complications and provide new treatment insights.
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Affiliation(s)
- Florian Rieder
- Dept. of Gastroenterology and Hepatology, NC22, Cleveland Clinic Foundation; 9500 Euclid Ave., Cleveland, OH, 44195.
| | - Piero Biancani
- 4Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island
| | - Karen Harnett
- 4Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island
| | - Lisa Yerian
- 3Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio; and
| | - Gary W. Falk
- 2Department of Gastroenterology and Hepatology, and
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13
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Ma J, Harnett KM, Behar J, Biancani P, Cao W. Signaling in TRPV1-induced platelet activating factor (PAF) in human esophageal epithelial cells. Am J Physiol Gastrointest Liver Physiol 2010; 298:G233-40. [PMID: 19959817 PMCID: PMC2822503 DOI: 10.1152/ajpgi.00409.2009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Transient receptor potential channel, vanilloid subfamily member 1 (TRPV1) receptors were identified in human esophageal squamous epithelial cell line HET-1A by RT-PCR and by Western blot. In fura-2 AM-loaded cells, the TRPV1 agonist capsaicin caused a fourfold cytosolic calcium increase, supporting a role of TRPV1 as a capsaicin-activated cation channel. Capsaicin increased production of platelet activating factor (PAF), an important inflammatory mediator that acts as a chemoattractant and activator of immune cells. The increase was reduced by the p38 MAP kinase (p38) inhibitor SB203580, by the cytosolic phospholipase A2 (cPLA(2)) inhibitor AACOCF3, and by the lyso-PAF acetyltransferase inhibitor sanguinarin, indicating that capsaicin-induced PAF production may be mediated by activation of cPLA(2), p38, and lyso-PAF acetyltransferase. To establish a sequential signaling pathway, we examined the phosphorylation of p38 and cPLA(2) by Western blot. Capsaicin induced phosphorylation of p38 and cPLA(2). Capsaicin-induced p38 phosphorylation was not affected by AACOCF3. Conversely, capsaicin-induced cPLA(2) phosphorylation was blocked by SB203580, indicating that capsaicin-induced PAF production depends on sequential activation of p38 and cPLA(2). To investigate how p38 phosphorylation may result from TRPV1-mediated calcium influx, we examined a possible role of calmodulin kinase (CaM-K). p38 phosphorylation was stimulated by the calcium ionophore A23187 and by capsaicin, and the response to both agonists was reduced by a CaM inhibitor and by CaM-KII inhibitors, indicating that calcium induced activation of CaM and CaM-KII results in P38 phosphorylation. Acetyl-CoA transferase activity increased in response to capsaicin and was inhibited by SB203580, indicating that p38 phosphorylation in turn causes activation of acetyl-CoA transferase to produce PAF. Thus epithelial cells produce PAF in response to TRPV1-mediated calcium elevation.
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Affiliation(s)
- Jie Ma
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; ,2School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Karen M. Harnett
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Jose Behar
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Piero Biancani
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
| | - Weibiao Cao
- 1Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island;
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14
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Cheng L, de la Monte S, Ma J, Hong J, Tong M, Cao W, Behar J, Biancani P, Harnett KM. HCl-activated neural and epithelial vanilloid receptors (TRPV1) in cat esophageal mucosa. Am J Physiol Gastrointest Liver Physiol 2009; 297:G135-43. [PMID: 19389802 PMCID: PMC2711757 DOI: 10.1152/ajpgi.90386.2008] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To test whether transient receptor potential channel vanilloid subfamily member-1 (TRPV1) mediates acid-induced inflammation in the esophagus, a tubular segment of esophageal mucosa was tied at both ends, forming a sac. The sac was filled with 0.01 N HCl (or Krebs buffer for control) and kept in oxygenated Krebs buffer at 37 degrees C. The medium around the sac (supernatant) was collected after 3 h. Supernatant of the HCl-filled sac abolished contraction of esophageal circular muscle strips in response to electric field stimulation. Contraction was similarly abolished by supernatant of mucosal sac filled with the TRPV1 agonist capsaicin (10(-6) M). These effects were reversed by the selective TRPV1 antagonist 5'-iodoresiniferatoxin (IRTX) and by the platelet-activating factor (PAF) receptor antagonist CV9388. Substance P and CGRP levels in mucosa and in supernatant increased in response to HCl, and these increases were abolished by IRTX and by tetrodotoxin (TTX) but not affected by CV9388, indicating that substance P and CGRP are neurally released and PAF independent. In contrast, the increase in PAF was blocked by IRTX but not by TTX. Presence of TRPV1 receptor was confirmed by RT-PCR and by Western blot analysis in whole mucosa and in esophageal epithelial cells enzymatically isolated and sorted by flow cytometry or immunoprecipitated with cytokeratin antibodies. In epithelial cells PAF increased in response to HCl, and the increase was abolished by IRTX. We conclude that HCl-induced activation of TRPV1 receptors in esophageal mucosa causes release of substance P and CGRP from neurons and release of PAF from epithelial cells.
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Affiliation(s)
- Ling Cheng
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Suzanne de la Monte
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Jie Ma
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Jie Hong
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Ming Tong
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Weibiao Cao
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Jose Behar
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Piero Biancani
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
| | - Karen M. Harnett
- Department of Medicine, Rhode Island Hospital and Brown University, Providence, Rhode Island; and School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, China
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15
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Park SY, Youm JH, Jung KC, Sohn UD. Inhibitory effect of hypochlorous acid on lower esophageal sphincter tone relaxation by vasoactive intestinal peptide. Arch Pharm Res 2008; 31:1552-8. [PMID: 19099223 DOI: 10.1007/s12272-001-2150-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Revised: 11/27/2008] [Accepted: 11/27/2008] [Indexed: 11/30/2022]
Abstract
Under physiological conditions, hypochlorous acid (HOCl) is the major product of myeloperoxidase, a ferric heme enzyme released in inflammatory diseases. In the present study, we investigated the effect of HOCl compared to hydrogen peroxide (H2O2) on the vasoactive intestinal polypeptide (VIP)-induced relaxation of feline lower esophageal sphincter (LES) strips. Isometric tension on LES strips was measured using a force transducer. VIP induced the relaxation of basal LES tone in a concentration-dependent manner. Pretreatment with HOCl (10(-4) M) significantly reduced the VIP-induced relaxation at smaller concentrations than H2O2 (10(-3) M). VIP-induced relaxation is mediated via the Gi/o protein, since pretreatment with Pertussis Toxin (PTX) showed an inhibitory effect on the relaxation. HOCl showed an additional inhibitory effect on the reduced relaxation by PTX, indicating that HOCl might affect another G protein as well as Gi/o. However, HOCl did not affect SNP-, SIN-1-, and 8-br-cGMP-induced relaxation. Nor did HOCl modify the relaxation induced by either forskolin or db-cAMP in LES muscle strips. These results suggest that during short-term treatment, HOCl may damage the upstream events including G protein level, and result in alteration of LES tone in the feline esophagus, similar to the inhibitory effects of H2O2.
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Affiliation(s)
- Sun Young Park
- Department of Pharmacology, College of Pharmacy, University of Chung-Ang, Seoul, 156-756, Korea
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16
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van Roon AHC, Mayne GC, Wijnhoven BPL, Watson DI, Leong MP, Neijman GE, Michael MZ, McKay AR, Astill D, Hussey DJ. Impact of gastro-esophageal reflux on mucin mRNA expression in the esophageal mucosa. J Gastrointest Surg 2008; 12:1331-40. [PMID: 18452049 DOI: 10.1007/s11605-008-0522-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2008] [Accepted: 03/26/2008] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Changes in the expression of mucin genes in the esophageal mucosa associated with uncomplicated gastro-esophageal reflux disease have not been evaluated even though such changes could be associated with reflux-induced mucosal damage. We therefore sought to identify reflux-induced changes in mucin gene expression using a cell line and biopsies from the esophageal mucosa in patients with and without reflux. METHODS MUC-1, MUC-3, MUC-4, and MUC-5AC gene expressions were investigated in the HET-1A cell line following exposure to acid (pH 4) and/or bile (120 muM of a bile salt milieu), and in esophageal mucosal biopsies from controls, subjects with non-erosive gastro-esophageal reflux, and subjects with reflux associated with ulcerative esophagitis (erosive). The mucosal biopsies were also evaluated for IL-6 mRNA expression (inflammatory marker) and CK-14 mRNA expression (mucosal basal cell layer marker). Gene expression was determined using real-time reverse transcriptase-polymerase chain reaction analysis. RESULTS In the cell line studies, there were differences in mRNA levels for all of the evaluated mucins following treatment with either acid or the acid and bile combination. In the studies which evaluated tissue specimens, IL-6 and CK-14 mRNA levels increased according to degree of reflux pathology. The expression of MUC-1 and MUC-4 in mucosa from patients with erosive reflux was lower than in subjects without reflux and in patients with non-erosive reflux, whereas the expression of MUC-3 and MUC-5AC was increased (although these differences did not reach significance at p < 0.05). When mRNA expression data for tissue samples from all groups were combined, significant correlations were identified between IL-6 vs. CK-14 and IL-6 vs. MUC-3, MUC-3 vs. CK-14 and MUC-3 vs. MUC-5AC, and for MUC-1 vs. MUC-5AC. The correlation between IL-6 and CK-14 was also significant within the control and non-erosive reflux groups. The correlation between IL-6 and MUC-3 was significant within the control and erosive reflux groups, and the correlation between MUC-1 and MUC-5AC was significant within the erosive reflux group. CONCLUSIONS The results of this study suggest that the profile of mucin expression in the esophageal mucosa is influenced by the pH and composition of the gastro-esophageal reflux. Further work should explore the response of these genes to acid and bile reflux, and their role in the etiology of mucosal damage in gastro-esophageal reflux.
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Affiliation(s)
- Aafke H C van Roon
- Department of Surgery, Flinders Medical Centre, Flinders University, Room 3D211, Bedford Park, South Australia, 5042, Australia
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17
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Abstract
Nonerosive reflux disease (NERD) is the most common phenotype of gastroesophageal reflux disease. By definition, patients with NERD have typical reflux symptoms caused by the intraesophageal reflux of gastric contents but have no visible esophageal mucosal injury. This is in contrast to patients with reflux esophagitis, also known as erosive reflux disease, and Barrett's esophagus, who have obvious esophageal mucosal injury on endoscopy. Only 50% of patients with NERD have pathologic esophageal acid contact time (ACT) as detected on 24-hour pH monitoring (ie, NERD-positive). NERD patients with physiologic esophageal ACT and good temporal correlation of symptoms with reflux events (symptom index > 50% or symptom-association probability > 95%) are considered to have esophageal hypersensitivity (ie, NERD-negative). Finally, patients with physiologic esophageal ACT but poor symptom-reflux correlation are now considered to have functional heartburn and not NERD. NERD-positive patients have motor dysfunction and acidic reflux abnormalities that are similar to patients with reflux esophagitis and Barrett's esophagus, whereas NERD-negative patients have minimal abnormalities that are not much different than healthy controls. The histopathologic feature most indicative of NERD is the presence of dilated intercellular spaces within squamous epithelium, an ultrastructural abnormality readily identified on transmission electron microscopy and on light microscopy.
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Affiliation(s)
- John D Long
- Section of Gastroenterology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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18
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Fornari F, Blondeau K, Durand L, Rey E, Diaz-Rubio M, De Meyer A, Tack J, Sifrim D. Relevance of mild ineffective oesophageal motility (IOM) and potential pharmacological reversibility of severe IOM in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2007; 26:1345-54. [PMID: 17892523 DOI: 10.1111/j.1365-2036.2007.03525.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Several studies showed high prevalence of ineffective oesophageal motility (IOM) in gastro-oesophageal reflux disease (GERD) and suggested an important role for ineffective oesophageal motility in increased acid exposure. However, impedance-manometric studies proposed that only severe ineffective oesophageal motility might affect oesophageal clearance. OBJECTIVES (i) To re-assess the relevance of mild IOM in GERD and (ii) to test the reversibility of IOM. METHODS Oesophageal motility, clearance and acid exposure were assessed in 191 GERD patients: 99 without IOM; 58 with mild IOM (30-80% ineffective contractions) and 34 with severe IOM (>80% ineffective contractions). In 30 patients with oesophagitis, the potential reversibility of IOM was evaluated with edrophonium intravenously. RESULTS Patients with mild IOM had identical oesophageal clearance and acid exposure in comparison with those without IOM. Patients with severe IOM had a higher probability of prolonged supine clearance and acid exposure [odds ratio: 2.88 (1.16-7.17); 2.48 (0.99-6.17)]. This effect was independent of the presence of hiatal hernia and male sex. Severe IOM could be transiently reverted in 55% of patients. CONCLUSIONS Mild IOM does not affect oesophageal clearance. Only severe IOM is associated with prolonged clearance and acid exposure, particularly in supine periods. The edrophonium test might be useful to predict severe IOM response to prokinetic medications.
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Affiliation(s)
- F Fornari
- Center for Gastroenterological Research, Catholic University of Leuven, Leuven, Belgium
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19
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Paterson WG, Kieffer CA, Feldman MJ, Miller DV, Morris GP. Role of platelet-activating factor in acid-induced esophageal mucosal injury. Dig Dis Sci 2007; 52:1861-6. [PMID: 17415649 DOI: 10.1007/s10620-006-9385-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Accepted: 04/06/2006] [Indexed: 12/09/2022]
Abstract
Studies on the pathophysiology of reflux esophagitis have focused on the associated motility and/or structural abnormalities, with relatively little attention directed to inflammatory mediators involved in the acid-induced mucosal injury. Mast cells line the subepithelial lamina propria in both humans and the opossum model, and are ideally positioned to respond to luminal agents that cross the mucosal barrier. To determine whether certain mast cell mediators are involved in acid-induced mucosal injury, epithelial injury scores following 60 min of luminal perfusion of the opossum esophagus with 100 mM HCl were compared in the presence and absence of two different mast cell stabilizers (disodium cromoglycate and doxantrazole) or the selective platelet-activating factor antagonist TCV-309. In control animals acid perfusion caused release of PAF and significant epithelial injury, characterized by epithelial sloughing and cleft formation. This injury was unaffected by pretreatment with disodium cromoglycate or doxantrazole but was completely prevented by TCV-309 (histology damage score, 2.40+/-0.28 in controls vs 0.50 +/- 0.14 in TCV-309-treated animals). These studies suggest that platelet-activating factor is an important mediator of acid-induced esophageal mucosal damage.
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Affiliation(s)
- W G Paterson
- GI Division, Hotel Dieu Hospital, Kingston, Ontario, K7L 5G2, Canada.
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20
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Abstract
Motor abnormalities of the oesophagus are characterised by a chronic impairment of the neuromuscular structures that co-ordinate oesophageal function. The best-defined entity is achalasia, which is discussed in a separate chapter. Other motor disorders with clinical relevance include diffuse oesophageal spasm, oesophageal dysmotility associated with scleroderma, and ineffective oesophageal motility. These non-achalasic motor disorders have variable prevalence but they could be associated with invalidating symptoms such as dysphagia, chest pain and gastro-oesophageal reflux disease. New oesophageal diagnostic techniques, including high-resolution manometry, high-frequency intraluminal ultrasound and intraluminal impedance, allow (1) better definition of peristalsis and sphincter function, (2) assessment of changes in oesophageal wall thickness, and (3) evaluation of pressure gradients within the oesophagus and across the sphincters that can produce normal or abnormal patterns of bolus transport. This chapter discusses recent advances in physiology, pathophysiology, diagnosis and treatment of non-achalasic oesophageal motor disorders.
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Affiliation(s)
- Daniel Sifrim
- Centre for Gastroenterological Research, Catholic University of Leuven, Faculty of Medicine, Belgium.
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21
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Cao W, Cheng L, Behar J, Biancani P, Harnett KM. IL-1beta signaling in cat lower esophageal sphincter circular muscle. Am J Physiol Gastrointest Liver Physiol 2006; 291:G672-80. [PMID: 16645161 DOI: 10.1152/ajpgi.00110.2006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In a cat model of acute experimental esophagitis, resting in vivo lower esophageal sphincter (LES) pressure and in vitro tone are lower than in normal LES, and the LES circular smooth muscle layer contains elevated levels of IL-1beta that decrease the LES tone of normal cats. We now examined the mechanisms of IL-1beta-induced reduction in LES tone. IL-1beta significantly reduced acetylcholine-induced Ca(2+) release in Ca(2+)-free medium, and this effect was partially reversed by catalase, demonstrating a role of H(2)O(2) in these changes. IL-1beta significantly increased the production of H(2)O(2), and the increase was blocked by the p38 MAPK inhibitor SB-203580, by the cytosolic phospholipase A(2) (cPLA(2)) inhibitor AACOCF3, and by the NADPH oxidase inhibitor apocynin, but not by the MEK1 inhibitor PD-98059. IL-1beta significantly increased the phosphorylation of p38 MAPK and cPLA(2). IL-1beta-induced cPLA(2) phosphorylation was blocked by SB-203580 but not by AACOCF3, suggesting sequential activation of p38 MAPK-phosphorylating cPLA(2). The IL-1beta-induced reduction in LES tone was partially reversed by AACOCF3 and by the Ca(2+)-insensitive PLA(2) inhibitor bromoenol lactone (BEL). IL-1beta significantly increased cyclooxygenase (COX)-2 and PGE(2) levels. The increase in PGE(2) was blocked by SB-203580, AACOCF3, BEL, and the COX-2 inhibitor NS-398 but not by PD-98059 or the COX-1 inhibitor valeryl salicylate. The data suggested that IL-1beta reduces LES tone by producing H(2)O(2), which may affect Ca(2+)-release mechanisms and increase the synthesis of COX-2 and PGE(2). Both H(2)O(2) and PGE(2) production depend on sequential activation of p38 MAPK and cPLA(2). cPLA(2) activates NADPH oxidases, producing H(2)O(2), and may produce arachidonic acid, converted to PGE(2) via COX-2.
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Affiliation(s)
- Weibiao Cao
- Dept. of Medicine, Brown Medical School and Rhode Island Hospital, 55 Claverick St., Rm. 336, Providence, RI 02903, USA
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Naito Y, Yoshida N, Yoshikawa T. Esophageal inflammation in gastroesophageal reflux disease (GERD): role of chemokines. Inflamm Regen 2006. [DOI: 10.2492/inflammregen.26.428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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