Human leukocyte antigen HLADRB1 determinants susceptibility to gastroesophageal reflux disease

BACKGROUND

- Gastroesophageal reflux disease (GERD) is characterized by diverse symptoms. There is an evidence for a genetic component to GERD as supported by familial aggregation of this disease.

OBJECTIVE

- To investigate whether certain human leucocyte antigen genes HLA-DRB1 are associated with GERD.

METHODS

- Patients and controls were prospectively recruited from GIT center at Al-Kindy Teaching Hospital (Baghdad-Iraq) between January 2014 and July 2016. Sixty Iraqi Arab Muslims patients with a history of heartburn and dyspepsia compared with 100 Iraqi Arab Muslims controls. All study patients and control groups underwent upper gastrointestinal endoscopic examinations and their serums were analyzed for CagA antibodies Immunoglobulin G (IgG) for H. pylori. HLA-DRB1 genotyping were done to both groups.

RESULTS

- A total of 60 patients with erosive gastritis; GERD (Grade II and III) were evaluated, together with 100 controls. There is a significant increase of H. pylori infection (P=0.0001) in GERD patients than control group. HLA-DRB1* 15:01 was significantly increased in GERD patients in comparison with control group and an increased frequency of HLADRB1*11:01 in control group compared with patients group.

CONCLUSION

- There is an association between HLA-DRB1 *15:01 in GERD patients with H. pylori positive patients.

Frequency of antisperm antibodies in infertile women

BACKGROUND

Infertility is one of the common problems seen in couples of reproductive age. Presence of antisperm antibodies in semen and serum are amongst the causes of immunoinfertility. This study was performed to determine antisperm antibodies in cervicovaginal secretions and serum of infertile women and also measure serum levels of immunoglobulins (IgG, IgM and IgA).

METHODS

The study consisted of 45 infertile women consulting the Kammal El-Sammrari Hospital for infertility from 2008 to 2009 and the control group consisted of 30 fertile women. Serum levels of immunoglobulins (IgG, IgA and IgM) were measured in the participants using single radial immune diffusion. Antisperm antibodies (ASAs) were detected in the serum of both infertile and control groups using indirect immune fluorescence test. ASAs were also detected in cervicovaginal secretion using direct sperm agglutination test in both infertile and control groups.

RESULTS

Antisperm antibodies were found in the cervicovaginal secretions (62.2%) and sera (64.4%) of infertile women which were significantly higher (p <0.001) than those of the control group (3.3% and 3.3% respectively). There was a significant increase (p <0.001) in serum levels of IgG and IgA of infertile women (16.2 and 3.25 g/L respectively) compared with the healthy control group (7 and 1.2 g/L).

CONCLUSION

Humoral immune response and antisperm antibodies may contribute to reproductive failure in couples of reproductive age.

Soluble HLA-E and Gastroesophageal Reflux Disease: A Novel Association‎

Background

Gastroesophageal reflux disease (GERD) is a prevalent clinical condition that affects millions ‎of individuals worldwide.‎.

Objective‎

To assess the level of soluble HLA-E (sHLA-E) as a biomarker in the diagnosis and ‎immunopathogenesis of GERD patients.‎.

Methods‎

The case-control prospective study included 40 GERD patients who were consulted at the ‎Gastroenterology Unit of Al-Kindy Teaching Hospital, as along with 40 healthy control ‎subjects. The study period extended from January 2023 to May 2024. Blood was drawn from ‎both groups and serum was separated to assesss HLA-E using a sandwich enzyme-linked ‎immunosorbent assay (ELISA) kit.‎.

Results

There was a statistically significant difference in sHLA-E levels between GERD patients and ‎healthy controls (p = 0.021). The median sHLA-E level was significantly higher in GERD ‎patients (0.370 ng/mL) compared to controls (0.148 ng/mL). A receiver operating characteristic ‎‎(ROC) curve was generated to evaluate the diagnostic performance of soluble HLA-E (sHLA-E) ‎in predicting GERD. The area under the ROC curve (AUC) was calculated to assess the ‎discriminatory ability of sHLA-E, with a value of 0.649 (95% CI: 0.534-0.752, p = 0.021). The ‎optimal cutoff value for sHLA-E was determined to be ≤0.65 ng/mL, with a sensitivity of ‎‎85.1%, specificity of 27.3%, positive predictive value of 65.9%, negative predictive value of ‎‎69.4%, and accuracy of 35.0%.‎.

Conclusion‎

The study provides evidence of an association between elevated sHLA-E levels and GERD. It ‎also suggests that sHLA-E has a moderate discriminatory ability as a biomarker in predicting ‎GERD.‎.

Galectins: A New Frontier in Gastroesophageal Reflux Disease Research

BACKGROUND

Gastroesophageal reflux disease (GERD) is a common chronic condition characterized by abnormal reflux and regurgitation of stomach contents into the esophagus. Its prevalence is increasing worldwide and poses a high economic burden.

AIM

To explore the potential correlation between galectin-1, galectin-3, galectin-8, galectin-9, and GERD, highlighting their potential role as biomarkers in disease diagnosis, and pathogenesis.

MATERIALS AND METHODS

A prospective cross-sectional study was conducted on 40 patients with GERD disease and 40 healthy control subjects from January 2023-May 2024 at Al-Kindy Teaching Hospital-Gastroenterology Unit. Venous blood was collected from patients and controls. Serums of both groups were quantified for galectin-1, galectin-3, galectin-8, and galectin-9 using a human ELISA kit.

RESULTS

Galectin-1 showed no statistically significant difference in the median levels between patients with GERD and controls (p = 0.567). A significant difference was found in the median levels of galectin-3, with higher levels in patients with GERD compared to controls (p = 0.0037). The most significant was galectin-3, AUC = 0.684 (95% CI: 0.570-0.784), p = 0.003, had a significant moderate discriminatory ability in differentiating between patients with GERD and healthy controls with cutoff value <13.682, sensitivity = 74.4%, specificity = 55%, and accuracy = 61.7%.

CONCLUSIONS

This study suggests that serum galectin-3 is the best potential noninvasive diagnostic biomarker for the prediction and identification of GERD.