The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease

Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parame...

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Main Authors: Andreas Nakos, Georgios Kouklakis, Michail Pitiakoudis, Petros Zezos, Eleni Efraimidou, Alexandra Giatromanolaki, Alexandros Polychronidis, Nikolaos Liratzopoulos, Efthimios Sivridis, Konstantinos Simopoulos
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2011/905872
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author Andreas Nakos
Georgios Kouklakis
Michail Pitiakoudis
Petros Zezos
Eleni Efraimidou
Alexandra Giatromanolaki
Alexandros Polychronidis
Nikolaos Liratzopoulos
Efthimios Sivridis
Konstantinos Simopoulos
author_facet Andreas Nakos
Georgios Kouklakis
Michail Pitiakoudis
Petros Zezos
Eleni Efraimidou
Alexandra Giatromanolaki
Alexandros Polychronidis
Nikolaos Liratzopoulos
Efthimios Sivridis
Konstantinos Simopoulos
author_sort Andreas Nakos
collection DOAJ
description Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI). The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53 GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53) of patients with GERD and in 13% (2/15) of controls (𝑃=0.02). Severe esophageal lesions were significantly more common in BRI (+) patients (14/25) compared to BRI (−) ones (𝑃=0.0049). Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa.
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spelling doaj-art-e3ab44274bbe485fa4f08ce7ab1b14cd2025-08-20T03:26:31ZengWileyGastroenterology Research and Practice1687-61211687-630X2011-01-01201110.1155/2011/905872905872The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux DiseaseAndreas Nakos0Georgios Kouklakis1Michail Pitiakoudis2Petros Zezos3Eleni Efraimidou4Alexandra Giatromanolaki5Alexandros Polychronidis6Nikolaos Liratzopoulos7Efthimios Sivridis8Konstantinos Simopoulos9Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, GreeceGastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece2nd Department of Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, GreeceGastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece1st Department of Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, GreecePathology Department, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, GreecePathology Department, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece1st Department of Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, GreecePathology Department, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece2nd Department of Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, GreeceIntroduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI). The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53 GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53) of patients with GERD and in 13% (2/15) of controls (𝑃=0.02). Severe esophageal lesions were significantly more common in BRI (+) patients (14/25) compared to BRI (−) ones (𝑃=0.0049). Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa.http://dx.doi.org/10.1155/2011/905872
spellingShingle Andreas Nakos
Georgios Kouklakis
Michail Pitiakoudis
Petros Zezos
Eleni Efraimidou
Alexandra Giatromanolaki
Alexandros Polychronidis
Nikolaos Liratzopoulos
Efthimios Sivridis
Konstantinos Simopoulos
The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
Gastroenterology Research and Practice
title The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
title_full The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
title_fullStr The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
title_full_unstemmed The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
title_short The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
title_sort histological and immunohistochemical aspects of bile reflux in patients with gastroesophageal reflux disease
url http://dx.doi.org/10.1155/2011/905872
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