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- Title
Fragments of e-Cadherin as Biomarkers of Non-erosive Reflux Disease.
- Authors
Jovov, Biljana; Reed, Craig C.; Shaheen, Nicholas J.; Pruitt, Amy; Ferrell, Kathleen; Orlando, Geraldine S.; Djukic, Zorka; Orlando, Roy C.
- Abstract
<bold>Background: </bold>Approximately, 20% of patients with heartburn and normal endoscopic findings do not symptomatically improve on proton pump inhibitor (PPI) therapy making diagnosis and treatment uncertain. A biomarker distinguishing PPI-responsive from PPI-refractory heartburn is desirable.<bold>Aims: </bold>We performed a pilot study assessing whether carboxy(C)-terminal fragments (CTFs) of e-cadherin in esophageal biopsies or amino(N)-terminal fragments (NTFs) of e-cadherin in serum could serve this purpose.<bold>Methods: </bold>Twenty-nine patients with endoscopy-negative heartburn had esophageal biopsies for CTFs on Western blot and blood for serum NTFs on ELISA. All patients received dexlansoprazole 30 mg daily for 4 weeks, and heartburn was assessed by daily diary entry. Post-treatment blood samples were obtained for serum NTFs. A control group without GERD symptoms (n = 6) had biopsies for CTFs and a second control group (n = 20) blood serum for serum NTFs.<bold>Results: </bold>Twenty-seven of 29 patients (93.1%) with endoscopy-negative heartburn, but 0 of 6 controls, were positive for CTFs. All patients and controls had measureable serum NTFs, but mean NTFs were significantly higher in those with PPI-responsive heartburn compared to those with PPI-refractory heartburn and controls. Following treatment, 24 of 29 (82.8) patients had relief of heartburn, which associated with a decline in mean NTFs compared to controls. NTFs in PPI-refractory patients (n = 5) were similar to controls before and after PPI therapy.<bold>Conclusions: </bold>When heartburn responds to PPI, elevated serum NTFs decline to normal. These data suggest that cleaved products of e-cadherin may serve as biomarkers of NERD. Further data are needed to assess and confirm this concept.
- Subjects
GASTROESOPHAGEAL reflux diagnosis; CADHERINS; ENDOSCOPIC surgery; BIOMARKERS; PROTON pump inhibitors; GASTROESOPHAGEAL reflux treatment; ESOPHAGUS; PILOT projects; RESEARCH; RESEARCH methodology; NON-erosive reflux disease; CASE-control method; EVALUATION research; COMPARATIVE studies; GLYCOPROTEINS; LANSOPRAZOLE; RESEARCH funding; HEARTBURN; DISEASE complications
- Publication
Digestive Diseases & Sciences, 2018, Vol 63, Issue 3, p628
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-017-4815-4