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Background: There is still controversy whether the existence of esophageal heterotopic gastric mucosa (EHGM) and its histological type are related to the laryngopharyngeal symptoms. Aims: To analyze the clinical and histological characteristics of EHGM and its correlation with gastroesophageal reflux. Methods: A retrospective study was conducted in consecutive gastroscopy-proved EHGM cases from September 2018 to January 2020 at the Second Affiliated Hospital of Baotou Medical College. Besides clinical data review and questionnaire survey on reflux symptoms, histological typing of EHGM and immunohistochemistry were also performed in some cases. Results: A total of 1 229 cases of EHGM were recruited. The male-to-female ratio was 1.67:1, and middle-aged people were predominant. Most of the heterotopic mucosa were located 15-18 cm away from the incisors, and were mainly single. Two hundred and ninety-four cases (23.9%) were complicated with reflux esophagitis (RE), of which Los Angeles grade A and B accounted for 96.6%. Regurgitation/acid reflux (15.5 %) and heartburn (12.3%) were the most common esophageal symptoms, while extraesophageal symptoms were rare. Histological typing was obtained in 57 cases, of which, 37 (64.9%) were cardia-type, 18 (31.6%) were fundic-type, and 2 (3.5%) were mixed type. There were no significant differences in gender, age, location and number of EHGM, expression levels of H
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Background:It has been demonstrated that H + -K + -ATPase expression in human parietal cells had a tendency to increase with aging. However,the effect of aging on activity of H + -K + -ATPase is still unclear. Aims:To investigate effect of aging on activity of H + -K + -ATPase. Methods:Fifteen male Sprague-Dawley(SD)rats were divided into 4,21,24, 27 and 30 months group,and 19 healthy beagle dogs were divided into younger group,junior elderly group and senior elderly group. The activity of H + -K + -ATPase in gastric fundal mucosa was assessed. Results:The activity of H + -K + -ATPase in gastric fundal mucosa in 4,21,24,27 and 30 months old rats were(4. 850 ± 0. 312)μmol·mg - 1 ·h - 1 , (5. 466 ± 0. 379)μmol·mg - 1 ·h - 1 ,(6. 068 ± 0. 228)μmol·mg - 1 ·h - 1 ,(5. 733 ± 0. 767)μmol·mg - 1 ·h - 1 and (6. 223 ± 0. 428)μmol · mg - 1 · h - 1 ,respectively. With aging,H + -K + -ATPase activity in rats had a tendency to increase(F = 4. 519,P = 0. 031). The activity of H + -K + -ATPase in beagle dogs in younger group,junior elderly group and senior elderly group were(11. 087 ± 4. 320)μmol·mg - 1 ·h - 1 ,(8. 549 ± 3. 250)μmol·mg - 1 ·h - 1 ,(12. 071 ± 2. 820)μmol·mg - 1 ·h - 1 ,respectively. There was no statistically significant difference among the three groups(F =1. 339,P = 0. 290). Conclusions:With aging,the activity of H + -K + -ATPase in rats and beagle dogs does not decline, but even has a tendency to increase.
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Objective To investigate the age-associated changes of ultrastructure,mRNA and protein expressions of H+-K+-ATPase in elderly gastric parietal cell. Methods Fifty patients with relative normal stomach without gastroduodenal diseases were enrolled,including younger group (aged 20-59 years,n=19) and elderly group (aged≥60 years,n=31).Furthermore,the elderly group was divided into 3 subgroups:60-69 years old (n =11 ),70-79 years old (n=10 ),above 80 years old (n =10).The ultrastructure of gastric parietal cell was observed under electron microscope.The expression of H+-K+-ATPase α subunit mRNA and H+-K+-ATPase β subunit protein were assessed by quantitative real-time PCR and Western-blot,respectively.The ageing-associated changes of all these data were respectively compared. Results No significant difference was showed in the morphology of gastric parietal cell and acid-secretion-associated organelles among all the groups.The average ratio Am to Ac (Am means the area of mitochondria,Ac means the area of cytoplasm) of gastric parietal cell and the average At to Ac ratio (At means the area of secretory canaliculi and tubulovesicular system )between younger group and elderly group had no significant difference[(48.4±7.5) ％ vs.(50.6±7.6) ％,t=-0.775,P=0.444; (13.8±4.1) ％ vs.(12.2±4.7) ％,t=0.984,P=0.332].Meanwhile,there were no distinctions in the expression of H+-K+ -ATPase α subunit mRNA and H+-K+-ATPase protein among all elderly subgroups(F=1.522,2.32,P=0.24,0.114).However,the mRNA expression of H+-K+-ATPase a subunit was higher in the elderly group than in the younger group(t=-3.682,P=0.001).Furthermore,the expression of H+ -K+ -ATPase protein in the elderly group was increased as compared with younger group(t=-3.389,P=0.004). Conclusions Acidsecretion-associated organelles of human gastric parietal cell have no degeneration and the expression of H + -K+-ATPase is in trend of increase with aging,indicating that healthy elderly people have the basis of ultrastructure and molecular biology to maintain well function of acid secretion.
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BACKGROUND AND OBJECTIVES: Reflux laryngitis gives rise to inflammatory change in the pharyngolaryngeal tissue with various otolaryngologic and respiratory symptoms. Histamine H2 receptor antagonists and H(+)-K(+)-Exchanging ATPase are currently used as therapeutic medications. However, the efficacy of those two drugs on reflux laryngitis has never been proven yet. Therefore, we intended to analyze and compare the efficacy of the two drugs on reflux laryngitis. MATERIALS AND METHOD: Among the patients who had visited the Department of Otolaryngology, those with the total score of greater than 6 and having more than 2 symptoms that score greater than 2, had undergone laryngoscopy. Of these, the patients who had shown greater than 7 on the Belafsky's Reflux Finding Score (RFS) were studied. The RAN (Ranitidine) group (59 subjects) with Ranitidine administered and RAB (Rabeprazole)group (66 subjects) with Rabeprazole were followed up for 12 weeks, and then the efficacy of each drug was evaluated at 2nd, 4th, and 12th week. Then, the Symptom Score Improvement (SSI) and RFS were compared and analyzed. RESULTS: In comparison the RAN group that had Histamine H2 receptor antagonists and prokinetic agents administered to the RAB group that had H(+)-K(+)-Exchanging ATPase and prokinetic agents administered for the improvement of symptoms caused by reflux laryngitis, no difference was observed till after the first 2 weeks. On the evaluation at 4th and 12th week, statistically higher therapeutic efficacy was shown to a great extent in the RAB group. The findings of laryngoscopy at the 12th week also showed higher therapeutic efficacy in the RAB group. In comparison of symptoms between the groups, there were significant differences in pharyngolaryngeal foreign body sense and chronic throat clearing, and laryngeal edema and injection as well. CONCLUSION: For therapy of reflux laryngitis patients with moderately severe symtpoms, the use of H(+)-K(+)-Exchanging ATPase and prokinetic agents were superior in improving symptoms and clinicopathologic findings of larynx than Histamine H2 receptor antagonists and prokinetic agents.