GERD食管上皮组织紧密连接蛋白和氧化应激在发病中的研究进展

Role of tight junction proteins and oxidative stress in the pathogenesis of GERD

胃食管反流病(GERD)是一种全球性疾病,国内外流行病学调查证明该病患病率正在增加,并且严重影响患者生活。目前研究显示该病的发病机制极其复杂,故对其研究也是日益深入。近年,有学者用透射电镜或电子光镜发现GERD患者食管下段上皮细胞存在细胞间隙增宽(DIS)这形态学改变,而这可能是食管上皮细胞损伤的一个早期、敏感的形态学指标,因其为食管微观结构的宏观改变,故激发了研究者的研究兴趣,欣起一片该研究方向的热潮。另一方面,氧化应激(OS)也被相关实验研究表明参与食管黏膜的损伤过程。近期国内外的研究进一步提出OS与GERD的发生发展有较密切的关系,而OS过量产生导致食管氧化/抗氧化防御系统受损,进而引起食管上皮存在的紧密连接蛋白结构和功能的异常,结果导致食管上皮的DIS可能是GERD发病机制之一。本文将对以上方面研究现状作一综述。

Gastroesophageal reflux disease (GERD) is a global diseases, the epidemiological studies from both domestic and oversea countries have shown that incidences rate of GERD significantly increased, and severely effects of patients quality of life. Now studies revealed that the pathogenesis of GERD greatly complicated, hence the research studies now gradually paying attention to its mechanism. Recent years, some investigators by using the transmission electron microscopy (TEM) or electronic light microscopy have found that there some morphological changes were exist in the lower esophageal epithelial cells of GERD patients, and speculate that change may be an early and sensitive morphological index of esophageal epithelial cell (microstructures of the esophagus) damage. Therefore, this finding were provided a potential ideas to researchers and inspired them a lot. Furthermore, relative experimental studies reveled that oxidative stress (OS) positively attained to the pathogenesis of esophageal mucosa damage. Just recently, the studies from both domestic and overseas further shown that OS significantly related to the occurrence and development of GERD. The over production of OS impairs the balances of oxidative/anti-oxidative defence system of esophagus, then leads to the abnormal change of esophageal microsturucre and function of tight junction (TJ) proteins, in result induce dilated intercellular space (DIS) of esophageal epithelial cells might be one of the potential mechanism of GERD. In this paper, the research status of the above aspects will further reviewed.