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Salivary bicarbonate as a major factor in the prevention of upper esophageal mucosal injury in gastroesophageal reflux disease.

Digestive diseases and sciences (2014-03-13)
Tomasz Skoczylas, Harathi Yandrapu, Cezary Poplawski, Mazen Asadi, Grzegorz Wallner, Jerzy Sarosiek
ABSTRACT

It has been previously demonstrated that the exposure of the lower esophageal mucosa to acid and pepsin results in significant increase in salivary protective factors secretion, mediated by the esophago-salivary reflex. The impact of the upper esophageal mucosal exposure to acid and pepsin on salivary secretory response remains unknown. To investigate the rate of salivary protective factors secretion during the upper esophageal mucosal exposure to acid and pepsin and to compare with the corresponding results recorded during the lower esophageal mucosal exposure, in the same group of asymptomatic volunteers. The study was conducted in 10 asymptomatic volunteers. Salivary samples were collected during the esophageal mucosal exposure to saline, followed by acid/pepsin and the final saline, using the esophageal perfusion catheter. Salivary bicarbonate and non-bicarbonate buffers were analyzed using TitraLab. Salivary mucin and protein were quantified through PAS and Lowry methodologies, respectively, whereas PE2 using radioimmunoassay. Statistical analysis was performed using Σ-Stat software. The rate of salivary bicarbonate secretion was significantly higher (3.1-fold) during the upper versus the lower esophageal mucosal exposure to acid and pepsin (87.5 ± 14.4 vs. 28.0 ± 7.70 μEq/min, p < 0.05). The volumes of saliva, pH, salivary protein, mucin and PE2 were similar in both esophageal perfusions. Threefold stronger secretion of salivary bicarbonate could be a major factor protecting the upper esophageal mucosa. This phenomenon may represent an ultimate defense mechanism potentially preventing further complications within the upper esophageal mucosa; however, it needs to be confirmed in patients of gastroesophageal reflux disease.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
胃蛋白酶 来源于猪胃粘膜, powder, ≥250 units/mg solid
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胃蛋白酶 来源于猪胃粘膜, lyophilized powder, ≥3,200 units/mg protein
Sigma-Aldrich
胃蛋白酶 来源于猪胃粘膜, powder, ≥400 units/mg protein
胃蛋白酶, powder, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
胃蛋白酶 来源于猪胃粘膜, powder, slightly beige, ≥500 U/mg
Sigma-Aldrich
胃蛋白酶 来源于猪胃粘膜, powder, slightly beige, 1200-2400 U/mg
Sigma-Aldrich
胃蛋白酶 来源于猪胃粘膜, Suitable for manufacturing of diagnostic kits and reagents, lyophilized powder, ≥3200 units/mg protein