Influence of some hormones and collagen metabolism on gastroesophageal reflux disease pathogenesis in children

Abstract

Aim. To study the collagen metabolism and secretion of hormones, and estimate their association in gastroesophageal reflux disease (GERD). Methods. 62 children with gastroesophageal reflux disease were examined. Control group included 32 children. Insulin and cortisol blood levels were determined by electro-chemiluminescence immunoassay (ECLIA), gastrin and somatostatin blood levels were determined by ELISA. Hydroxyproline and sialic acids levels were measured in gastric juice. Results. Esophageal mucosa lesions of different stages were diagnosed in all children with GERD: 36 (58%) children had I stage of esophagitis, 24 (38.7 %) children - II stage, 2 (3.2%) children - III stage. It was revealed that children with GERD demonstrated increased collagen breakdown level in esophageal and gastric mucosa, confirmed by high free hydroxyproline levels (29.6±3.2 μmol/L; p <0,05) and peptin-associated hydroxyproline (25.5±2.1 μmol /L; p <0.01). This collagen breakdown might be possible due to high cortisol level (389±15.5 nmol/L versus 204.4±12.1 nmol/L in control group, р <0.05). Increased insulin level (28.5±3.2 μU/ml vs 9.3±2.5 μU/ml; р <0,05) in patients with GERD might be a compensatory reaction to catabolic processes. Increased level of somatostatin (0.457±0.14 nmol/L; р <0.001) associated with low levels of gastrin (7.2±1.4 nmol/L) was discovered in children with GERD aged 9-12 years. On the contrary, children older than 12 years demonstrated high gastrin levels (18.72±3.2 nmol/L) associated with low levels of somatostatin (0.129±0.09 nmol/L). Conclusion. Influence of cortisol increased blood level on mucosa results in disbalance between aggressive and protective gastroduodenal factors in children with GERD, resulting in collagen breakdown. Increased insulin level signs the stimulation of the protective and adaptation mechanisms in children with GERD.

Keywords

esophagitis / gastroesophageal reflux disease / children / hormones / sialic acids / hydroxyprolin

RIGHTS & PERMISSIONS

Butorina N.V., Vakhrushev Y.M., Zaprudnov A.M.