eng Science and Education Publishing American Journal of Clinical Medicine Research 2328-403X 2015-11-09 3 4 64 69 10.12691/ajcmr-3-4-2 AJCMR2015342 article Vladimir Ivashkin 1 Yulia Evsyutina uselina@mail.ru 1 Alexander Trukhmanov 1 Svetlana Lyamina 2 Igor Malyshev 2 Department of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University, Moscow, Russian Federation Department of Pathophysiology, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation Aim. To characterize the systemic inflammatory response in patients with various forms of GERD. Materials and methods. The prospective clinical study included 45 patients with GERD and 10 healthy volunteers. An analytic survey of all participants was carried out which included, the collection of complaints and anamnesis, the identification of risk factors for GERD; esophagogastroduodenoscopy and a 24-hour esophageal pH-impedance monitoring. Using the method of flow cytometry, the levels of 7 cytokines were determined: two anti-inflammatory - IL-4 and IL-10, three pro-inflammatory - IL-8, IFN-γ and TNF-α, and two cytokines which may manifest as anti-inflammatory as well as pro-inflammatory activity depending on the circumstances (bivalent) - IL-2 and IL-6. Results. In patients with erosive and ulcerative esophagitis when compared to patients with NERD, Barrett's esophagus and healthy individuals, there was an increased expression of pro-inflammatory cytokines. Whereas in patients with Barrett's esophagus, when compared to other patients and healthy individuals, there was a resultant overexpression of anti-inflammatory cytokines. The levels of TNF-γ and IL-8 correlates with the total number of acid reflux and acid bolus exposure, whereas the levels of IL-4 and IL-10 correlate with the total number of weakly alkaline reflux and weakly alkaline bolus exposure. The high level of IL-8 was associated with an increased incidence of recurrence of erosive esophagitis, despite the ongoing therapy for 2 years. Conclusions. In patients with erosive and ulcerative esophagitis in comparison with patients with NERD and Barrett's esophagus, there is a predomination in the production of pro-inflammatory cytokines such as IL-8, IFN-γ and TNF-α, indicating the development of Th1 immune response. In patients with Barrett's esophagus, there was an increased expression of anti-inflammatory cytokines such as IL-4 and IL-10, indicating the formation of the Th2 immune response. http://pubs.sciepub.com/ajcmr/3/4/2/ajcmr-3-4-2.pdf gastroesophageal reflux disease systemic inflammatory response cytokines