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背景:环氧合酶(COX)-2在炎症、肿瘤等的发生、发展过程中发挥重要作用,但其在反流性食管炎(RE)中的作用尚未明确。目的:研究COX-2在混合性RE大鼠食管组织中的表达,探讨COX-2的表达与RE的关系。方法:采用贲门肌切开术加十二指肠半结扎术建立混合性RE大鼠模型。22只健康Sprague-Dawley大鼠随机分为RE模型组(n=12)和假手术组(n=10),于术前和术后1周测定食管下段和胃液pH值。处死大鼠,分别应用放射免疫测定和免疫组化方法检测食管组织中前列腺素(PG)E2的含量和COX-2的表达,光镜观察食管组织的形态学改变。结果:RE模型组术后食管下段pH值显著低于假手术组(P<0.05),胃液pH值则显著高于假手术组(P<0.05);食管组织PGE2含量亦较假手术组显著增高(P<0.001),COX-2表达均为阳性,假手术组食管组织中无COX-2表达。光镜观察显示RE模型组食管黏膜病理损害明显。结论:COX-2高表达和PGE2含量增高参与了混合性RE的发生、发展过程,COX-2可能通过升高PGE2含量而在RE的发病中起重要作用。
BACKGROUND Cyclooxygenase (COX) -2 plays an important role in the development and progression of inflammation and tumor, but its role in reflux esophagitis (RE) has not been clarified. Objective: To investigate the expression of COX-2 in esophageal tissue of mixed RE rats and to explore the relationship between COX-2 expression and RE. Methods: A mixed RE rat model was established by cardiomyotomy and duodenal ligation. Twenty-two healthy Sprague-Dawley rats were randomly divided into RE model group (n = 12) and sham operation group (n = 10). The lower esophageal and gastric fluid pH values were measured preoperatively and one week after surgery. The rats were sacrificed and the contents of prostaglandin (PG) E2 and the expression of COX-2 in esophageal tissues were detected by radioimmunoassay and immunohistochemistry respectively. Morphological changes of esophageal tissues were observed under light microscope. Results: The pH value of esophageal lower segment in RE model group was significantly lower than that in sham operation group (P <0.05), while the pH value in gastric juice group was significantly higher than that in sham operation group (P <0.05). The content of PGE2 in esophageal tissue was also significantly increased (P <0.001). The expression of COX-2 in the sham-operation group was no expression of COX-2 in the esophageal tissue. Light microscope observation showed that the pathological changes of esophageal mucosa in RE model group were obvious. CONCLUSION: COX-2 overexpression and increased PGE2 content are involved in the development and progression of mixed RE. COX-2 may play an important role in the pathogenesis of RE by increasing PGE2 content.