GERD Tag

08 Jul

Posted at 21:05h in Gastrointestinal Disease
[caption id="attachment_74872" align="alignleft" width="150"]Dr. Johnston, Ph.D. Dr. Johnston, Ph.D.[/caption]

MedicalResearch.com Interview with:

Nikki Johnston, Ph.D.

Professor of Otolaryngology and Communication Sciences & Microbiology and Immunology

Medical College of Wisconsin

Co-founder and Chief Scientific Officer, N-Zyme Biomedical Inc.

MedicalResearch.com: Please provide a summary of your findings in your Modulation of Pepsin-Mediated Inflammatory Responses in Vocal Cord Epithelial Cells by Amprenavir and how that is impacting your future research studies.

Dr. Johnston: In this study, we wanted to know whether pepsin — the key nonacid component of reflux — could trigger inflammatory signaling in vocal cord epithelial cells, and whether a pepsin inhibitor could reverse that response. We found that exposing human vocal cord cells to pepsin at neutral pH, mimicking the nonacidic conditions typical of laryngopharyngeal reflux (LPR), significantly increased the transcription factor HIF-2α along with the downstream inflammatory genes IL8, IL1B, and ICAM1. Co-treatment with amprenavir, a pepsin inhibitor and the active metabolite of fosamprenavir, reduced HIF-2α levels and significantly suppressed IL8, ICAM1, and TNF expression.

Interestingly, when we blocked HIF-2α's transcriptional activity directly, only IL1B expression was reduced; IL8 and ICAM1 were unaffected or even further increased. This tells us that HIF-2α is one contributor to pepsin-driven inflammation in the vocal cords, but not the whole story — pepsin is very likely activating several parallel stress pathways (NF-κB and MAPK signaling, among others) at the same time. For our future work, this reinforces that a single downstream pathway inhibitor is unlikely to fully quiet pepsin-induced inflammation, whereas a pepsin inhibitor acting further upstream, like amprenavir, has the potential to blunt several of these pathways at once. We are now examining whether similar mechanisms extend to pepsin's emerging role in pulmonary fibrotic disease and gastro-esophageal reflux disease (GERD).

26 Sep

Posted at 12:56h in Gastrointestinal Disease
[caption id="attachment_63533" align="aligncenter" width="500"]digestive-disorders.png Image source[/caption] Digestive disorders are far more common than many people realize, affecting around 40 million individuals in the US. Despite how widespread these conditions are, many people ignore the early signs, dismissing them as minor inconveniences. Unfortunately, what may seem like a little discomfort can often be a warning of a more significant health issue waiting to escalate. The key to preventing these issues from spiraling into long-term complications is recognizing the early signs. Many people don’t realize that digestive disorders, when caught early, can often be managed or even reversed with the right treatment plan. By ignoring symptoms like bloating, heartburn, or abdominal pain, we risk allowing our bodies to suffer silently, which could lead to more serious conditions. This article will help you guide you through the early signs of digestive disorders, helping you identify when it’s time to seek medical advice.

21 Dec

Posted at 21:37h in Author Interviews, Cancer Research, Esophageal, Gastrointestinal Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_39050" align="alignleft" width="184"]Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center Dr. McCoul[/caption] Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Population-level data suggests a link between gastroesophageal reflux disease and cancer of the throat and sinuses in adults over 65 years of age.  T he strength of association between reflux and cancer is strongest for anatomic sites closest to the esophagus, where acid and other stomach contents may have the greatest exposure.

11 Mar

Posted at 17:59h in Author Interviews, Gastrointestinal Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_32846" align="alignleft" width="142"]Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University Dr. Ronnie Fass[/caption] Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University MedicalResearch.com: What is the background for this study? Response: The endoscopic radiofrequency procedure (Stretta) has been used for more than a decade to treat patients with gastroesophageal reflux disease (GERD). Over time, there were several Meta-analyses with variable designs of the Stretta procedure providing conflicting results. Thus, the purpose of the current systematic review and meta-analysis was to determine the efficacy of the Stretta procedure using all currently available controlled and cohort studies.

24 Jan

Posted at 21:55h in Author Interviews, Gastrointestinal Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_31334" align="alignleft" width="126"]Dr. Mark Noar Director of The Heartburn and Reflux Study Center Towson, MD Dr. Mark Noar[/caption] Dr. Mark Noar Director of The Heartburn and Reflux Study Center Towson, MD  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was developed out of a need to know whether the Stretta procedure was effective in both the short and long-term in all forms of reflux. This included standard refluxing patients who had never had surgery but also in the subpopulation of patients who had recurring reflux after having had reflux corrective surgery. The question to be answered was whether the Stretta procedure would be less effective, more effective, or just as effective in the patient who had had prior surgery compared to patients who did not have surgery. The main findings were that independent of whether a patient had had surgery for the correction of reflux or just had standard reflux without prior surgery, the Stretta procedure was equally effective in all patient subgroups both in the short-term and the long-term.

18 Jun

Posted at 03:51h in Author Interviews, Case Western, Sleep Disorders
Ronnie Fass, M.D., FACG, Professor of Medicine Case Western Reserve University Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center Cleveland, OHMedicalResearch.com Interview with: Ronnie Fass, M.D., FACG, Professor of Medicine Case Western Reserve University Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center Cleveland, OH MedicalResearch: What are the main findings of the study? Dr. Fass: This is the first study to compare the extent of acid reflux between nighttime sleep and daytime naps in patients with Gastroesophageal reflux disease. The results of our study show that naps are associated with significantly greater esophageal acid exposure compared to sleep. Acid reflux events were more frequent and their total duration was longer during naps when compared with acid reflux events during nighttime sleep. Additionally, the fraction of time that the subjects were experiencing acid reflux with pH < 4 was significantly higher during naps than nighttime sleep and subjects experienced more symptoms due to acid reflux during their nap than their sleep.

11 Sep

Posted at 14:23h in Case Western, Esophageal, Gastrointestinal Disease, University of Michigan
Joel H. Rubenstein, MD, MSc, FACG, FASGE Research Scientist, Veterans Affairs Center for Clinical Management Research Assistant Professor, Division of Gastroenterology, University of Michigan Medical School VA Medical Center 111-D 2215 Fuller Rd. Ann Arbor, MI 48105MedicalResearch.com Interview with: Joel H. Rubenstein, MD, MSc, FACG, FASGE Research Scientist, Veterans Affairs Center for Clinical Management Research Assistant Professor, Division of Gastroenterology, University of Michigan Medical School VA Medical Center Ann Arbor, MI 48105 MedicalResearch.com: What are the main findings of the study? Dr. Rubenstein: In a set of case-control studies within the same population, we found that H. pylori was inversely associated with erosive esophagitis, and with Barrett’s esophagus, but we did not find such a relation with symptoms of gastroesophageal reflux disease (GERD).