Acid Reflux Research Today is a free monthly online journal that collates and summarizes the latest research about Acid Reflux, including details on diet, gerd (gastro-esophageal reflux disease), treatment, symptoms.

CCN1 is critical for acid-induced esophageal epithelial cell transformation.

Modak C, Mouazzen W, Narvaez R, Reavis KM, Chai J

VA Long Beach Healthcare System, 5901 E. Seventh Street, Long Beach, CA 90822, USA.

CCN1 is a matricellular protein involved in both wound healing and cancer cell invasion. Increased CCN1 expression has been associated with the development of Barrett's esophagus and the increased risk of progression to esophageal adenocarcinoma. In both cases, acid reflux is a major contributor. Low pH has been shown to induce CCN1 gene expression in esophageal epithelial cells. Here we demonstrated that both CCN1 and low pH could cause esophageal epithelial cell transformation, including loss of E-cadherin, disruption of cell-cell junctions, and expression of mesenchymal markers. Furthermore, knockdown of CCN1 through RNA interference sufficiently attenuated acid-driven cell phenotypic changes, while over-expression of CCN1 exacerbated these effects, indicating a critical role of CCN1 in acid-induced esophageal epithelial cell transformation. Given the pivotal role of low pH in gastro-esophageal reflux disease and its progression towards esophageal adenocarcinoma, our study identified CCN1 as a key molecule mediating this process.

Published 22 February 2010 in Biochem Biophys Res Commun, 392(4): 533-7.
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Articles on Acid Reflux published 1 February 2010:

Differential molecular changes in patients with asymptomatic long-segment Barrett's esophagus treated by antireflux surgery or medical therapy.   Am J Surg, 199(2): 137-43.

BACKGROUND: The Barrett's to adenocarcinoma sequence is characterized by molecular changes including activation of nuclear factor-kappaB (NF-kappaB) and related cytokines. In this observational nonrandomized study this molecular environment was compared in matched asymptomatic cohorts who had undergone either fundoplication or therapy with proton pump inhibitors (PPIs). METHODS: Asymptomatic patients with long-segment Barrett's esophagus had endoscopic biopsy specimens taken from 2 cm below the ... [Abstract] [Full-text]

Articles on Acid Reflux published 29 January 2010:

Development of consensus guidelines for the histologic recognition of microscopic esophagitis in patients with gastroesophageal reflux disease: the Esohisto project.   Hum Pathol, 41(2): 223-31.

No gold standard test exists for gastroesophageal reflux disease (GERD). Diagnostic difficulties are greatest when reflux symptoms occur without visible esophageal mucosal damage at conventional endoscopy. However, two thirds of such patients do have microscopic esophageal lesions. This study aimed to develop and standardize criteria for recognizing these microscopic esophageal lesions in GERD. Draft histologic criteria were developed and tested by an international group of 5 independent ... [Abstract] [Full-text]

Articles on Acid Reflux published 27 January 2010:

Lung transplantation, gastroesophageal reflux, and fundoplication.   Ann Thorac Surg, 89(2): 653-60.

Lung transplantation is an accepted treatment strategy for end-stage lung disease; however, bronchiolitis obliterans syndrome is a major cause of morbidity and mortality. This review explores the role of gastroesophageal reflux disease in bronchiolitis obliterans syndrome and the evidence suggesting the benefits of anti-reflux surgery in improving lung function and survival. There is a high prevalence of gastroesophageal reflux in patients post lung transplantation. This may be due to a high ... [Abstract] [Full-text]

Articles on Acid Reflux published 25 January 2010:

The impact of gastric bypass on gastroesophageal reflux disease in patients with morbid obesity: a prospective study based on the Montreal Consensus.   Ann Surg, 251(2): 244-8.

OBJECTIVES: To assess the impact of gastric bypass (GBP) on gastroesophageal reflux disease (GERD) based on Montreal Consensus. METHODS: In this study, 86 patients (25 men; aging 38 +/- 12 years; body mass index 45 [35-68 kg/m2]) were investigated for GERD before GBP and 6 months later. Esophageal and extraesophageal syndromes were assessed based on Montreal Consensus. Esophageal acid exposure and gastric pouch acidity were also evaluated. RESULTS: Overall prevalence of GERD was 64% before GBP ... [Abstract] [Full-text]

Articles on Acid Reflux published 12 January 2010:

GERD-related health care utilization, therapy, and reasons for transfer of GERD patients between primary care providers and gastroenterologists in a US managed care setting.   Dig Dis Sci, 55(2): 328-37.

PURPOSE: Patient flow between primary care physicians and gastroenterologists in the continuum of gastroesophageal reflux disease (GERD) care is poorly understood. Using administrative claims data from a large US health plan linked with data abstracted from medical records, we examined: health care resource utilization for GERD subjects treated by primary care physicians (PCPs) and gastroenterologists (GEs), determinants of GERD subject transfer between these physician types, and reasons for ... [Abstract] [Full-text]

Articles on Acid Reflux published 30 December 2009:

A preliminary report on the efficacy of the Multicare AR-Bed in 3-week-3-month-old infants on regurgitation, associated symptoms and acid reflux.   Arch Dis Child, 95(1): 26-30.

OBJECTIVES: The aim of this preliminary study was to evaluate the efficacy of a 40 degrees supine body position on infant regurgitation, reflux-associated symptoms and acid reflux. INTERVENTION: Thirty of 52 consecutive infants presenting with frequent regurgitation and reflux-associated symptoms occurring mainly during feeding were evaluated in the Multicare AR-Bed (Peos, Ninove, Belgium). The Infant-Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R) and an oesophageal pH monitoring were ... [Abstract] [Full-text]

Articles on Acid Reflux published 29 December 2009:

The association between cholecystectomy and gastroesophageal reflux symptoms: a prospective controlled study.   Ann Surg, 251(1): 40-5.

OBJECTIVE: A large controlled prospective observational study to compare pre- and postsurgery changes in reflux symptoms between cholecystectomy and hernia repair surgery patients. SUMMARY BACKGROUND DATA: Six studies have suggested that gastroesophageal reflux worsens after cholecystectomy. However, all these studies had design limitations. METHODS: We recruited 302 patients scheduled to undergo elective cholecystectomy (study group) or hernia repair (controls) at 2 hospitals. Both groups ... [Abstract] [Full-text]

Articles on Acid Reflux published 24 December 2009:

Eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease.   Dig Dis Sci, 55(1): 28-31.

BACKGROUND: Eosinophilic esophagitis is among the causes of refractory reflux disease. Biopsy of esophagus is the gold standard for diagnosis. In this study we determined the frequency of eosinophilic esophagitis (EE) in refractory reflux cases referred to Motility Department of Shahid Beheshti Research Center of Gastroenterology and Liver Disease, Tehran, Iran. METHODS: In this cross-sectional study, 68 cases with refractory reflux disease underwent endoscopy and had biopsies taken. Specimens ... [Abstract] [Full-text]

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