Ricerc@Sapienza

Pathogenesis of Sensor-motor esophageal (SMD) dysphagia (non-obstructive dysphagia), is still unknown. This condition has been scarcely related to inflammation, but it is the main symptom of Eosinophilic Esophagitis which can be considered a model for the relationship between inflammation and sensor-motor dysphagia. The presence of eosinophils in the esophageal layer is an index of inflammation. Previous ex-vivo animal studies demonstrated that the incubation of normal esophageal strips with the pro-inflammatory cytokines IL-1ß or IL-6 significantly reduced, up to 50%, the neurogenic muscle contraction. In addition, extracellular matrix secretion by human esophageal fibroblasts was increased in response to IL-43. The high resolution manometry (HRM) can provides an accurate description of motor abnormalities as they are listed in the Chicago classification but it does not provide any information on pathological mechanisms.
Aim of this study was to evaluate the ex-vivo cytokine secretion by esophageal mucosa of SMD patients in comparison with a control group and any potential association with the different HRM patterns.
Methods: mucosal biopsy specimens will taken during routine gastroscopies from the mid and distal esophagus of consecutive SMD patients and in dyspeptic patients with non evidence of gastroe-asophagel reflux disease as control group.
Biopic specimens will be used for standard hystologiacal examination and for ex-vivo culture. Cytokines quantification in organ culture medium will be assessed by multiplex chemi-luminescence immunoassay. HRM will performed in all dysphagic patients.
Expected results. The study protocol is aimed to identify the association between different immune-hystological profile and altered motor pattern in SMD patients. Currently this symptom is managed with ex adiuvantibus therapy, the identification of different groups of patients by HRM and immune histological profile may support targeted treatments.