Expression of IFN-γ and IL-4 in the Esophageal Mucosa of Patients with Reflux Esophagitis and Barrett's Esophagus and Their Relationship with Endoscopic and Histologic Grading

This study investigated the expression of interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) in the esophageal biopsies from patients with reflux esophagitis (RE) and Barrett's esophagus (BE) and their relationships with endoscopic grading and histologic grading. Ninety individuals were recruited (30 RE, 30 BE, and 30 normal control) and underwent upper gastrointestinal endoscopy with esophageal biopsy. Immunohistochemistry was used to semi-quantitatively detect the expression of IFN-gamma and IL-4 in the specimens. IFN-gamma was overexpressed in BE and RE compared with the control (P < 0.01), whereas IL-4 was up-regulated in BE compared with RE and control (P < 0.01). A positive correlation between the level of IFN-gamma and the endoscopic grading (r = 0.509, P < 0.01) and histologic grading of RE (r = 0.493, P < 0.01) was observed. Th1 and Th2 immune responses play different roles in the development of RE and BE. Th1 immune response is the major pathway for RE development, whereas both Th1 and Th2 immune responses are implicated in BE pathogenesis. The expression of IFN-gamma is associated with the endoscopic and histologic grading of RE.