The relationship between the esophageal tissue content of neurotensin and the presence or absence of esophageal inflammation.

Neurotensin (NT) decreases lower esophageal sphincter pressure and impedes gastric emptying, thus exacerbating gastroesophageal reflux. The aim was to determine the content of esophageal tissue NT in patients with erosive esophagitis compared to those with normal endoscopy with or without abnormal acid exposure. Consecutive patients (N = 21) with gastroesophageal reflux disease symptoms underwent an upper endoscopy, at which two biopsies from opposite walls were obtained from normal-appearing mucosa. Patients with normal upper endoscopy underwent a pH test. NT tissue content was determined using radioimmunoassay. Six patients had erosive esophagitis, seven normal endoscopy but abnormal acid exposure, and eight both normal upper endoscopy and normal acid exposure. The NT/protein ratio was significantly higher in patients with normal upper endoscopy and normal or abnormal pH test compared to those with erosive esophagitis (8.7 +/- 1.4 and 8.0 +/- 1.2 vs. 3.8 +/- 0.5, respectively; P < 0.01). There was no significant difference in NT/protein ratio in patients with normal upper endoscopy with versus those without abnormal acid exposure (P = 0.7). There was no correlation between the extent of acid exposure and the NT/protein ratio. We suggest that the lower tissue content detected in patients with erosive esophagitis may represent a local protective mechanism against gastroesophageal reflux.