THE PURPOSE OF THE STUDY: Determine the pathogenetic significance of express molecules PCNA, Bcl-2, NF-Kb and tachykinins (substance P, neurokinin A) in patients with gastroesophageal reflux disease (GERD), receiving polychemotherapy (PCT). MATERIALS AND METHODS: In total 60 patients were examined with GERD time-divided into 2 equal groups on the receiving PCT Leukemia over standard dose for at least one year. The first group consisted of 30 subjects with non-erosive GERD (NEGERD) endoscopically positive form receiving PCT. The second group consisted of 30 subjects with erosive form of GERD (EFGERD) receiving PCT. Patients underwent endoscopy, morphological and immunohistochemical examination of the esophageal mucosa to the definition expression of molecules PCNA, Bcl-2, neurokinin A, substance P and factor Nf-Kb. In patients with refractory form of GERD to proton pump inhibitors therapy (PPIs), additionally imposed ursodeoxycholic acid. THE RESULTS: Patients with NEGERD receiving PCT in 33.3% of cases formed refractory to PPIs form of the disease, when EFGERD refractoriness occurs in 46.7% of patients, which is associated with slowing the proliferation of epithelial cells of the esophagus due to decreased expression of PCNA. Reduced expression of neurokinin A in patients receiving PCT is associated with less activity and intensity of inflammation of esophageal mucosa. Against the background of a high degree of PCT expression of Bcl-2 and factor Nf-Kb, which may explain the frequent detection of atrophic and meta- plastic changes in the esophageal mucosa. Appointment of ursodeoxycholic acid in the complex therapy of GERD can overcome resistance to PPIs and improve the performance of cell renewal. CONCLUSION: Due to the frequent development of GERD refractory to PPIs in patients suffering from diseases requiring the appointment of long-term courses of PCT requires the appointment of cytoprotective therapy, as that can be used ursodeoxycholic acid.
THE PURPOSE OF THE STUDY: Determine the pathogenetic significance of express molecules PCNA, Bcl-2, NF-Kb and tachykinins (substance P, neurokinin A) in patients with gastroesophageal reflux disease (GERD), receiving polychemotherapy (PCT). MATERIALS AND METHODS: In total 60 patients were examined with GERD time-divided into 2 equal groups on the receiving PCT Leukemia over standard dose for at least one year. The first group consisted of 30 subjects with non-erosive GERD (NEGERD) endoscopically positive form receiving PCT. The second group consisted of 30 subjects with erosive form of GERD (EFGERD) receiving PCT. Patients underwent endoscopy, morphological and immunohistochemical examination of the esophageal mucosa to the definition expression of molecules PCNA, Bcl-2, neurokinin A, substance P and factor Nf-Kb. In patients with refractory form of GERD to proton pump inhibitors therapy (PPIs), additionally imposed ursodeoxycholic acid. THE RESULTS:Patients with NEGERD receiving PCT in 33.3% of cases formed refractory to PPIs form of the disease, when EFGERD refractoriness occurs in 46.7% of patients, which is associated with slowing the proliferation of epithelial cells of the esophagus due to decreased expression of PCNA. Reduced expression of neurokinin A in patients receiving PCT is associated with less activity and intensity of inflammation of esophageal mucosa. Against the background of a high degree of PCT expression of Bcl-2 and factor Nf-Kb, which may explain the frequent detection of atrophic and meta- plastic changes in the esophageal mucosa. Appointment of ursodeoxycholic acid in the complex therapy of GERD can overcome resistance to PPIs and improve the performance of cell renewal. CONCLUSION: Due to the frequent development of GERD refractory to PPIs in patients suffering from diseases requiring the appointment of long-term courses of PCT requires the appointment of cytoprotective therapy, as that can be used ursodeoxycholic acid.