Does the healing of the esophageal mucosa improve the function of the esophageal submucosal and salivary glands?

Abstract

The esophageal pre-epithelial barrier encompasses components of secretions from both the esophageal submucosal and salivary glands. We demonstrated, in patients with reflux esophagitis (RE), significantly diminished luminal release of esophageal epidermal growth factor (EGF). The rate of luminal release of esophageal prostaglandin E₂ (PGE₂ ) was significantly higher compared with controls and significantly declined after healing of RE. Patients with RE also exhibited significant declines in esophageal mucin secretion; however, after healing of RE with rabeprazole, this rate increased significantly. The rate of salivary EGF and bicarbonate secretion in patients with RE was significantly lower than in controls. We have demonstrated that mastication of tasteless parafilm, which could be substituted with sugarless chewing gum in the clinical scenario, resulted in profound and significant increases in the rate of secretion of salivary protective factors, such as bicarbonate, mucin, protein, EGF, and PGE₂ , in patients with RE. Our data clearly indicate that there is a relationship between the form or the structure of the esophageal mucosa and the secretory function of not only the esophageal submucosal glands but also the salivary glands. Application of masticatory stimulation in a clinical scenario may also have some therapeutic potential.

Keywords: esophageal protection; esophageal secretion; protective factors; reflux esophagitis; saliva.