Abstract

Laryngopharyngeal reflux disease (LPRD) is caused by pharyngeal mucosal damage due to the reflux of gastric contents, including acid, pepsin, and bile juice. Our previous study has demonstrated that LPRD is associated with the cleavage of E-cadherin, which is facilitated by the acid-activated matrix metalloproteinase-7 (MMP-7); however, the mechanism by which the acid activates MMP-7 remains unclear. The purpose of this study was to investigate the mechanism by which MMP-7 is activated in the pharyngeal epithelial cells that are exposed to acid. The levels of reactive oxygen species (ROS) were measured in the epithelial cells exposed to acid. To investigate the signaling mechanism of ROS in the expression of MMP-7, the mechanism of action of the mitogen-activated protein kinase was examined. The expression of various signaling factors was determined, according to the presence or absence of each inhibitor in the acid-exposed pharyngeal epithelial cells. To identify changes in the cleavage of E-cadherin, the integrity of the mucosal membrane was assessed using a transepithelial permeability test. We found that acid exposure increased the levels of ROS, phosphorylated-extracellular signal-regulated kinase (p-ERK) 1/2, and phosphorylated-c-Jun (p–c-Jun) in pharyngeal epithelial cells. The ROS inhibitor reduced the expression of p-ERK and MMP-7, while the ERK inhibitor reduced the expression of p–c-Jun and MMP-7. Moreover, the c-Jun inhibitor reduced the expression of MMP-7 and blocked the degradation of E-cadherin. In addition, decrease in the levels of immunostained E-cadherin and increase in transepithelial permeability after acid exposure were collectively alleviated by the inhibitors of ROS, ERK, and c-Jun. The degradation of E-cadherin that occurs after human mucosal cells are exposed to acid appears to be caused by an increase in the expression of MMP-7 via the ROS/ERK/c-Jun pathway, which is thought to be an important mechanism associated with the development of LPRD.Key messages• ROS is triggered when reflux occurs.• ROS regulates the transcription factor c-Jun via the ERK pathway.• The increase in MMP-7 that induces LPRD is induced via the ROS/ERK/c-Jun pathway.• This study revealed for the first time the expression mechanism of MMP-7, which is one of the causes of LPRD.

Highlights

  • Laryngopharyngeal reflux disease (LPRD) is caused by the reflux of gastric contents, including acid, pepsin, and bile juice, which causes damage to the larynx and pharynx [1]

  • Our previous study has demonstrated that the expression of matrix metalloproteinase-7 (MMP-7) increases in pharyngeal epithelial cells exposed to acid and that the mucosal adhesion molecule, E-cadherin, is degraded by Matrix metalloproteinases (MMPs)-7 [16]

  • These results indicate that the expression of MMP-7 in pharyngeal epithelial cells exposed to an acidic environment may be regulated by reactive oxygen species (ROS)

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Summary

Introduction

Laryngopharyngeal reflux disease (LPRD) is caused by the reflux of gastric contents, including acid, pepsin, and bile juice, which causes damage to the larynx and pharynx [1]. Oxidative stress has been associated with the development of several inflammatory diseases, such as cancer, cardiovascular disease, airway disease, and rheumatoid arthritis [6,7,8,9] In these diseases, ROSs are associated with tissue remodeling, cellular injury, and apoptosis. Matrix metalloproteinases (MMPs) are enzymes involved in tissue remodeling and degradation of the extracellular matrix Among these MMPs, matrix metalloproteinase-7 (MMP-7) is expressed by exocrine and mucosal epithelial cells in various tissues and plays an important role in the remodeling of cell surface molecules, such as the epidermal growth factor receptor, heparin-binding epidermal growth factor, Fas ligand, and E-cadherin [11,12,13,14,15]. The aim of the present study is to investigate ROS-related mitogen-activated protein kinase (MAPK) to find out through what process the increase in MMP-7 expression caused by acid exposure occurred

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