Possible implications of TGF-alpha in oesophageal dysmotility in systemic sclerosis.

OBJECTIVES: Hypoxia is a characteristic feature of systemic sclerosis (SSc).Transforming growth factor alpha (TGF-α) has an important role in excessive inflammation under hypoxic conditions. Since oesophageal dysmotility is one of the most common signs of SSc, the aim of this study was to explore the relation between TGF-α and oesophageal dysmotility in SSc. METHODS: The study included 35 patients with SSc and 32 healthy controls matched for sex and age. Serum concentrations of TGF-α were measured using ELISA. Oesophageal motility was assessed by oesophageal scintigraphy. A multiple-swallow test was performed in the study population with 99mTc-DTPA. A region of interest over the entire oesophagus was defined and the retention index (RI) was calculated. RESULTS: Statistically significant differences in serum concentration of TGF-α as well as of RI of 99mTc-DTPA were found between patients with SSc and healthy controls. A statistically significant correlation was found between serum concentrations of TGF-α and RIs of 99mTc-DTPA. This correlation was inverse, i.e. when serum concentrations of TGF-α increased, the RI of 99mTc-DTPA decreased (Spearman rho =-0361, p=0.033). CONCLUSIONS: These results point to a possible relation between TGF-α and oesophageal dysmotility in SSc. Although the results do not explain the exact role of this cytokine in the pathogenesis of esophageal changes, the finding of inverse correlation between TGF-α and oesophageal dysmotility is intriguing and requires further investigation.