Genetic risk factors for perception of symptoms in GERD: an observational cohort study

Aliment Pharmacol Ther. 2018 Jan;47(2):289-297. doi: 10.1111/apt.14414. Epub 2017 Nov 17.

Abstract

Background: Genetic polymorphisms in G-protein beta-3 subunit (GNβ3) and beta-2 adrenergic receptor (ADRB2) are associated with pain and gut hypersensitivity, which can overlap with gastroesophageal reflux disease (GERD).

Aim: To evaluate relationships between single nucleotide polymorphisms (SNPs) within GNβ3 and ADRB2 systems, and reflux symptom burden, GERD phenotypes from ambulatory reflux monitoring, and quality of life.

Methods: Symptomatic adults undergoing ambulatory reflux testing were recruited and phenotyped based on acid burden and symptom reflux association; major oesophageal motor disorders and prior foregut surgery were exclusions. A comparison asymptomatic control cohort was also identified. Subjects and controls completed questionnaires assessing symptom burden on visual analog scales, short-form health survey-36 (SF-36), and Beck Anxiety and Depression Inventories (BAI and BDI). Genotyping was performed from saliva samples; 6 SNPs selected from each of the two genes of interest were compared.

Results: Saliva from 151 study subjects (55.3 ± 1.2 years, 63.6% F) and 60 control subjects (50.9 ± 2.2 years, 66.7%) had sufficient genetic material for genotyping. Study subjects had higher symptom burden, worse total and physical health, and higher anxiety scores compared to controls (P ≤ .002). Tested SNPs within ADRB2 were similar between study subjects and controls (P > .09). Study subjects with recessive alleles in 3 GNβ3 SNPs (Rs2301339, Rs5443, and Rs5446) had worse symptom severity (P = .011), worse mental health (P = .03), and higher depression scores (P = .005) despite no associations with GERD phenotypes or reflux metrics.

Conclusions: Genetic variation within GNβ3 predicts oesophageal symptom burden and affect, but not oesophageal acid burden or symptom association with reflux episodes.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Cost of Illness
  • Female
  • Food Hypersensitivity / complications
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / genetics*
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / epidemiology
  • Gastroesophageal Reflux / genetics*
  • Genetic Predisposition to Disease*
  • Genotype
  • Heterotrimeric GTP-Binding Proteins / genetics
  • Humans
  • Male
  • Middle Aged
  • Pain / epidemiology
  • Pain / etiology
  • Pain / genetics*
  • Pain Measurement
  • Pain Perception*
  • Pilot Projects
  • Polymorphism, Single Nucleotide
  • Receptors, Adrenergic, beta-2 / genetics
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • G-protein beta3 subunit
  • Receptors, Adrenergic, beta-2
  • Heterotrimeric GTP-Binding Proteins