Introduction Severe oesophagitis, oesophageal adenocarcinoma (OAC) are more common in men and post-menopausal women. Female sex hormones may protect pre-menopausal women from gastro-oesophageal reflux mediated mucosal damage, delaying the onset of BO and development of OAC in women. We have demonstrated more rapid mucosal healing and less inflammatory response in females in a murine buccal model of reflux injury. We have used a model comparing intact female mice with oestrogen deprived mice (by removal of their ovaries) to determine if this effect may be oestrogen driven.
Methods Female mice (C57 strain) were divided into three groups of 5: ovariectomised (OVX), OVX with oestrogen replacement (OVX+E) (50 μg oestradiol per day dorsal implants) and intact females. 1.5 mm buccal ulcers were induced using a punch biopsy and treated with 1 M hydrochloric acid. Wounds were harvested at day 4. Wound planimetry and immunohistochemistry for macrophages and neutrophils were compared in a blinded fashion.
Results Results: Re-epithelialisation was greatest in the intact group (mean 0.88 mm SEM ± 0.22) compared to the OVX (0.51 mm ± 0.13) or OVX+E (0.79 mm ± 0.12) groups. The difference between intact and OVX groups was statistically significant (p=0.04). Neutrophil wound infiltration (cells/wound area) was greater in the OVX group (1842±75) than the intact group (1279±169, p There was a greater number of macrophages in the OVX wounds (1556±128) than both OVX+E (984±95 (p=0.02) and the intact group (1026±91, p=0.01).
Conclusion Lack of systemic oestrogen delays mucosal healing in buccal wounds. This may explain gender differences in the oesophageal epithelial response to gastro-oesophageal reflux injury.
Competing interests None declared.