Co-culture of representative GS2 and GS1 isolates as well as C. rectus ESOS44-4 with primary esophageal epithelial cells showed that all isolates could induce TNF and IL-17 signaling but only the GS1 isolates (ESOS14-1 and ESOS44-1) and C. rectus led to an upregulation of EGR1, a gene that was also upregulated in patients with GERD and MET. The gene discussed is TNF; the disease is gastroesophageal reflux disease.