I'm not sure I follow how a cytokine can be a cause.
Cytokines are, generally, cell signalling molecules. In the case of GERD, if I understand the process correctly, these cytokines are instructing the tissue of the esophagus, and associated immune system cells, to initiate the inflammatory response.
Inflammatory responses in mucosal tissues typically include an increase in mucous production, which is the body's attempt to protect the tissue from the refluxed stomach acid.
So it follows that the first tissue changes you should expect to see are inflammation and increase mucous production as the body tries to protect itself from exposure to stomach acid.
This doesn't mean the cytokines cause the inflammation, nor that they cause acid reflux, they're just the cell signalling molecule that initiates the inflammatory response, released in response to increased acidity on the tissue surfaces, released long before gross changes occur as a result of acid damage.
If we give medicines to dampen the cytokine release, or dampen the inflammatory response to the cytokines, thereby reducing the inflammation, that doesn't mean the tissue won't be damaged by the acid reflux - if anything, down-regulating the normal inflammatory immune response will worsen the damage caused by the acid.
If A results in B being taken as a preventative measure (to stop Q), and then C occurs as a result of that preventative measure, then the causal graph looks like A->B->C.
That is, both A and B can be said to cause C, in the standard counterfactual sense of the word "cause": if you hold everything but X constant, and add more X, and more Y occurs, then X causes Y.
That doesn't mean you shouldn't do B. If Q is worse than C, it's still a good choice. But it does cause C.
Cytokines are, generally, cell signalling molecules. In the case of GERD, if I understand the process correctly, these cytokines are instructing the tissue of the esophagus, and associated immune system cells, to initiate the inflammatory response.
Inflammatory responses in mucosal tissues typically include an increase in mucous production, which is the body's attempt to protect the tissue from the refluxed stomach acid.
So it follows that the first tissue changes you should expect to see are inflammation and increase mucous production as the body tries to protect itself from exposure to stomach acid.
This doesn't mean the cytokines cause the inflammation, nor that they cause acid reflux, they're just the cell signalling molecule that initiates the inflammatory response, released in response to increased acidity on the tissue surfaces, released long before gross changes occur as a result of acid damage.
If we give medicines to dampen the cytokine release, or dampen the inflammatory response to the cytokines, thereby reducing the inflammation, that doesn't mean the tissue won't be damaged by the acid reflux - if anything, down-regulating the normal inflammatory immune response will worsen the damage caused by the acid.
The question is: what is causing the acid reflux?