Carlo Pomari1, Luisa Mauroner2, Simona Paiano1, Luca Rosario Assante1, Luca Bertolaccini3, Giacomo Ruffo4, Paride Mainardi5, Paolo Bocus6, Andrea Geccherle7, Sergio Ivan Albanese8, Stefano Ciaffoni2. 1. Thoracic Endoscopy Unit, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy. 2. Laboratory Unit, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy. 3. Thoracic Surgery Unit, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy. 4. Division of General Surgery, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy. 5. Radiological Department, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy. 6. Digestive Endoscopy Unit, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy. 7. Intestinal Bowel Disease Unit, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy. 8. Otolaryngology-Head and Neck Surgery, Sacro Cuore Don Calabria Hospital - Cancer Care Center, Negrar Verona, Italy.
Abstract
BACKGROUND: Pepsin plays a role in gastroesophageal reflux (GER). Aims of this study were to verify if pepsin could be the cause of frequent bronchial exacerbations and to check if the persistence of chronic respiratory symptoms were correlated with pre-existing respiratory diseases. METHODS: From January to May 2016, 42 patients underwent a diagnostic bronchoscopy. All patients had a history of at least one bronchial exacerbation during the previous year. Bronchial lavage fluid specimens were obtained. A semiquantitative assessment of pepsin in the samples was carried out based on the intensity of the test sample. RESULTS: Pepsin was present in 37 patients (88%), but in patients with bronchial asthma and chronic obstructive pulmonary disease (COPD), the finding of pepsin in the bronchoalveolar fluid was 100%. There was a strong positive statistical correlation between pepsin detection and radiological signs of GER (ρ=0.662), and between pepsin detection and diagnosis (ρ=0.682). No correlation was found between the bacteriology and the presence of pepsin in the airways (ρ=0.006). CONCLUSIONS: The presence of pepsin in the airways shows the occurrence of reflux. The persistence of respiratory symptoms by at least 2 months suggest an endoscopic bronchial examination. This straightforward test confirms the cause possible irritation of the airways and may prevent further diagnostic tests, such as an EGD or pH monitoring esophageal.
BACKGROUND: Pepsin plays a role in gastroesophageal reflux (GER). Aims of this study were to verify if pepsin could be the cause of frequent bronchial exacerbations and to check if the persistence of chronic respiratory symptoms were correlated with pre-existing respiratory diseases. METHODS: From January to May 2016, 42 patients underwent a diagnostic bronchoscopy. All patients had a history of at least one bronchial exacerbation during the previous year. Bronchial lavage fluid specimens were obtained. A semiquantitative assessment of pepsin in the samples was carried out based on the intensity of the test sample. RESULTS: Pepsin was present in 37 patients (88%), but in patients with bronchial asthma and chronic obstructive pulmonary disease (COPD), the finding of pepsin in the bronchoalveolar fluid was 100%. There was a strong positive statistical correlation between pepsin detection and radiological signs of GER (ρ=0.662), and between pepsin detection and diagnosis (ρ=0.682). No correlation was found between the bacteriology and the presence of pepsin in the airways (ρ=0.006). CONCLUSIONS: The presence of pepsin in the airways shows the occurrence of reflux. The persistence of respiratory symptoms by at least 2 months suggest an endoscopic bronchial examination. This straightforward test confirms the cause possible irritation of the airways and may prevent further diagnostic tests, such as an EGD or pH monitoring esophageal.
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