Prospects in non-invasive diagnosis of bronchial asthma-related gastroesophageal reﬂux disease: a single-stage open uncontrolled non-randomised observational study

E V Gorban,E S Kameneva,V V Gorban

doi:10.25207/1608-6228-2021-28-6-14-28

E V Gorban, E S Kameneva + Show 1 more

Open Access

https://doi.org/10.25207/1608-6228-2021-28-6-14-28

Copy DOI

Abstract

Background . Respiratory symptoms of bronchial asthma (BA) comorbid with gastroesophageal reflux disease (GERD) may provoke duodenogastroesophageal reflux (DGER) via aggressive agents like pepsinogens and bilirubin. Objectives . A clinical and functional study of the saliva pepsinogen and bilirubin-associated BA-comorbid GERD for non-invasive DGER diagnosis. Methods. A total of 29 patients with an allergic BA phenotype, comorbid GERD and 50 , 2 ± 2 , 4 years mean age have been examined. Biochemical blood panel included bilirubin, C-reactive protein and allergen-specifi c IgE. Saliva bilirubin was estimated in colorimetry, and the pepsinogen-1, -2 content — in immunological tests. Grade A–D reflux oesophagitis (RO) in oesophagoscopy was assigned to erosive reflux disease, and grade N–M oesophageal mucosa (OM) lesions — to non-erosive reflux disease. External respiratory function (ERF) was assessed with forced expiratory volume (FEV 1 , L/s), forced vital capacity (FVC), Tiffeneau index (FEV 1 /FVC), pre- and post-berodual FEF 1 and FVC dynamics. Results. The BA–GERD patients were markedly polymorbid. Cough and chest tightness associated with age, and the tight chest rate — with a higher body mass index and lower FEV 1 /FVC. The association between higher pepsinogen-I and lower FEV 1 /FVC–FVC in response to inhaled berodual, as well as between higher saliva bilirubin and lower FVC–FEV 1 after berodual intake reflects a significant high-DGER effect on BA representation. Conclusion. In BA–GERD patients, saliva pepsinogen and bilirubin are biomarkers of both DGER and respiratory inflammation with bronchospasm.

Highlights

Respiratory symptoms of bronchial asthma (BA) comorbid with gastroesophageal reflux disease (GERD) may provoke duodenogastroesophageal reflux (DGER) via aggressive agents like pepsinogens and bilirubin
The study complies with the standards of the Declaration of Helsinki and was approved by the Independent Committee for Ethics of Kuban State Medical University, Ministry of Health of the Russian Federation (Mitrofana Sedina str., 4, Krasnodar, Russia), Minutes No 39 of 13.10.2020
Immunoserologic pepsin detection in the saliva as a non-invasive rapid diagnostic test for laryngopharyngeal reflux

Summary

Methods

A total of 29 patients with an allergic BA phenotype, comorbid GERD and 50,2 ± 2,4 years mean age have been examined. Biochemical blood panel included bilirubin, C-reactive protein and allergen-specific IgE. Saliva bilirubin was estimated in colorimetry, and the pepsinogen-1, -2 content — in immunological tests. External respiratory function (ERF) was assessed with forced expiratory volume (FEV1, L/s), forced vital capacity (FVC), Tiffeneau index (FEV1/FVC), pre- and post-berodual FEF1 and FVC dynamics. Cough and chest tightness associated with age, and the tight chest rate — with a higher body mass index and lower FEV1/ FVC. The association between higher pepsinogen-I and lower FEV1/FVC–FVC in response to inhaled berodual, as well as between higher saliva bilirubin and lower FVC–FEV1 after berodual intake reflects a significant high-DGER effect on BA representation

Conclusion

Findings

COMPLIANCE WITH ETHICAL STANDARDS