Correlation between gastro-oesophageal reflux disease (GERD) lung volumes and exacerbation of bronchial asthma: Italian pilot observational retrospective study GERDAS

Abstract

Reflux asthma is an entity characterised by typical symptoms and in some cases is 'silent' and is more dangerous when associated with obesity and sleep apnoea syndrome. Its prevalence in the general population is high, as demonstrated by numerous studies listed below, and it is particularly a problem in the paediatric population; where, despite treatment by medical specialists, asthma symptoms are poorly controlled with a high risk of acute exacerbations. The aim of this clinical study is to show how the addition of a particular type of alginate (Deflux plus sachets) containing hyaluronic acid and melatonin at low doses administered over a prolonged period of six months, causes a reduction in vagal reflex stimulation of the oesophagus and pulmonary microaspiration reflexes by regulating lower oesophageal sphincter (LES) motility in asthmatic patients; improving the ACT score (asthma control test score). In the reported statistical analysis, ROC curves were performed for sensitivity and specificity for the analysed parameters, including the ACT score with statistically significant data p<0.0001. We conclude that the combination of conventional therapy for reflux asthma associated with alginates may improve the risk of acute asthma exacerbation and dynamic lung volumes.

Elevated Saliva Pepsin Concentration as a Risk Factor for Asthma in Children with Allergic Rhinitis: A Preliminary Study

“…Additionally, a preliminary clinical study has suggested the coexistence of both mechanisms. 3 The findings of the present study could provide robust evidence supporting the first mechanism, given that pepsin A is an enzyme exclusively produced by gastric chief cells. Its presence in upper airway secretions may be considered as a marker of reflux.…”

“…Gastroesophageal reflux disease (GERD) has been considered as a risk factor for asthma and a trigger for asthma attacks in children. [1][2][3] It has been estimated to be present in 40-80% of children with asthma. 4 Nevertheless, the precise pathophysiological mechanism by which GERD exacerbates asthma remains elusive.…”

“…This improvement contributes to a more effective subjective control of asthma. 3 Notably, pepsin, consistently found in all refluxate, may be a significant contributor, distinguishing itself from other gastric components, such as bile acids. In vitro experiments suggested that pepsin exposure disrupts respiratory epithelium and causes direct contact between submucosal tissue and allergens and pathogens.…”