Cystic Fibrosis and gastroesophageal reflux disease

Maqbool, Asim; Pauwels, Ans

doi:10.1016/j.jcf.2017.07.007

Cited by 42 publications

(34 citation statements)

References 134 publications

(203 reference statements)

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“…In addition, markers for oxidative stress are overexpressed in patients with GERD, which indicates that increased ROS may be primarily responsible for the development of GERD (34). ROS also leads to esophageal fibrosis by increasing the expression of TGF-β1, which enhances the synthesis of esophageal collagen and suppresses the degradation of collagen in the GERD model (35). In the present study, chronic restrain stress upregulated subunits of NOX, a major source of ROS and downregulated antioxidant proteins in the esophagus.…”

Section: Discussionmentioning

confidence: 99%

Chronic restraint stress induces esophageal fibrosis with enhanced oxidative stress in a murine model

et al. 2019

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Although the underlying mechanism of stress remains unknown, it has been associated with the pathophysiology of gastroesophageal reflux diseases, the development of which appear to be accelerated by oxidative stress and fibrosis. The aim of the current study was to investigate the effect of chronic restraint stress on esophageal oxidative stress and fibrosis, as well as the impact of oxidative stress in a murine model whereby 8-week old C57BL/6J male mice were subjected to intermittent chronic restraint stress for a two-week period. The current study demonstrated that chronic restraint stress significantly reduced the body weight of mice compared with the control group. Although chronic restraint stress did not significantly alter the levels of triglycerides or cholesterol, free fatty acid concentration was significantly increased compared with the control group. Furthermore, chronic restraint stress significantly upregulated the expression levels of several fibrotic biomarkers including collagen type I, transforming growth factor β-1, α-smooth muscle actin and SMAD-3 compared with the control group. In addition, the expression levels of the reactive oxygen species (ROS) NADPH oxidase-4 and malondialdehyde were significantly increased, while the expression levels of nuclear factor erythroid 2-related factor 2 and heme oxygenase-1 were significantly decreased in esophageal tissue from mice in the chronic restraint stress group compared with the control group. In conclusion, chronic restraint stress may induce esophageal fibrosis by accumulating ROS and increasing fibrotic gene expression in a murine model.

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Section: Discussionmentioning

confidence: 99%

Chronic restraint stress induces esophageal fibrosis with enhanced oxidative stress in a murine model

et al. 2019

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“…Alongside other side effects, including increased insulin resistance and immunosuppression, proximal myopathy due to long term corticosteroid use may worsen joint pains in the longer‐term. Non‐steroidals carry some risks for patients with CF that may be higher than in the general population: a high prevalence of gastro‐oesophageal reflux disease may predispose to gastrointestinal side effects …”

Section: Evidence For Treatmentmentioning

confidence: 99%

“…Probe position is shown in the picture on the right population: a high prevalence of gastro-esophageal reflux disease may predispose to gastrointestinal side effects. 34 In four patients in whom episodic arthritis progressed to persistent disease, treatments including nonsteroidal anti-inflammatory drugs, gold, hydroxychloroquine, and prednisolone were used; specific case outcomes were not reported. 6 Outside of the literature, hydroxychloroquine has been used for CFA, but all evidence for its use as monotherapy is extrapolated from its use in other rheumatic diseases.…”

Section: Evidence For Treatmentmentioning

confidence: 99%

Assessing arthritis in the context of cystic fibrosis

Clarke

Watson

Freeston

et al. 2019

Pediatric Pulmonology

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Inflammatory arthritis in the context of cystic fibrosis (CF) can represent a diagnostic and therapeutic challenge. Poor recognition and under‐treatment of musculoskeletal conditions increases symptom burden, affects quality of life, and may lead to changes to an individual's ability to carry out activities of daily living and to exercise. A careful assessment and multidisciplinary approach is essential when considering a diagnosis of CF‐associated arthritis (CFA), both in terms of identifying other treatable conditions, such as rheumatoid arthritis, and effectively addressing symptoms. In this collaboration between CF specialists and Rheumatologists, we consider joint symptoms in patients with CF, with a focus on CFA. We offer a differential diagnosis list and consider steps to assess and manage CF patients presenting with arthralgia including appropriate up‐to‐date rheumatological assessment.

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“…[27][28][29][30] This delayed small bowel transit may be both a cause and effect of dysbiosis, as we know that animals that are germ-free or colonized only with Escherichia coli have slower intestinal transit than those with normal flora. 27 This is likely relevant to our CF population as the predominant species that overgrows in the CF mouse small intestine is E. coli, and treatment of CF mice with the osmotic laxative Table 2 Treatment options for GERD; dosing references: Lexicomp, Maqbool and Pauwels (2017), 185 polyethylene glycol (PEG) normalized intestinal transit time, reduced intestinal mucus accumulation, eradicated bacterial overgrowth, and led to better weight gain. 28 Given that the CF intestine is commonly affected by dysbiosis and dysmotility, intestinal inflammation can often ensue.…”

Section: Testmentioning

confidence: 99%

Gastrointestinal and Hepatobiliary Disease in Cystic Fibrosis

Gabel

Galante

Freedman

2019

Semin Respir Crit Care Med

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Cystic fibrosis (CF) is a multiorgan disease, and gastrointestinal (GI) manifestations can contribute to significant morbidity and mortality for individuals with CF. Up to 85% of patients with CF experience GI symptoms, thus addressing the GI aspects of this disease is paramount. With the advent of highly effective CF transmembrane conductance regulator modulators that are increasingly available, many individuals with CF now have significantly improved life expectancy. With these advances, GI manifestations that can be a detriment to quality of life such as gastroesophageal reflux disease, dysbiosis, and chronic abdominal pain have become a priority for patients and caregivers. In addition, as individuals have increased longevity, it has become essential for care providers to be aware of topics such as hepatobiliary disease and colorectal cancer screening. An understanding of the wide scope of GI manifestations in CF can enable providers to optimize the overall health and well-being of their patients. In this review, we aim to provide an up-to-date overview of key aspects of GI and hepatic disease in CF.

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Cystic Fibrosis and gastroesophageal reflux disease

Cited by 42 publications

References 134 publications

Chronic restraint stress induces esophageal fibrosis with enhanced oxidative stress in a murine model

Chronic restraint stress induces esophageal fibrosis with enhanced oxidative stress in a murine model

Assessing arthritis in the context of cystic fibrosis

Gastrointestinal and Hepatobiliary Disease in Cystic Fibrosis

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