Gastroesophageal Reflux in Children with Asthma

Lupu, Vasile Valeriu; Miron, Ingrith; Ţarcă, Elena; Trandafir, Laura Mihaela; Anton-Păduraru, Dana-Teodora; Moisă, Ştefana Maria; Stârcea, Iuliana Magdalena; Cernomaz, Andrei Tudor; Miron, Lucian; Lupu, Ancuța

doi:10.3390/children9030336

Cited by 11 publications

(5 citation statements)

References 33 publications

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“…Severe asthmatic phenotypes are often accompanied by the presence of comorbidities such as obesity, rhinosinusitis, or gastroesophageal reflux disease or are treated with oral corticosteroids, variables that can influence the composition of the pulmonary microbiota [ 80 , 88 ]. During the first year of life, the composition of the nasopharyngeal microbiome is a determining factor in the occurrence and spread of respiratory infections, increasing the risk of developing asthma in the future.…”

Section: Clinical and Pathogenic Aspectsmentioning

confidence: 99%

The Footprint of Microbiome in Pediatric Asthma—A Complex Puzzle for a Balanced Development

Lupu,

Jechel,

Mihai

et al. 2023

Nutrients

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Considered to be of greater complexity than the human genome itself, the microbiome, the structure of the body made up of trillions of bacteria, viruses, and fungi, has proven to play a crucial role in the context of the development of pathological processes in the body, starting from various infections, autoimmune diseases, atopies, and culminating in its involvement in the development of some forms of cancer, a diagnosis that is considered the most disabling for the patient from a psychological point of view. Therefore, being a cornerstone in the understanding and optimal treatment of a multitude of ailments, the body’s microbiome has become an intensively studied subject in the scientific literature of the last decade. This review aims to bring the microbiome–asthma correlation up to date by classifying asthmatic patterns, emphasizing the development patterns of the microbiome starting from the perinatal period and the impact of pulmonary dysbiosis on asthmatic symptoms in children. Likewise, the effects of intestinal dysbiosis reflected at the level of homeostasis of the internal environment through the intestine–lung/vital organs axis, the circumstances in which it occurs, but also the main methods of studying bacterial variability used for diagnostic purposes and in research should not be omitted. In conclusion, we draw current and future therapeutic lines worthy of consideration both in obtaining and maintaining remission, as well as in delaying the development of primary acute episodes and preventing future relapses.

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Section: Clinical and Pathogenic Aspectsmentioning

confidence: 99%

The Footprint of Microbiome in Pediatric Asthma—A Complex Puzzle for a Balanced Development

Lupu,

Jechel,

Mihai

et al. 2023

Nutrients

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“…According to controlled studies, infants or children with chronic otitis media with suppurations reported higher pepsin concentrations in middle ear secretions and acid pharyngeal reflux events at the dual-probe pH study than controls [ 50 , 54 ]. Other studies supported a potential association between reflux and chronic rhinosinusitis [ 56 , 57 , 58 ], choanal atresia [ 59 ], asthma and chronic aspirations [ 60 , 61 , 62 , 63 ], but the lack of controlled study with (HE)MII-pH limits the draw of reliable conclusions.…”

Section: Pathophysiologymentioning

confidence: 99%

Pediatric Laryngopharyngeal Reflux: An Evidence-Based Review

Lechien

2023

Children

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Purpose: Pediatric laryngopharyngeal reflux (P-LPR) is associated with the development of common otolaryngological symptoms and findings. In the present study, the findings about epidemiology, clinical presentation, diagnostic and therapeutic outcomes of pediatric population were reviewed. Methods: A PubMed, Cochrane Library, and Scopus literature search was conducted about evidence-based findings in epidemiology, clinical presentation, diagnostic and therapeutic outcomes of P-LPR. Findings: The prevalence of LPR remains unknown in infant and child populations. The clinical presentation depends on age. Infants with LPR symptoms commonly have both gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux and related digestive, respiratory and ear, nose and throat symptoms. The GERD prevalence appears to decrease over the growth, and the clinical picture is increasingly associated with LPR symptoms and findings without GERD. The prevalence of LPR and proximal acid and nonacid esophageal reflux events may be high in some prevalent otolaryngological conditions (chronic otitis media, laryngolomalacia and apnea). However, the lack of use of hypopharyngeal–esophageal multichannel intraluminal impedance pH monitoring (HEMII-pH) limits the establishment of etiological associations. Proton pump inhibitors are less effective in P-LPR patients compared to GERD populations, which may be related to the high prevalence of weakly or nonacid reflux events. Conclusions: Many gray areas persist in P-LPR and should be not resolved without the establishment of diagnostic criteria (guidelines) based on HEMII-pH. The unavailability of HEMII-pH and the poor acid-suppressive therapeutic response are all issues requiring future investigations. Future controlled studies using HEMII-pH and enzyme measurements in ear, nose or throat fluids may clarify the epidemiology of P-LPR according to age and its association with many otolaryngological conditions.

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“…Gastroesophageal reflux disease (GERD) is another pathology often associated with asthma, an aspect that increases the chance of patients manifesting GERD by up to 2.86 times, being not only an important step in the therapeutic course of asthmatics, but also proof of the need to address possible complications when we face resistance to therapy [ 94 ]. Thakkar et al examined the prevalence of GERD, estimated to be approximately 60% for adults, analyzing 20 articles in which it was documented via pH testing, contrast imaging, impedance, esophagogastroduodenoscopy and questionnaires based on symptoms or diagnostic codes, and noting that there is a possible association between GERD and bronchial asthma in children, but this is incompletely researched due to the lack of longitudinal studies [ 95 ].…”

Section: Challenges In Managementmentioning

confidence: 99%

Current Approaches in the Multimodal Management of Asthma in Adolescents—From Pharmacology to Personalized Therapy

Lupu,

Jechel,

Fotea

et al. 2023

Biomedicines

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Asthma and adolescence are two sensitive points and are difficult to manage when they coexist. The first is a chronic respiratory condition, with frequent onset in early childhood (between 3 and 5 years), which can improve or worsen with age. Adolescence is the period between childhood and adulthood (12–19 years), marked by various internal and external conflicts and a limited capacity to understand and accept any aspect that is delimited by the pattern of the social circle (of the entourage) frequented by the individual. Therefore, the clinician is faced with multiple attempts regarding the management of asthma encountered during the adolescent period, starting from the individualization of the therapy to the control of compliance (which depends equally on the adverse reactions, quality of life offered and support of the close circle) and the social integration of the subject, communication probably having a more important role in the monitoring and evolution of the condition than the preference for a certain therapeutic scheme. Current statistics draw attention to the increase in morbidity and mortality among children with bronchial asthma, an aspect demonstrated by the numerous hospitalizations recorded, due either to an escalation in the severity of this pathology or to faulty management. The purpose of this article is to review the delicate aspects in terms of controlling symptoms and maintaining a high quality of life among teenagers.

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Gastroesophageal Reflux in Children with Asthma

Cited by 11 publications

References 33 publications

The Footprint of Microbiome in Pediatric Asthma—A Complex Puzzle for a Balanced Development

The Footprint of Microbiome in Pediatric Asthma—A Complex Puzzle for a Balanced Development

Pediatric Laryngopharyngeal Reflux: An Evidence-Based Review

Current Approaches in the Multimodal Management of Asthma in Adolescents—From Pharmacology to Personalized Therapy

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