Meta-analysis of Gastroesophageal Reflux Disease and Idiopathic Pulmonary Fibrosis

Méthot, David Bédard; Leblanc, Evelyne; Lacasse, Yves

doi:10.1016/j.chest.2018.07.038

Cited by 100 publications

(70 citation statements)

References 52 publications

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“…The higher rate of gastroesophageal reflux in WHWTs has been hypothesized to play a role in the onset and/or in the progression of CIPF [33]. In man, gastroesophageal reflux is associated with IPF although the role of these exposures in the pathogenesis of IPF is still only hypothetical [34]. A pathogenic role of Rhodoluna, Limnohabitans Brochothrix, Curvibacter, Pseudarcicella and Flavobacteriaceae genus bacteria in the lung has only been reported for bacteria of the Flavobacteriacea genus [32].…”

Section: The Lm In Cipf Whwtsmentioning

confidence: 99%

Assessment of the lung microbiota in dogs: influence of the type of breed, living conditions and canine idiopathic pulmonary fibrosis

et al. 2020

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Background: Literature about the lung microbiota (LM) in dogs is sparse. Influence of breed and living conditions on the LM in healthy dogs is currently unknown, as well as the influence of chronic respiratory diseases such as canine idiopathic pulmonary fibrosis (CIPF) in West highland white terriers (WHWTs). Aims of this study were (1) to assess the characteristics of the healthy LM according to breed and living conditions, and (2) to study LM changes associated with CIPF in WHWTs. Forty-five healthy dogs divided into 5 groups: domestic terriers (n = 10), domestic shepherds (n = 11), domestic brachycephalic dogs (n = 9), domestic WHWTs (n = 6) (H-WHWTs) and experimental beagles (n = 9) and 11 diseased WHWTs affected with CIPF (D-WHWTs) were included in the study to achieve those objectives.Results: In healthy domestic dogs, except in H-WHWTs, the presence of few discriminant genera in each type of breed was the only LM modification. LM of experimental dogs displayed a change in b-diversity and an increased richness compared with domestic dogs. Moreover, Prevotella_7 and Dubosiella genera were more abundant and 19 genera were discriminant in experimental dogs. LM of both H-WHWTs and D-WHWTs revealed increased abundance of 6 genera (Brochothrix, Curvibacter, Pseudarcicella, Flavobacteriaceae genus, Rhodoluna and Limnohabitans) compared with other healthy domestic dogs. Brochothrix and Pseudarcicella were also discriminant in D-WHWTs compared with H-WHWTs and other healthy domestic dogs.Conclusions: In domestic conditions, except for H-WHWT, the breed appears to have minor influence on the LM. LM modifications were found in experimental compared with domestic living conditions. LM modifications in H-WHWTs and D-WHWTs compared with other healthy domestic dogs were similar and seemed to be linked to the breed. Whether this breed difference might be related with the high susceptibility of WHWTs for CIPF requires further studies.

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Section: The Lm In Cipf Whwtsmentioning

confidence: 99%

Assessment of the lung microbiota in dogs: influence of the type of breed, living conditions and canine idiopathic pulmonary fibrosis

et al. 2020

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“…1 This is similar to one of our subgroup analyses that considered only the studies in which the diagnosis of IPF was based on an objective method (e- Fig 2G in our article). 2 In this analysis, heterogeneity remained significant. Also, based on a novel methodology called "trial sequential analysis," Dr Corrao and colleagues suggested that our meta-analysis may have falsely concluded that GERD and IPF are associated.…”

Section: Responsementioning

confidence: 70%

Response

Lacasse

Leblanc

Méthot

2019

Chest

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results correspond to a z-curve within computed a boundaries. On the other hand, false negative results correspond to a z-curve that does not cross computed futility boundaries. Meta-analyses cannot be a mere exercise of pooling data, and TSA seems a useful tool for drawing not-biased conclusions. Our iterative sequential analysis (Fig 2) shows a z-curve within computed a boundaries, proving that data from the metaanalysis are inconclusive, and further studies are needed. In conclusion, the available data do not support an association between GERD and IPF. Finally, we hope that further, methodologically correct studies will be carried out, in particular with more stringent inclusion and exclusion criteria to avoid selection biases.

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“…However, evidences are not all in agreement. Although apparently the two pathologies seemed to be associated in 18 case-control studies, a subsequent meta-regression analysis controlling for smoking revealed no correlation between GERD and IPF 30. Possible biases, not constantly ruled out, are the presence of risk factors and comorbidities, such as aging and male gender 31.…”

Section: Relationship Between Gerd and Ipfmentioning

confidence: 90%

<p>Idiopathic pulmonary fibrosis and GERD: links and risks</p>

Ghisa¹,

Marinelli²,

Savarino³

et al. 2019

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Gastroesophageal reflux disease (GERD) and idiopathic pulmonary fibrosis (IPF) are two pathological conditions often strictly related, even if a clear relationship of causality has not been demonstrated. GERD is a frequent comorbidity in IPF patients, as demonstrated using combined multichannel intraluminal impedance-pH, despite being mostly clinically silent. According to that, it has been hypothesized that microaspiration of gastric material may play a fundamental role in the fibrotic transformation of pulmonary parenchyma. In contrast, it cannot be excluded that IPF may favor GERD by increasing the negative intrathoracic pressure. Therefore, this relationship is uncertain as well as not univocal. Nevertheless, the latest international guidelines recommend the use of proton pump inhibitors (PPIs) in IPF based on several data showing that PPIs can stabilize lung function, reduce disease flares and hospitalizations. On the contrary, recent studies not only question the relevance of these results, but also associate the use of PPIs with an increased risk of lung infections and a negative prognostic outcome. The aim of this review is to analyze the possible links between GERD and IPF and their possible therapeutic implications, trying to translate this scientific evidence into useful information for clinical practice.

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Meta-analysis of Gastroesophageal Reflux Disease and Idiopathic Pulmonary Fibrosis

Cited by 100 publications

References 52 publications

Assessment of the lung microbiota in dogs: influence of the type of breed, living conditions and canine idiopathic pulmonary fibrosis

Assessment of the lung microbiota in dogs: influence of the type of breed, living conditions and canine idiopathic pulmonary fibrosis

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<p>Idiopathic pulmonary fibrosis and GERD: links and risks</p>

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