Pulmonary Aspiration Shown by Scintigraphy in Gastroesophageal Reflux-Related Respiratory Disease

Ravelli, A; Panarotto, Maria Beatrice; Verdoni, Lucio; Consolati, V.; Bolognini, Stefania

doi:10.1378/chest.130.5.1520

Cited by 120 publications

(76 citation statements)

References 25 publications

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“…Oesophageal pH studies were not helpful in the diagnosis of aspiration in this study, with a sensitivity of 24%, specificity of 65% and positive predictive value of 46%. 65 These studies highlight the challenges facing clinicians and investigators. The test characteristics of BAL bile salts and of pulmonary scintigraphy are not well known, and without that information, they cannot be used as the gold standard against which to compare pH studies.…”

Section: Diagnostic Testing: the Current Limiting Factormentioning

confidence: 99%

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Sweet

Patti

Hoopes

et al. 2009

Thorax

125

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Section: Diagnostic Testing: the Current Limiting Factormentioning

confidence: 99%

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Sweet

Patti

Hoopes

et al. 2009

Thorax

125

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“…It is likely that oesophago-laryngeal reflux as well as microaspirations of HCl occurred in this chronic model of GORD as well as microaspiration of gastric content, as suggested by the observation of microscopic food fragments in the airways of some HCl-exposed untreated mice (data not shown). Pulmonary microaspiration of gastric content has also been demonstrated in children with chronic respiratory symptoms [16,17]. Stimulation of the larynx or the trachea with HCl causes a much greater bronchoconstriction than oesophageal stimulation [18][19][20], suggesting that oesophago-laryngeal reflux is a more likely mechanism for the bronchoconstriction and airway inflammation associated with GORD than an oesophageal-bronchial reflex.…”

Section: Discussionmentioning

confidence: 99%

Tiotropium reduction of lung inflammation in a model of chronic gastro-oesophageal reflux

Cui

Devillier²,

Kuang³

et al. 2009

Eur Respir J

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Gastro-oesophageal reflux is frequent in chronic airway diseases and is considered a trigger for symptoms. In animal models, bilateral vagotomy or muscarinic antagonists prevent the increase in airway resistance and the microvascular leakage induced by acute oesophageal acid instillation.The present study investigates lung inflammation and remodelling in an animal model of chronic gastro-oesophageal reflux disease (GORD), and the effectiveness of pretreatments with tiotropium, atropine and dexamethasone.Mice were exposed to twice-daily intra-oesophageal HCl instillations for 21 days. Exposure to HCl causes: marked infiltration by inflammatory cells of the airways and of peribronchial areas; an increase in epithelial thickness; histological features of interstitial pneumonitis; an increase in cell numbers and in the levels of interleukin-8; and soluble intercellular adhesion molecule in bronchoalveolar lavage fluids, as well as of in vitro tracheal contractility. The administration of nebulised tiotropium or intraperitoneal atropine prior to each instillation of HCl, considerably inhibited all these changes.These results indicate a major role of acetylcholine in airway inflammation and remodelling in a GORD model, and demonstrate that tiotropium and atropine can prevent lung inflammation with an effectiveness similar to intraperitoneal dexamethasone, providing additional evidence that anticholinergics might contribute to the control of inflammatory processes in airway diseases.

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“…The cough may be caused via vagally mediated airway hyperresponsiveness or by pulmonary microaspiration through the upper esophageal sphincter. Overnight scintigraphy performed in children with unexplained and refractory respiratory manifestations showed pulmonary aspiration, suggesting GER as a causal factor [17].…”

Section: Laryngopharyngeal Manifestationsmentioning

confidence: 96%

ENT manifestations of gastroesophageal reflux

Passàli

Caruso²,

Passàli

2008

Curr Allergy Asthma Rep

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Gastroesophageal reflux (GER) has been associated with a variety of supraesophageal symptoms or diseases, including chronic cough, laryngeal disorders, rhinosinusitis, otitis media, and oral cavity lesions. In this article, we review the relationship between GER and ear, nose, and throat (ENT) symptoms. Data in the published literature are frequently conflicting. Only a few studies are controlled, and an evidence-based approach provides weak support for a causal association between GER and ENT manifestations. The GER diagnostic method should be standardized utilizing new parameters, and the definition and diagnostic accuracy of ENT pathologies also must be better specified. A firm connection remains controversial, and further randomized trials are needed.

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Pulmonary Aspiration Shown by Scintigraphy in Gastroesophageal Reflux-Related Respiratory Disease

Cited by 120 publications

References 25 publications

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Tiotropium reduction of lung inflammation in a model of chronic gastro-oesophageal reflux

ENT manifestations of gastroesophageal reflux

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