GASTRO-ESOPHAGEAL REFLUX AND PULMONARY FIBROSIS IN SCLERODERMA: A STUDY USING HRCT AND pH-IMPEDANCE

Savarino, Edoardo; Parodi, A. Ferretto; Marabotto, Elisa; Sammito, Giorgio; Cassan, Chiara De; Dulbecco, Pietro; Zentilin, Patrizia; Bazzica, Marco; Ghio, Massimo; Indiveri, F; Negrini, Simone; Savarino, Vincenzo

doi:10.1016/s1590-8658(09)60123-7

Cited by 4 publications

(8 citation statements)

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“…In addition, SSc patients had to stop PPIs before their study; this increases the role of reflux during PPI therapy since the large majority of SSc patients receive long-term therapy with these drugs. Nevertheless, one of the important points in this study was the demonstration of the presence of non-acid reflux and also the proximal extent of reflux episodes [12]. This suggests that reflux-reducing, and not only acid-suppressive, therapies should be included in future studies aimed at the evaluation of the influence of oesophageal involvement on ILD outcomes.…”

Section: Lung Involvement Of Systemic Disease M Gilson Et Almentioning

confidence: 90%

“…Moreover, they identified an association between GOR and DL,CO, which depended on both ILD and vasculopathy, but no correlation with FVC, which better reflects ILD. More recently, in a cohort of 40 patients, SAVARINO et al [12] identified greater oesophageal acid exposure (assessed by 24-h impedance pH monitoring) in SSc patients with ILD than in those without ILD. The design of this study differs from that of the present study as it was cross-sectional, whereas the present study was prospective.…”

Section: Lung Involvement Of Systemic Disease M Gilson Et Almentioning

confidence: 99%

“…The design of this study differs from that of the present study as it was cross-sectional, whereas the present study was prospective. SAVARINO et al [12] identified some factors associated with ILD, including reflux episodes. However, only univariate analyses were provided, thus not permitting estimation of the weight of the reflux among various associated factors.…”

Section: Lung Involvement Of Systemic Disease M Gilson Et Almentioning

confidence: 99%

“…A possible causative role of gastro-oesophageal reflux (GOR) in promoting idiopathic lung fibrosis [8,9], as well as SSc-ILD [10][11][12], was raised by previous studies. In particular, MARIE et al [11] suggested that the level of gastro-oesophageal dysmotility was associated with the frequency and severity of pulmonary involvement.…”

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confidence: 99%

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Prognostic factors for lung function in systemic sclerosis: prospective study of 105 cases

Gilson¹,

Zerkak²,

Wipff³

et al. 2009

European Respiratory Journal

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The aims of the present study were to identify prognostic factors for systemic sclerosis (SSc)-related interstitial lung disease and to clarify the possible causative role of manometric oesophageal involvement.Consecutive SSc patients underwent pulmonary function tests and oesophageal manometry. They were included in the study if pulmonary function tests were repeated .12 months after baseline. The primary end-point was a decrease of o10% of the predicted value in forced vital capacity (FVC). The secondary end-points were a decrease of o15% pred in lung carbon monoxide diffusing capacity (DL,CO) and a decrease of o20% pred in FVC.Of the 105 patients (45 diffuse SSc; median disease duration 2.0 yrs), 23 (23%) had a FVC of ,80% pred, 60 (59%) had a DL,CO of ,80% pred and 57 (54%) showed severe oesophageal hypomotility at baseline. Over 72¡46 months, 29 (28%) patients displayed a decrease of o10% pred in FVC, 39 (40%) of 98 patients displayed DL,CO decline and 19 (18%) patients displayed a decrease of o20% pred in FVC. On multivariate analysis, diffuse SSc was a significant predictor for a decrease of o10% pred in FVC (p50.01). No other predictor of a decrease in pulmonary function was identified.Only diffuse SSc was predictive of a decrease in pulmonary function in this early-SSc cohort. This does not support preliminary data suggestive of a causative role of oesophageal involvement.

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Section: Lung Involvement Of Systemic Disease M Gilson Et Almentioning

confidence: 90%

Section: Lung Involvement Of Systemic Disease M Gilson Et Almentioning

confidence: 99%

Section: Lung Involvement Of Systemic Disease M Gilson Et Almentioning

confidence: 99%

mentioning

confidence: 99%

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Prognostic factors for lung function in systemic sclerosis: prospective study of 105 cases

Gilson¹,

Zerkak²,

Wipff³

et al. 2009

European Respiratory Journal

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“…11 The fi broproliferative changes seen in BOS have some histologic similarities, with changes seen in usual interstitial pneumonia and other forms of refl ux-associated fi brotic lung disease. [16][17][18] These similarities caused us to question whether col(V) autoreactivity plays an intermediary role in the observed refl ux and BOS association. To answer this question, we evaluated a cohort of patients with primary lung transplantation for their col(V) reactivity as it related to refl ux status.…”

Section: Human Subjects Designmentioning

confidence: 99%

Reflux-Induced Collagen Type V Sensitization

Bobadilla

Jankowska‐Gan

et al. 2010

Chest

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Background: Lung transplantation continues to have poor long-term survival partly because of the high incidence of bronchiolitis obliterans syndrome (BOS). Gastroesophageal refl ux disease (GERD) has been implicated in BOS pathogenesis. We investigated the role of collagen type V [col(V)] sensitization in this process. Methods: Only primary lung transplant recipients were included. Refl ux status was assessed with pH monitoring, impedance plethysmography, and esophagogastroduodenoscopy. Sensitivity to col(V) was determined with trans vivo delayed-type hypersensitivity reaction (DTH). KaplanMeier analyses were performed. Results: Of the 54 recipients, 26 had proven GERD. There were no signifi cant between-group differences in diagnosis; donor and recipient age; sex; ischemic time; single vs bilateral; human leukocyte antigen A, B, and DR matching cytomegalovirus status; acute rejections; or mean follow-up period. The mean DTH response in the GERD group was 25.7 3 10 2 4 inches vs 18.3 3 10 2 4 inches in the non-GERD group ( P 5 .023). There was a signifi cant reduction in BOSfree survival in the GERD group for both BOS-I (GERD 1 , 28.3%; GERD 2 , 86.6%; P 5 .0001) and BOS-II/III (GERD 1 , 66.2%; GERD 2 , 91.7%; P 5 .0374). A second cohort of 53 patients awaiting lung transplantation also was assayed. The mean DTH response in the GERD group was 24.0 3 10 2 4 inches vs 13.1 3 10 2 4 inches in the non-GERD group ( P 5 .003). There were no differences in age or sex. Conclusions: GERD is strongly associated with the development of BOS after primary lung transplantation. Col(V) sensitization is associated with refl ux and BOS and may play an intermediary role in the pathogenesis of BOS. Trials using col(V) reactivity to assess the impact of antirefl ux procedures in patients with lung transplantation and idiopathic pulmonary fi brosis are warranted. CHEST 2010; 138(2):363-370Abbreviations: BOS 5 bronchiolitis obliterans syndrome; BOS-I 5 low-grade BOS; BOS-II/III 5 high-grade BOS; col(II) 5 collagen type II; col(V) 5 collagen type V; EBV 5 Epstein-Barr virus; GERD 5 gastroesophageal refl ux disease; IPF 5 idiopathic pulmonary fi brosis; TV-DTH 5 trans vivo delayed-type hypersensitivity

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Impedance-pH reflux patterns can differentiate non-erosive reflux disease from functional heartburn patients

et al. 2011

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GASTRO-ESOPHAGEAL REFLUX AND PULMONARY FIBROSIS IN SCLERODERMA: A STUDY USING HRCT AND pH-IMPEDANCE

Cited by 4 publications

References 0 publications

Prognostic factors for lung function in systemic sclerosis: prospective study of 105 cases

Prognostic factors for lung function in systemic sclerosis: prospective study of 105 cases

Reflux-Induced Collagen Type V Sensitization

Impedance-pH reflux patterns can differentiate non-erosive reflux disease from functional heartburn patients

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