Клинико-Функциональный Портрет Детей Раннего Возраста С Синдромом Регургитации

Ilchenko, S.I.; Mozheiko, T.V.; Kramarenko, N.M.; Duplenko, N.V.

doi:10.22141/2224-0551.14.6.2019.179241

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Соляна кислота та активований пепсин як фактор агресії набу вають значення в більш старшому віці [13]. Клі нічні прояви ГЕРХ у немовлят і дітей раннього віку вкрай варіабельні та неспецифічні [3]. Це може призвести як до неадекватної діагно стики, так і до необґрунтованого лікування [5].…”

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The results of daily monitoring of salivary pepsin levels in young children with regurgitation syndrome

Ilchenko¹,

Mozheiko²,

Fialkovska³

et al. 2021

MPU

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Regurgitation syndrome in infants is one of the manifestations of gastroesophageal reflux disease (GER), which can be both an age-related physiological condition and pathological one with the risk of gastroesophageal reflux disease (GERD) developing. Differential diagnosis of GERD in infants and young children is difficult due to invasiveness and low availability of the recommended diagnostic methods, in particular esophageal pH3metry. Today, the search for new non-invasive and simple, but sensitive and specific, methods for diagnosing GERD in pediatric practice is relevant and promising. Purpose — to determine the dynamic patterns of the salivary pepsin level in young children within the framework of daily monitoring and depending on the clinical manifestations of regurgitation. Materials and methods. 55 children from 3 to 18 months were examined, among them was 38 children with visible regurgitation syndrome and 17 healthy children without clinical manifestations of the regurgitation syndrome. The intensity of regurgitation was assessed using a five-point scale «ESPGHAN». A reflux questionnaire was used for screening diagnostics of pathological GER in children. Salivary pepsin level was determined three times a day by enzyme-linked immunosorbent assay (ELISA pepsin). Statistical processing was performed using «Statistica v.6.1» software package. Results. Regurgitation syndrome was registered in all children of the main group according to their current complaints. The results of reflux questionnaire showed the following data: half of the children (52.6%) had no signs of GER, possible reflux was revealed in 31.6% of children, and probable reflux was revealed in 15.8% of children. The results of daily monitoring of salivary pepsin level in infants showed that it was significantly higher in children with regurgitation than in control group, both in terms of average daily values and intermediate values. It was found that the maximum pepsin activity in children was immediately after regurgitation. There were no significant differences between the three saliva samples and the average daily pepsin index in the children of the main group, which may indicate the presence of latent episodes of reflux during the day. Сhildren with a high risk of GERD according to the reflux questionnaire had significantly higher values of salivary pepsin on an empty stomach and its average daily level, which has sufficient specificity and predictive value according to the ROC analysis results. Conclusions. Determination of salivary pepsin levels in infants can be included in screening noninvasive tests for the GER diagnosis. The use of these tests to predict the risk of extraesophageal damage requires further study. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: regurgitation, GER, GERD, pepsin, children.

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The results of daily monitoring of salivary pepsin levels in young children with regurgitation syndrome

Ilchenko¹,

Mozheiko²,

Fialkovska³

et al. 2021

MPU

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The Prognostic Significance of Salivary Pepsin Level in the Development of Recurrent Respiratory Pathology in Infants With Rumination Syndrome

Ilchenko,

Mozheiko,

Fialkovska

2023

EUMJ

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Introduction. Infant rumination syndrome (IRS) is most common among infants with functional disorders of the gastrointestinal tract and can lead to the development of recurrent respiratory pathology. Pepsin is believed to play a key role in the upper airway mucosa impairment. The objective of the study was to determine the prognostic significance of salivary pepsin level in the development of recurrent respiratory pathology in infants with rumination syndrome. Materials and Methods. We analyzed the clinical and anamnestic data of 55 infants: the main group consisted of 38 children with apparent rumination syndrome, and the comparison group included 17 healthy children with no clinical manifestations of this syndrome. Salivary pepsin and IL-8 levels were measured three times a day by the enzyme-linked immunosorbent assay (Human Pepsin Elisa Kit and Human IL-8 ELISA Kit, USA). The study results were statistically processed using the Statistica v.6.1 software package. To assess the diagnostic significance of salivary pepsin level, ROC analysis was performed to determine the optimal cut-off point and calculate the area under the ROC curve (AUC) with 95% CI and operating characteristics of the criterion (sensitivity and specificity). Results and Discussion. Daily monitoring of salivary pepsin in infants showed that pepsin level was significantly higher in the main group vs. the comparison group, both for average daily values and intermediate indicators. No statistically significant difference was found between the three saliva samples and the daily average pepsin level in the main group of infants, which may be indicative of latent episodes of reflux during the day. A direct correlation was found between salivary levels of IL-8 and pepsin levels in the main group of children (r = 0.78, p < 0.05). Among the potential predictors of recurrent respiratory pathology risk in infants with rumination syndrome, the following were established: fasting pepsin level > 309.27 pg/ml, pepsin level in 1 hour after feeding > 275.73 pg/ml, and pepsin level after regurgitation > 532.31 pg/ml. Conclusions. Fasting pepsin level > 309.27 pg/ml and pepsin level in 1 hour after feeding > 275.73 pg/ml can be used in a multiple logistic regression model to predict the risk of recurrent respiratory pathology, taking into account other clinical, anamnestic, and laboratory data. A post-regurgitation pepsin level > 532.31 pg/ml is an independent predictor and can be used alone.

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Клинико-Функциональный Портрет Детей Раннего Возраста С Синдромом Регургитации

Cited by 2 publications

References 5 publications

The results of daily monitoring of salivary pepsin levels in young children with regurgitation syndrome

The results of daily monitoring of salivary pepsin levels in young children with regurgitation syndrome

The Prognostic Significance of Salivary Pepsin Level in the Development of Recurrent Respiratory Pathology in Infants With Rumination Syndrome

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