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Bronchial Responsiveness During Esophageal Acid Infusion

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Abstract

Among the possible mechanisms explaining the worsening of asthma due to gastroesophageal reflux disease (GERD) is the increase in bronchial hyperresponsiveness. The effects of GERD on bronchial hyperresponsiveness in patients with bronchial asthma have yet to be studied in significant detail. The aim of this study was to determine the effects of esophageal acid perfusion on bronchial responsiveness to bradykinin in patients with both asthma and GERD. In 20 patients with asthma and GERD disease, esophageal pH was monitored with a pH meter and bronchial responsiveness was evaluated by aerosol inhalation of bradykinin during esophageal acid perfusion and, 24 h earlier or later the patients were submitted to another bronchial provocation test without acid infusion. No significant changes were observed in FEV1, FEF25-75%, FVC, or PEF during acid perfusion. The response to the bronchial provocation test did not differ between the control day and the day of acid infusion (p = 0.61). The concentration provoking a 20% fall in FEV1 (geometric mean ± geometric SD) was 1.09 ± 5.84 on the day of acid infusion and 0.98 ± 5.52 on the control day. There is no evidence that acid infusion changes bronchial responsiveness to bradykinin. These findings strongly question the significance of acid infusion as a model to study the pathogenesis of GERD-induced asthma.

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Abbreviations

FEF25–75% :

Forced expiratory flow from 25 to 75% of FVC

FEV1 :

Forced expiratory volume at 1 second

FVC:

Forced vital capacity

GERD:

Gastroesophageal reflux disease

HCl:

Hydrochloric acid

PC20 :

Concentration provoking a 20% fall in FEV1

PEF:

Peak expiratory flow

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Acknowledgments

The authors gratefully acknowledge Elizabet Sobrani, Elizabete Aparecida dos Santos, and Anália Arruda for technical assistance.

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Authors and Affiliations

  1. Pulmonary Division, Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Av. Bandeirantes, 3900, Ribeirão Preto, SP, 14048-900, Brazil

    Ana Carla S. Araujo, Lílian Rose O. Aprile, Roberto O. Dantas, João Terra-Filho & Elcio O. Vianna

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  1. Ana Carla S. Araujo
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  2. Lílian Rose O. Aprile
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Correspondence to Elcio O. Vianna.

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Araujo, A.C.S., Aprile, L.R.O., Dantas, R.O. et al. Bronchial Responsiveness During Esophageal Acid Infusion. Lung 186, 123–128 (2008). https://doi.org/10.1007/s00408-008-9072-z

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  • DOI: https://doi.org/10.1007/s00408-008-9072-z

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