Bronchial Responsiveness During Esophageal Acid Infusion |
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Authors: | Ana Carla S Araujo Lílian Rose O Aprile Roberto O Dantas João Terra-Filho Elcio O Vianna |
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Institution: | 1. Pulmonary Division, Department of Medicine, University of S?o Paulo Medical School at Ribeir?o Preto, Av. Bandeirantes, 3900, Ribeir?o Preto, SP, 14048-900, Brazil
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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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Keywords: | Asthma Bradykinin Bronchial provocation test Gastroesophageal reflux |
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