Savarino Edoardo, Ghio Massimo, Marabotto Elisa, Zentilin Patrizia, Sammito Giorgio, Cittadini Giuseppe, Sconfienza Luca, Murolo Carmelina, Gemignani Lorenzo, Indiveri Francesco, Savarino Vincenzo
Di.M.I., Dipartimento di Medicina Interna, Unità di Gastroenterologia con Endoscopia Digestiva, Università Genova.
Recenti Prog Med. 2009 Nov;100(11):512-6.
Interstitial lung disease represents the main cause of morbidity and mortality in patients with systemic sclerosis. The mechanisms leading to interstitial lung disease are poorly understood and thus current strategies have little effect on this progressive and fatal disease. Therefore, it appears relevant the importance to assess the possible risk factors involved in its pathogenesis. Previous studies in vivo and in vitro suggested that pulmonary fibrosis can occur after repeated aspiration of small amounts of gastric contents over long periods of time. Recently, our group observed that patients with systemic sclerosis and pulmonary fibrosis have a more severe degree of gastroesophageal reflux with a greater number of reflux events and a higher percentage of reflux episodes reaching the proximal esophagus, causing an increasing risk of microaspiration, compared to patients with systemic sclerosis without lung involvement. Further larger controlled studies are necessary to evaluate whether or not the development of interstitial lung disease in systemic sclerosis patients can be prevented by treating gastroesophageal reflux.
间质性肺病是系统性硬化症患者发病和死亡的主要原因。导致间质性肺病的机制尚不清楚，因此目前的治疗策略对这种进行性致命疾病效果甚微。因此，评估其发病机制中可能涉及的危险因素显得至关重要。先前的体内和体外研究表明，长期反复少量误吸胃内容物后可发生肺纤维化。最近，我们的研究小组观察到，与无肺部受累的系统性硬化症患者相比，患有系统性硬化症和肺纤维化的患者胃食管反流程度更严重，反流事件更多，反流至食管近端的发作百分比更高，导致微误吸风险增加。需要进一步开展更大规模的对照研究，以评估治疗胃食管反流是否可以预防系统性硬化症患者间质性肺病的发生。
