Faculty of Medicine, University of Iceland, Vatnsmyarvegur 16, 101 Reykjavik, Iceland ; Department of Respiratory Medicine and Sleep, Landspitali University Hospital, 108 Reykjavik, Iceland.
Gastroenterol Res Pract. 2013;2013:148086. doi: 10.1155/2013/148086. Epub 2013 Apr 9.
Gastroesophageal reflux (GER) is commonly associated with respiratory symptoms, either through a vagal bronchoconstrictive reflex or through microaspiration of gastric contents. No diagnostic test is available, however, to diagnose when respiratory illnesses are caused by GER and when not, but research in this field has been moving forward. Various biomarkers in different types of biosamples have been studied in this context. The aim of this review is to summarize the present knowledge in this field. GER patients with respiratory diseases seem to have a different biochemical profile from similar patients without GER. Inflammatory biomarkers differ in asthmatics based on GER status, tachykinins are elevated in patients with GER-related cough, and bile acids are elevated in lung transplant patients with GER. However, studies on these biomarkers are often limited by their small size, methods of analysis, and case selections. The two pathogenesis mechanisms are associated with different respiratory illnesses and biochemical profiles. A reliable test to identify GER-induced respiratory disorders needs to be developed. Bronchoalveolar lavage is too invasive to be of use in most patients. Exhaled breath condensate samples need further evaluation and standardization. The newly developed particles in exhaled air measurements remain to be studied further.
胃食管反流（GER）常与呼吸系统症状相关，其发生机制可能是通过迷走神经反射引起支气管收缩，或通过胃内容物的微量误吸。然而，目前尚无诊断试验可用于确定呼吸系统疾病是否由 GER 引起，尽管该领域的研究一直在不断推进。在这种情况下，已经研究了不同类型生物样本中的各种生物标志物。本文旨在总结该领域的现有知识。患有呼吸系统疾病的 GER 患者的生化特征似乎与无 GER 的相似患者不同。根据 GER 状态，哮喘患者的炎症生物标志物不同，与 GER 相关咳嗽的患者中的速激肽升高，GER 肺移植患者中的胆汁酸升高。然而，这些生物标志物的研究通常受到样本量小、分析方法和病例选择的限制。这两种发病机制与不同的呼吸系统疾病和生化特征相关。需要开发一种可靠的测试方法来识别 GER 引起的呼吸障碍。支气管肺泡灌洗因过于侵入性而不适用于大多数患者。呼出气冷凝液样本需要进一步评估和标准化。新开发的呼出气颗粒测量方法仍需进一步研究。
