Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Saudi J Gastroenterol. 2013 May-Jun;19(3):121-5. doi: 10.4103/1319-3767.111954.
BACKGROUND/AIM: Gastro-esophageal reflux has been suggested to be associated with several pulmonary complications such as asthma, and post-transplant bronchiolitis obliterans (BO). Pepsin or bile salts in the sputum is shown to be an optimal molecular marker of gastric contents macro/micro aspiration. In this study, we investigated sputum pepsin as a marker of micro-aspiration in sulfur mustard (SM) exposed cases compared to healthy controls.
In a case controlled study, 26 cases with BO and 12 matched healthy controls were recruited and all cases were symptomatic and their exposure to SM was previously documented during Iran-Iraq conflict. Pepsin levels in sputum and total bile acids were measured using enzymatic assay. The severity of respiratory disorder was categorized based upon the spirometric values.
The average concentration of pepsin in sputum was higher in the case group (0.29 ± 0.23) compared with healthy subjects (0.13 ± 0.07; P ± 0.003). Moreover, the average concentration of bile acids in the sputum cases was not significantly different in comparison to the controls ( P = 0.5).
Higher pepsin concentrations in sputum of SM exposed patients compared with healthy control subjects indicate the occurrence of significantly more gastric micro-aspiration in SM exposed patients.
背景/目的：胃食管反流与多种肺部并发症有关，如哮喘和移植后细支气管炎性闭塞（BO）。痰中的胃蛋白酶或胆盐被证明是胃内容物宏/微吸入的最佳分子标志物。在这项研究中，我们研究了与健康对照组相比，在暴露于硫芥子气（SM）的病例中，痰胃蛋白酶作为微吸入的标志物。
在病例对照研究中，招募了 26 例 BO 病例和 12 例匹配的健康对照组，所有病例均有症状，并且在伊朗-伊拉克冲突期间有 SM 暴露史。使用酶联免疫吸附法测定痰中胃蛋白酶和总胆汁酸的水平。根据肺量计值对呼吸障碍的严重程度进行分类。
病例组痰中胃蛋白酶的平均浓度（0.29 ± 0.23）高于健康对照组（0.13 ± 0.07；P ± 0.003）。此外，与对照组相比，病例组痰中胆汁酸的平均浓度没有显著差异（P = 0.5）。
与健康对照组相比，暴露于 SM 的患者痰中胃蛋白酶浓度较高，表明暴露于 SM 的患者胃微吸入的发生率显著增加。
