Farooqi Muhammad S, Podury Sanjiti, Crowley George, Javed Urooj, Li Yiwei, Liu Mengling, Kwon Sophia, Grunig Gabriele, Khan Abraham R, Francois Fritz, Nolan Anna
Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, New York.
Department of Population Health, Division of Biostatistics, NYUGSoM, New York, New York.
Gastro Hep Adv. 2023;2(4):608-620. doi: 10.1016/j.gastha.2023.01.014. Epub 2023 Jan 21.
Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder that may complicate conditions such as obstructive airway disease. Our group has identified predictive biomarkers of GERD in particulate exposed first responders with obstructive airway disease. In addition, GERD diagnosis and treatment is costly and invasive. In light of these clinical concerns, we aimed to systematically review studies identifying noninvasive, multiOmic, and multicompartmental biomarkers of GERD.
A systematic review of PubMed and Embase was performed using keywords focusing on reflux disease and biomarkers and registered with PROSPERO. We included original human studies in English, articles focusing on noninvasive biomarkers of GERD published after December 31, 2009. GERD subtypes (non-erosive reflux disease and erosive esophagitis) and related conditions (Barrett's Esophagus [BE] and Esophageal Adenocarcinoma). Predictive measures were synthesized and risk of bias assessed (Newcastle-Ottawa Scale).
Initial search identified n = 238 studies andn 13 articles remained after applying inclusion/exclusion criteria. Salivary pepsin was the most studied biomarker with significant sensitivity and specificity for GERD. Serum assessment showed elevated levels of Tumor Necrosis Factor-alpha in both GERD and Barrett's. Exhaled breath volatile sulfur compounds and acetic acid were associated with GERD. Oral Microbiome: Models with , , and showed the greatest discrimination between BE and controls vs ; ROC 0.94 (95% confidence interval; 0.85-1.00).
Prior studies identified significant multiOmic, multicompartmental noninvasive biomarker risks for GERD and BE. However, studies have a high risk of bias and the reliability and accuracy of the biomarkers identified are greatly limited, which further highlights the need to discover and validate clinically relevant noninvasive biomarkers of GERD.
胃食管反流病（GERD）是一种常见的胃肠道疾病，可能会使诸如阻塞性气道疾病等病情复杂化。我们的研究小组已经在患有阻塞性气道疾病且接触颗粒物的急救人员中确定了GERD的预测生物标志物。此外，GERD的诊断和治疗成本高昂且具有侵入性。鉴于这些临床问题，我们旨在系统地回顾确定GERD的非侵入性、多组学和多隔室生物标志物的研究。
使用聚焦于反流疾病和生物标志物的关键词对PubMed和Embase进行系统回顾，并在PROSPERO上注册。我们纳入了英文的原始人体研究，以及2009年12月31日之后发表的关注GERD非侵入性生物标志物的文章。GERD亚型（非糜烂性反流病和糜烂性食管炎）及相关病症（巴雷特食管[BE]和食管腺癌）。对预测指标进行综合分析，并评估偏倚风险（纽卡斯尔-渥太华量表）。
初步检索确定了n = 238项研究，应用纳入/排除标准后保留了13篇文章。唾液胃蛋白酶是研究最多的生物标志物，对GERD具有显著的敏感性和特异性。血清评估显示，GERD和巴雷特食管患者的肿瘤坏死因子-α水平均升高。呼出气体中的挥发性硫化合物和乙酸与GERD有关。口腔微生物群：含有、和的模型在BE与对照组之间的区分能力最强，与相比；受试者工作特征曲线下面积为0.94（95%置信区间；0.85 - 1.00）。
先前的研究确定了GERD和BE存在显著的多组学、多隔室非侵入性生物标志物风险。然而，这些研究存在较高的偏倚风险，所确定的生物标志物的可靠性和准确性受到极大限制，这进一步凸显了发现和验证GERD临床相关非侵入性生物标志物的必要性。
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