Gastroesophageal Refluxes As A Modificator Of Inflammatory Response In Bronchial Asthma And Tumor: The Role And Personalized Treatment Opportunities Of Water Pepsin

The presence of GERD in patients with BA and COPD is accompanied by a significant increase in the detection frequency and concentration of pepsin in the saliva. GERD varies in the inflammatory profile in BA and COPD, which confirms the need for a non-specific approach. Therapy with the addition of a prokinetic (itoprid) leads to a significant decrease in pepsin levels, a reduction in systemic inflammation, and an improvement in external respiratory function. Gastroesophageal reflux disease (GERD) is widespread among patients suffering from bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD), and is considered a factor aggravating the clinical course of respiratory pathology. However, the contribution of various types of reflux, including weak acid and mixed reflux, to the formation of the inflammatory response has not yet been sufficiently studied. The aim of the study was to evaluate the impact of GERD on the systemic inflammatory profile and external respiratory function indicators in patients with BA and COPD, as well as to determine the diagnostic significance of pepsin in saliva as a proximal reflux marker. The study included 120 patients (n=60 symptomatic, n=60 asymptomatic) distributed by the presence of GERD symptoms, with additional stratification by nosology. All patients underwent clinical assessment, spirometry, endoscopy, daily pH measurement, determination of C-reactive protein, and measurement of salivary pepsin content (bottom ≥ 16 ng/ml). The presence of GERD signs is associated with a significant increase in the frequency of pepsin and its concentration detection in BA and COPD (p<0.001). In patients with BA, GERD was accompanied by a more pronounced systemic inflammatory reaction. The inflammatory profile in COPD is primarily neutrophilic-eosinophilic in nature, demonstrating a less direct correlation with the clinical manifestations of GERD. Against the background of therapy with itopride, a statistically significant decrease in pepsin concentration, S-reactive protein levels, and an improvement in OFV1 indicators were noted (p<0.05).

Gastroesophageal reflux, bronchial asthma, COPD, salivary pepsin

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