PMID- 21592756
OWN - NLM
STAT- MEDLINE
DCOM- 20110909
LR  - 20220309
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 105
IP  - 8
DP  - 2011 Aug
TI  - Pepsin and bile acids in induced sputum of chronic cough patients.
PG  - 1257-61
LID - 10.1016/j.rmed.2011.04.015 [doi]
AB  - One of the theories which explain, why gastroesophageal reflux disease (GORD) may 
      provoke cough, is the occurrence of aspiration of gastric content into the 
      airways. The aim of the study was to assess the presence of aspiration markers: 
      pepsin and bile acids (BA) in induced sputum in gastroesophageal reflux-related 
      (GOR-related) chronic cough (CC) patients. Forty-one CC patients and 20 healthy 
      controls were enrolled in the study. GORD as cause of CC was diagnosed by 
      presence of GORD-related symptoms, gastroscopy and/or improvement of cough upon 
      treatment with proton pump inhibitors (PPI). Patients were divided into two 
      groups based on the response to PPI treatment. In all patients and healthy 
      controls induced sputum was obtained and differential cell counts were 
      calculated. Levels of pepsin and BA were measured in sputum supernatants. Pepsin 
      was detectable in 48.8% samples in CC patients and in 60% healthy controls 
      (p = NS). In pepsin positive samples no significant difference in pepsin 
      concentration could be found between CC patients and control subjects. Pepsin 
      levels in pepsin positive samples were significantly decreased in patients 
      treated with PPI compared to non-treated patients. BA were detectable in 56% 
      samples of CC patients and in 70% healthy controls (p = NS). BA concentration in 
      BA positive samples in CC group was not different from healthy controls. There 
      was also no difference when comparing patients who took PPI and those who did 
      not. Patients characterized as PPI-responders and PPI-non-responders had similar 
      pepsin and BA concentrations. Airway cellularity was not significantly different 
      between groups of patients with or without pepsin or BA in induced sputum. Our 
      results demonstrated the lack of differences in gastric content aspiration 
      between patients with probable GOR-related CC and healthy control subjects. This 
      might imply that the reflex cough theory may be more relevant than the 
      reflux-associated aspiration theory in the pathophysiology of GORinduced chronic 
      cough.
CI  - Copyright (c) 2011 Elsevier Ltd. All rights reserved.
FAU - Grabowski, Marcin
AU  - Grabowski M
AD  - Department of Internal Medicine, Geriatrics and Allergology, Wroclaw Medical 
      University,Wroclaw, Poland. marcingrabow@o2.pl
FAU - Kasran, Ahmad
AU  - Kasran A
FAU - Seys, Sven
AU  - Seys S
FAU - Pauwels, Ans
AU  - Pauwels A
FAU - Medrala, Wojciech
AU  - Medrala W
FAU - Dupont, Lieven
AU  - Dupont L
FAU - Panaszek, Bernard
AU  - Panaszek B
FAU - Bullens, Dominique
AU  - Bullens D
LA  - eng
PT  - Journal Article
DEP - 20110517
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
RN  - 0 (Bile Acids and Salts)
RN  - 0 (Biomarkers)
RN  - 0 (Proton Pump Inhibitors)
RN  - EC 3.4.23.1 (Pepsin A)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bile Acids and Salts/*analysis
MH  - Biomarkers/analysis
MH  - Bronchoalveolar Lavage Fluid/chemistry
MH  - Case-Control Studies
MH  - Chronic Disease
MH  - Cough/drug therapy/*etiology
MH  - Female
MH  - Gastroesophageal Reflux/*complications/drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pepsin A/*analysis
MH  - Pneumonia, Aspiration/*metabolism
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Sputum/*chemistry
MH  - Young Adult
EDAT- 2011/05/20 06:00
MHDA- 2011/09/10 06:00
CRDT- 2011/05/20 06:00
PHST- 2010/12/27 00:00 [received]
PHST- 2011/03/03 00:00 [revised]
PHST- 2011/04/22 00:00 [accepted]
PHST- 2011/05/20 06:00 [entrez]
PHST- 2011/05/20 06:00 [pubmed]
PHST- 2011/09/10 06:00 [medline]
AID - S0954-6111(11)00161-2 [pii]
AID - 10.1016/j.rmed.2011.04.015 [doi]
PST - ppublish
SO  - Respir Med. 2011 Aug;105(8):1257-61. doi: 10.1016/j.rmed.2011.04.015. Epub 2011 
      May 17.