Assessment of Exhaled Breath Condensate for Non-Invasive Diagnosis of Gastroesophageal Reflux Disease

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F18%3A00069909" target="_blank" >RIV/65269705:_____/18:00069909 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/18:00106045

Výsledek na webu

<a href="https://www.gastrojournal.org/article/S0016-5085(18)31829-8/pdf?referrer=https%3A%2F%2Fwww.gastrojournal.org%2Farticle%2FS0016-5085%2818%2931829-8%2Ffulltext" target="_blank" >https://www.gastrojournal.org/article/S0016-5085(18)31829-8/pdf?referrer=https%3A%2F%2Fwww.gastrojournal.org%2Farticle%2FS0016-5085%2818%2931829-8%2Ffulltext</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/S0016-5085(18)31829-8" target="_blank" >10.1016/S0016-5085(18)31829-8</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Assessment of Exhaled Breath Condensate for Non-Invasive Diagnosis of Gastroesophageal Reflux Disease

Popis výsledku v původním jazyce

Introduction: Gastroesophageal reflux disease (GERD) is a disease caused by backflow of gastric contents into the esophagus due to the failure of physiological antireflux mechanisms and can lead to esophageal and extraesophageal symptomatology. Extraesophageal reflux (EER) is a condition where refluxate penetrate above the upper esophageal sphincter in to the oral cavity, pharynx, upper and lower respiratory tract and leads to pathological changes. Monitoring of various parameters in exhaled breath condensate (EBC) in patients suffering from extraesophageal symptoms of GERD is non-invasive and simple approach to assess the gastroesophageal reflux. The aim was to compare the pH and total ionic profile of EBC with 24-hour multichannel intraluminal impedance and pH monitoring (MII-pH) and Peptest in a group of patients with acid reflux (pH&lt;4), weakly acid reflux (pH 4-7) and healthy controls. Methods: A portable EBC sampler was constructed and 10 µL samples of EBC were analyzed. The pH was measured with a pH-microelectrode and total ionic profile (anions, cations, organic acids - NH4+, K+, Ca2+, Na+, Mg2+, Cl-, NO2-, NO3-, SO4 2-, acetate, lactate, propionate, butyrate) was analyzed by capillary electrophoresis in each sample. The data from EBC werecompared with MII-pH and PepTest. In total the study comprised of 39 participants. The patients were divided by dominant findings from MII-pH in to groups with acid reflux (n=17), weakly acid reflux (n=8) and without reflux (n=14). Results: The values of pH (after CO2 removal with N2) were significantly higher in the group with acid reflux (p&lt;0.01), (mean pH: 7.13, interquartile ranges: 6.83-7.47) and in the group with weakly acid reflux (p&lt;0.01) (mean pH 7.37, (7.18-7.57)) vs. healthy controls (mean pH 6.8, (6.65-6.99) µM). In total ionic profile we found statistically significant difference in chloride (Cl-), nitrate (NO3-) and sodium (Na+) ions concentration. Cl- was elevated (p&lt;0.01) in group with acidic reflux vs. healthy controls. On contrary NO3 - and Na+ were elevated (p&lt;0.01) in group with weakly acidic reflux vs. healthy controls. We did not found statistical significance in Peptest results in between different group of patients. Conclusion: We found statistically significant difference in pH and ionic profile between the different groups of patients. Therefore the assessment of EBC can provide a fast and non-invasive diagnostic method for GERD with EER symptoms in the future. This can potentially reduce the diagnostic cost and avoid unnecessary invasive MII-pH testing in future. Peptest showed no significant data for accurate differentiation between the groups of patient.

Název v anglickém jazyce

Assessment of Exhaled Breath Condensate for Non-Invasive Diagnosis of Gastroesophageal Reflux Disease

Popis výsledku anglicky

Introduction: Gastroesophageal reflux disease (GERD) is a disease caused by backflow of gastric contents into the esophagus due to the failure of physiological antireflux mechanisms and can lead to esophageal and extraesophageal symptomatology. Extraesophageal reflux (EER) is a condition where refluxate penetrate above the upper esophageal sphincter in to the oral cavity, pharynx, upper and lower respiratory tract and leads to pathological changes. Monitoring of various parameters in exhaled breath condensate (EBC) in patients suffering from extraesophageal symptoms of GERD is non-invasive and simple approach to assess the gastroesophageal reflux. The aim was to compare the pH and total ionic profile of EBC with 24-hour multichannel intraluminal impedance and pH monitoring (MII-pH) and Peptest in a group of patients with acid reflux (pH&lt;4), weakly acid reflux (pH 4-7) and healthy controls. Methods: A portable EBC sampler was constructed and 10 µL samples of EBC were analyzed. The pH was measured with a pH-microelectrode and total ionic profile (anions, cations, organic acids - NH4+, K+, Ca2+, Na+, Mg2+, Cl-, NO2-, NO3-, SO4 2-, acetate, lactate, propionate, butyrate) was analyzed by capillary electrophoresis in each sample. The data from EBC werecompared with MII-pH and PepTest. In total the study comprised of 39 participants. The patients were divided by dominant findings from MII-pH in to groups with acid reflux (n=17), weakly acid reflux (n=8) and without reflux (n=14). Results: The values of pH (after CO2 removal with N2) were significantly higher in the group with acid reflux (p&lt;0.01), (mean pH: 7.13, interquartile ranges: 6.83-7.47) and in the group with weakly acid reflux (p&lt;0.01) (mean pH 7.37, (7.18-7.57)) vs. healthy controls (mean pH 6.8, (6.65-6.99) µM). In total ionic profile we found statistically significant difference in chloride (Cl-), nitrate (NO3-) and sodium (Na+) ions concentration. Cl- was elevated (p&lt;0.01) in group with acidic reflux vs. healthy controls. On contrary NO3 - and Na+ were elevated (p&lt;0.01) in group with weakly acidic reflux vs. healthy controls. We did not found statistical significance in Peptest results in between different group of patients. Conclusion: We found statistically significant difference in pH and ionic profile between the different groups of patients. Therefore the assessment of EBC can provide a fast and non-invasive diagnostic method for GERD with EER symptoms in the future. This can potentially reduce the diagnostic cost and avoid unnecessary invasive MII-pH testing in future. Peptest showed no significant data for accurate differentiation between the groups of patient.

Druh

O - Ostatní výsledky

CEP obor

—

OECD FORD obor

30219 - Gastroenterology and hepatology

Projekt

<a href="/cs/project/NV17-31945A" target="_blank" >NV17-31945A: Vývoj neinvazivní diagnostiky extraezofageálních projevů refluxní choroby jícnu</a><br>

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů