Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease

Iov, Diana-Elena; Bărboi, Oana-Bogdana; Floria, Mariana; Neamțu, Andrei; Iliescu, Radu; Drug, Vasile-Liviu

doi:10.3390/jpm12081296

Open AccessReview

Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease

by

Diana-Elena Iov

^1,2

,

Oana-Bogdana Bărboi

^1,2,*,

Mariana Floria

^1,2,*

,

Andrei Neamțu

³,

Radu Iliescu

^4,† and

Vasile-Liviu Drug

^1,2,†

¹

Internal Medicine Department, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania

²

Saint Spiridon Emergency Hospital, 700111 Iași, Romania

³

Physiology Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania

⁴

Pharmacology Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Pers. Med. 2022, 12(8), 1296; https://doi.org/10.3390/jpm12081296

Submission received: 10 July 2022 / Revised: 3 August 2022 / Accepted: 4 August 2022 / Published: 7 August 2022

(This article belongs to the Special Issue Recent Advancement in the Diagnosis and Management of Gastrointestinal Disorders)

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Abstract

Gastroesophageal reflux disease (GERD) is one of the most commonly encountered disorders in clinical practice nowadays, with an increasing burden on healthcare systems worldwide. GERD-related respiratory symptoms such as unexplained chronic cough, bronchial asthma or chronic obstructive pulmonary disease (COPD) with frequent exacerbations often pose diagnostic and therapeutic challenges and may require a multidisciplinary approach. Moreover, a potential role of GERD as a risk factor has been proposed for chronic rejection in patients who underwent lung transplantation. Pepsin has gained considerable attention from the scientific community in the last few years as a possible surrogate biomarker for GERD. The aim of this narrative review was to provide an overview of the potential utility of pepsin detection as a marker of micro-aspiration in various biological fluids retrieved from patients with suspected GERD-induced respiratory manifestations and in lung transplant patients with allograft dysfunction. Data on the subject remains highly contradictory, and while certain studies support its applicability in investigating atypical GERD manifestations, at the moment, it would be realistic to accept a modest utility at best. A major lack of consensus persists regarding topics such as the optimal timeframe for fluid collection and cut-off values. Further research is warranted in order to address these issues.

Keywords: GERD; pepsin; bronchial asthma; COPD; chronic cough; lung transplant

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MDPI and ACS Style

Iov, D.-E.; Bărboi, O.-B.; Floria, M.; Neamțu, A.; Iliescu, R.; Drug, V.-L. Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease. J. Pers. Med. 2022, 12, 1296. https://doi.org/10.3390/jpm12081296

AMA Style

Iov D-E, Bărboi O-B, Floria M, Neamțu A, Iliescu R, Drug V-L. Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease. Journal of Personalized Medicine. 2022; 12(8):1296. https://doi.org/10.3390/jpm12081296

Chicago/Turabian Style

Iov, Diana-Elena, Oana-Bogdana Bărboi, Mariana Floria, Andrei Neamțu, Radu Iliescu, and Vasile-Liviu Drug. 2022. "Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease" Journal of Personalized Medicine 12, no. 8: 1296. https://doi.org/10.3390/jpm12081296

APA Style

Iov, D.-E., Bărboi, O.-B., Floria, M., Neamțu, A., Iliescu, R., & Drug, V.-L. (2022). Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease. Journal of Personalized Medicine, 12(8), 1296. https://doi.org/10.3390/jpm12081296

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Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease

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