• Pathogenetic mechanisms of respiratory pathology with comorbid gastroesophageal reflux disease in frequently ill children
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Pathogenetic mechanisms of respiratory pathology with comorbid gastroesophageal reflux disease in frequently ill children

PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.1(73):98-104; doi 10.15574/PP.2018.73.98

Pochinok T. V., Zhuravel O. V., Voronina S. S., Gurieva O. V.
O.O. Bogomolets National Medical University, Kyiv, Ukraine

Objective – to analyse the literature data on common pathogenetic mechanisms of respiratory pathology associated with gastroesophageal reflux disease in frequently ill children.
Methods. Methods of semantic evaluation, comparison, system as well as structural-logical analysis were used.
Results and conclusions. Two leading mechanisms are distinguished: microaspirating and reflexly vagal. It has been established that in the development of inflammation with frequent acute respiratory diseases associated with gastroesophageal reflux disease in children and adolescents, the dysfunction of the local immune system (MALT) (mucosa associated lymphoid tissue) plays a significant role, and the pathological process in the airways of patients with associated gastroesophageal reflux disease, is caused by the immune system changes, including a violation of the T- and B-lymphocyte ratio, imbalance of C3, C4 and C5 components of the complement IgG, IgM, IgA. It is indicated in the literature that in case of the respiratory pathology with comorbid gastroesophageal reflux disease, the vegetative and endocrine regulation in children of pubertal age should be taken into account. It was found that in the combination of respiratory pathology and gastroesophageal reflux disease, endocrine endothelial activity and the intensity of lipid peroxidation processes are of great importance. The researches has shown that the main pathogenetic contribution of gastroesophageal reflux disease to the development of respiratory pathology is the decreased functioning of the antireflux barrier and reduced oesophageal clearance, which cause the development of reflux-associated bronchial obstruction. In such comorbidity, a vicious circle is formed and the mutual burdening of diseases takes place.
Key words: gastroesophageal reflux disease, respiratory disease, frequently ill children, pathogenetic mechanisms.

References

1. Belmer SV, Kokolina VF. (2011). Prakticheskoe rukovodstvo po detskim boleznyam. T.2. Gastroenterologiya detskogo vozrasta. Moskva: Medpraktika: 468.

2. Bryiksina EYu, Pochivalov AV. (2014). Osobennosti techeniya bronholegochnoy displazii na fone mikroaspiratsii zheludochnogo soderzhimogo. Nauchnyie vedomosti. 18 (189): 119—123.

3. Burkov SG. (2011). Klinicheskoe techenie, diagnostika i lechenie gastroezofagealnoy reflyuksnoy bolezni, assotsiirovannoy s bronhialnoy astmoy. Farmateka. 6: 38—43.

4. Zhihareva NS. (2013). Gastroezofagealnaya reflyuksnaya bolezn u detey. Meditsinskiy sovet. 3: 34—41.

5. Prosekova EB. (2013). Dinamika IL-1 i IL-6 v otsenke aktivnosti vospalitelnogo protsessa i effektivnosti terapii pri bronhialnoy astme u detey. Rossiyskiy vestnik perinatologii i pediatrii. 1: 25—42.

6. Svistunov BD, Andreev VG, Makarova GV et al. (2011). Primenenie oksida azota v kompleksnom lechenii bolnyih tuberkulezom legkih. Problemyi tuberkuleza i bolezney legkih. 6: 50—52.

7. Shabalov NP. (2011). Detskaya gastroenterologiya. Rukovodstvo dlya vrachey. Moskva: MEDpress-inform: 736.

8. Annagur A, Kendirli SG, Yilmaz M et al. (2012). Is there any relationship between asthma and asthma attack in children and atypical bacterial infections; Chlamydia pneumoniae, Mycoplasma pneumoniae and helicobacter pylori. J. Trop. Pediatr. 53 (5): 313—318.

9. Axford SE, Sharp N, Ross PE et al. (2011). Cell biology of laryngeal epithelial defenses in health and disease: preliminary studies. Ann. Otol. Rhinol. Laryngol. 110 (12): 1099—1108.

10. Benedictis FM, Bush А. (2017). Infantile wheeze: rethinking dogma. 102 (4): 371—375.

11. Beule A. (2015). Epidemiology of chronic rhinosinusitis, selected risk factors, comorbidities, and economic burden. GMS Curr. Top.Otorhinolaryngol. Head Neck Surg. 14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702060.

12. Carpagnano GE, Resta O, Ventura MT. (2015). Airway inflammation in subjects with gastro-oesophageal reflux and gastrooesophageal reflux — related asthma. J. Intern. Med. 259: 323—331.

13. Casselbrant ML, Mandel EM, Doyle WJ. (2016). Information on co-morbidities collected by history is useful for assigning Otitis Media risk to children. Int. J. Pediatr. Otorhinolaryngol. 85: 136—140.

14. Cheng CM, Hsieh CC, Lin CS et al. (2010). Macrophage activation by gastric fluid suggests MMP involvement in aspiration — induced lung disease. Immunobiology. 215: 173—181.

15. Fan WC, Ou SM, Feng JY et al. (2016). Increased risk of pulmonary tuberculosis in patients with gastroesophageal reflux disease. Int. J. Tuberc. Lung Dis. 20 (2): 265—270.

16. Friesen CA, Rosen JM, Schurman JV. (2016). Prevalence of overlap syndromes and symptoms in pediatric functional dyspepsia. BMC Gastroenterol. 16 (1): 75.

17. Ghezzi M, Silvestri M, Sacco O et al. (2016). Mild tracheal compression by aberrant innominate artery and chronic dry cough in children. Pediatr Pulmonol. 51 (3): 286—294.

18. Hoshino M, Omura N, Yano F et al. (2017). Comparison of the multichannel intraluminal impedance pH and conventional pH for measuring esophageal acid exposure: a propensity score-matched analysis. Surg. Endosc. 31 (12): 5241—5244.

19. Houghton LA., Smith JA. (2017). Gastro-oesophageal reflux events: just another trigger in chronic cough? Gut. 66 (12): 2047—2048.

20. Hunt EB, Ward C, Power S et al. (2017). The Potential Role of Aspiration in the Asthmatic Airway. Chest. 151 (6): 1272—1278.

21. Jang AS, Yeum CH, Son MH. (2013). Epidemiologic evidence of a relationship between airway hyperresponsiveness and exposure to polluted air. Allergy. 58 (7): 585—588.

22. Jang AS. (2012). Severe airway hyperresponsiveness in school-aged boys with a high body mass index. Korean J. Intern. Med. 21 (1): 10—14.

23. Kang SY, Kim GW, Song WJ et al. (2016). Chronic cough: a literature review on common comorbidity. Asia Pac Allergy. 6 (4): 198—206.

24. Konturek SJ, Konturek PC, Brzozowska I et al. (2011). Localization and biological activities of melatonin in intact and diseased gastrointestinal tract (GIT). Journal of physiology and pharmacolog: an official journal of the Polish physiological society. 58 (3): 381—405.

25. Koufman JA. (2012). The otolaryngologic manifestation of reflux disease. A clinical investigation of 225 patients hour pH monitoring and an experimental investigation pepsin in the development of laryngeal injury. Laryngoscope. 101 (53): 1—78.

26. Kurukulaaratchy RJ, Matthews SH. (2012). Arshad Relationship between childhood atopy and wheeze: what mediates wheezing in atopic phenotypes? Ann. Allergy Asthma Immunol. 97 (1): 84—91.

27. Lai YG, Wang ZG, Ji F et al. (2012). Animal study for airway inflammation triggered by gastro-oesophageal reflux. Chin. Med. J. 122: 2775—22778.

28. Mandal A, Sahi PK. (2017). Serum Vitamin D Levels in Children with Recurrent Respiratory Infections and Chronic Cough: Correspondence. Indian J. Pediatr. 84 (2): 172—173.

29. Pellegrino R. (2011). Airway hyperresponsiveness with chest strapping: A matter of heterogeneity or reduced lung volume? Respir. Physiol. Neurobiol. 166 (1): 47—53.

30. Porsbjerg C. (2015). Outcome in adulthood of asymptomatic airway hyperresponsiveness to histamine and exercise — induced bronchospasm in childhood. Ann. Allergy Asthma Immunol. 95 (2): 137—142.

31. Rao CV. (2013). Vijayakumar M. Effect of quercetin, flavonoids and alpha — tocopherol, an antioxidant vitamin, on experimental reflux oesophagitis in rats. Eur. J. Pharmacol. 589 (1—3): 233—238.

32. Ruigomez A, Johansson S, Nagy P. (2017). Utilization and safety of proton-pump inhibitors and histamine-2 receptor antagonists in children and adolescents: an observational cohort study. Curr. Med. Res. Opin. 33 (12): 2201—2209.

33. Schioler L, Ruth M, Jogi R et al. (2015). Nocturnal GERD — a risk factor for rhinitis/rhinosinusitis: the RHINE study. Allergy. 70 (6): 697—702.

34. Solidoro P, Patrucco F, Fagoonee S et al. (2017). Asthma and gastroesophageal reflux disease: a multidisciplinary point of view. 108 (4): 350—356.

35. Suzuki A, Kondoh Y. (2017). The clinical impact of major comorbidities on idiopathic pulmonary fibrosis. Respir. Investig. 55 (2): 94—103.

36. Thomas AD. (2012, May). Gastroesophageal reflux-associated aspiration alters the immune respose in asthma. Surgical Endoscopy. 24 (5): 1066—1074.

37. Tuchman DN, Boyle JT, Pack AI et al. (2011). Comparison of airway responses following tracheal or esophageal acidification in the cat. Gastroenterology. 87 (4): 872—881.

38. Yildiz F, Mungan D, Gemicioglu B et al. (2017). Asthma phenotypes in Turkey: a multicenter cross-sectional study in adult asthmatics; PHENOTURK study. Clin. Respir. J. 11 (2): 210—223.

39. Zhang X, Ding F, Li H et al. (2016). Low Serum Levels of Vitamins A, D, and E are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study. PLoS One. 11 (12): e0167689. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147939.