Airway inflammation in subjects with gastro-oesophageal reflux and gastro-oesophageal reflux-related asthma

J Intern Med. 2006 Mar;259(3):323-31. doi: 10.1111/j.1365-2796.2005.01611.x.


Study objectives: Asthma and gastro-oesophageal reflux (GER) are both characterized by airway inflammation.

Design: The purposes of this work were (i) to study airway inflammation in patients troubled by gastro-oesophageal reflux (GER) and GER associated with asthma, (ii) to ascertain whether GER can aggravate asthma by exacerbating the pre-existing airway inflammation and oxidative stress and (iii) to establish the validity of analysing breath condensate and induced sputum when studying the airways of subjects affected by GER. PATIENT S AND METHODS: We enrolled 14 patients affected by mild asthma associated with GER (40 +/-12 years), nine with mild but persistent asthma (39 +/- 13 years), eight with GER (35 +/- 11 years) and 17 healthy subjects (37 +/- 9 years). Sputum cell counts and concentrations of interleukin-4 (IL-4), IL-6 and 8-isoprostane were measured in breath condensate and supernatant.

Measurements and results: GER-related asthma is characterized by an eosinophilic inflammation, as determined by elevated concentrations of IL-4 in breath condensate and sputum supernatant, and by sputum cell analysis. GER alone presents a neutrophilic pattern of inflammation when determined by elevated concentrations of IL-6 in sputum cell analysis. A concomitant increase has been found in 8-isoprostane in GER associated (or not associated) with asthma.

Conclusions: We conclude that GER is characterized by a neutrophilic airway inflammation and by increased oxidative stress. GER does not however aggravate pre-existing airway inflammation in asthma patients. Determinations of inflammatory and oxidant markers in the breath condensate of subjects with GER reflect these measured in the induced sputum.

MeSH terms

  • Adult
  • Asthma / etiology*
  • Asthma / metabolism
  • Asthma / physiopathology
  • Biomarkers / analysis
  • Breath Tests
  • Cross-Sectional Studies
  • Dinoprost / analogs & derivatives
  • Dinoprost / analysis
  • Female
  • Forced Expiratory Volume
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / metabolism
  • Gastroesophageal Reflux / physiopathology
  • Humans
  • Hydrogen-Ion Concentration
  • Inflammation Mediators / analysis
  • Interleukin-4 / analysis
  • Interleukin-6 / analysis
  • Male
  • Middle Aged
  • Oxidative Stress
  • Sputum / chemistry
  • Sputum / cytology
  • Vital Capacity


  • Biomarkers
  • Inflammation Mediators
  • Interleukin-6
  • Interleukin-4
  • 8-epi-prostaglandin F2alpha
  • Dinoprost