Pepsin levels and oxidative stress markers in exhaled breath condensate of patients with gastroesophageal reflux disease

• Published in: Journal of pediatric surgery Vol. 48; no. 11; pp. 2247 - 2250
• Main Authors: Soyer, Tutku, Soyer, Özge Uysal, Birben, Esra, Kısa, Üçler, Kalaycı, Ömer, Çakmak, Murat
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2013
• Subjects: Adolescent; Asthma - etiology; Biomarkers; Breath Tests; Child; Child, Preschool; Children; Cough - etiology; Exhaled breath condensate; Female; Gastric Acidity Determination; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - metabolism; Gastroesophageal reflux disease; Humans; Lung Diseases - etiology; Male; Nitrogen Oxides - analysis; Oxidative Stress; Pediatrics; Pepsin; Pepsin A - analysis; Prospective Studies; Sampling Studies; Sulfhydryl Compounds - analysis; Surgery; Oxidative stress; Pepsin; Children; Exhaled breath condensate; Gastroesophageal reflux disease
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2013.02.100

Abstract Aim To evaluate the pepsin and oxidative stress markers in exhaled breath condensate (EBC) in patients with gastroesophageal reflux disease (GERD). Patients and Method Patients with a presumptive diagnosis of GERD with recurrent respiratory and gastrointestinal problems aged between 2 and 14 years were included in the study. All patients underwent pH monitoring. Patients with a reflux index (RI) ≥ 4 were assessed as the reflux group, and those with an RO < 4 were assessed as the non-reflux group. Pepsin levels and oxidative stress markers [NO metabolites (NOX) and total sulphydrile (TSH) levels] were measured in the EBC. Results There were 24 patients in the reflux group [RI 17.6 (6.6–46.4)] [median, interquartile range] and 23 in the non-reflux group [RI 0.8 (0.5–1.9) (p < 0.001). Pepsin levels in the EBC were below the level of detection. The median levels of NOx in the EBC of children with reflux [13.7 μmol/L (7.3–24.5)] were lower in than non-reflux group [21.0 μmol/L (14.0–25.2)] (p = 0.034). There was a negative correlation between reflux index and NOX levels in EBC (rs: − 0.331, p = 0.023). In contrast, there was no difference in TSH levels between the reflux and non-reflux groups [37.4 μmol/L (30.2–44.6) vs 40.1 μmol/L (37.4–44.9), respectively, (p > 0.05)]. Conclusion Decreased levels of NOX in patients with GER disease suggest increased oxidative stress in airways of these patients.