Electron microscopic study of intercellular space: Correlation analysis of bronchial asthma and gastroesophageal reflux disease
Electron microscopic study of intercellular space: Correlation analysis of bronchial asthma and gastroesophageal reflux disease
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DOI：
10.1111/j.1440-1746.2010.06410.x
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发表时间：
2011-01-01
影响因子：
4.1
通讯作者：
Lee, Sung Joon
中科院分区：
文献类型：
--
作者：
Park, Sanghoon;Lee, Eun Joo;Lee, Sung Joon
背景和目的：支气管哮喘（BA）是胃食管反流病（GERD）的一种食管外综合征，其病理生理基础较差。我们分析了GERD与BA之间的相关性，用透射电镜（TEM）检查食管上皮，沿着临床发现。方法：BA患者的控制和部分控制的水平纳入本研究。提供了肺和胃肠道（GI）问卷。无症状的患者加入对照组。通过食管胃镜从两组中取出食管粘膜组织并进行TEM处理。结果：对照组（n = 20）和BA组（n = 20）在基线特征上无显著差异。所有BA患者均使用皮质类固醇吸入剂，其中7例患者近期有急性加重史。至少有一种GI症状的患者占BA组的70%（14/20），40%的患者检测到胃灼热和/或反流。GERD的内镜检查结果为粘膜破裂（n = 3）。对照组的IS为0.389 +/- 0.297 um，而BA组为0.806 +/- 0.556 um（P = 0.001）。GERD症状的存在（P = 0.306）和最近的哮喘发作史（P = 0.710）并没有表现出显着的差异。结论：BA组显示出显着差异的扩张IS相比，对照组，这表明较高的患病率GERD在BA患者和密切的病理生理相关性。
Background and Aims:Bronchial asthma (BA) is considered an extra-esophageal syndrome of gastroesophageal reflux disease (GERD) with poor pathophysiological background. We analyzed the correlation between GERD and BA, examining esophageal epithelium with transmission electron microscopy (TEM), along with clinical findings.Methods:BA patients of controlled and partly-controlled levels were enrolled in the study. A pulmonary and gastrointestinal (GI) questionnaire was given. Patients with no symptoms joined the control group. Esophageal mucosal tissue was taken by esophagogastroduodenoscopy from both groups and processed for TEM. Intercellular space (IS) was measured with an image analyzing program, 100 times for each patient.Results:The control (n = 20) and BA (n = 20) groups revealed no significant differences in baseline characteristics. All BA patients were using corticosteroid inhalers, with seven patients having a recent history of acute exacerbation. Patients with at least one GI symptom made up 70% (14/20) of the BA group, and heartburn and/or regurgitation were detected in 40% of patients. Endoscopic findings of GERD were mucosal breaks (n = 3). The IS of the control group was 0.389 +/- 0.297 um, while the BA group was 0.806 +/- 0.556 um (P = 0.001). The presence of GERD symptoms (P = 0.306) and a history of recent asthma attacks (P = 0.710) did not show significant differences.Conclusions:The BA group showed a significant difference in the dilatation of IS compared to the control group, suggesting a higher prevalence of GERD in BA patients and a close pathophysiological correlation.