Lung Function and Bronchial Hyperreactivity

  • R. W. Dal Negro
  • C. Pomari


Gastroesophageal reflux (GER) is a digestive dysfunction which frequently occurs in healthy people to some extent, and is then regarded as a physiological event in these cases. GER occurrence frequently combines with the onset of one or more respiratory symptoms of different severities, creating a situation which may assume a significant clinical impact [1]. In these cases, cough and wheezing are the most important clinical signs, and those most frequently and spontaneously referred to GER occurrence by the patient. Unfortunately, except in a few paradigmatic circumstances, the cause-effect relationship between the occurrences of GER and of respiratory symptoms is still difficult to assess in the majority of cases, and can only be presumed or established on the basis of the patient’s clinical history in many cases.


Peak Expiratory Flow Rate Eosinophil Cationic Protein Asthmatic Subject Atopic Asthmatic Bronchial Hyperreactivity 
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  1. 1.
    Irwin RS, Zawacki JK, Curley FJ, et al (1989) Chronic cough as the sole presenting manifestation of gastroesophageal reflux. Am Rev Respir Dis 140:1294–1300PubMedCrossRefGoogle Scholar
  2. 2.
    Mansfield LE, Hameister HH, Spaulding MS, et al (1981) The role of the vagus nerve in airway narrowing caused by intraesophageal hydrocloric acid provocation and esophageal distention. Ann Allergy 47:431–434PubMedGoogle Scholar
  3. 3.
    Kjellen G, Tibbling L, Wranne B (1981) Bronchial obstruction after oesophageal acid perfusion in asthmatic. Clin Physiol 1:285–292PubMedCrossRefGoogle Scholar
  4. 4.
    Tan WC, Martin RJ, Pandy R, et al (1990) Effects of spontaneous and stimulated gastroesophaeal reflux on sleeping asthmatics. Am Rev Respir Dis 141:1394–1399PubMedGoogle Scholar
  5. 5.
    Schan CA, Harding SM, Haile JM, et al (1994) Gastroesophageal reflux-induced bronchoconstriction: an intraesophageal acid infusion study using state-of-the art technology. Chest 106:731–737PubMedCrossRefGoogle Scholar
  6. 6.
    Harding SM, Guzzo MR, Maples R, et al (1995) Gastroesophageal reflux induced bronchoconstriction: vagolytic doses of atropine diminish airway responses to esophageal acid infusion. Am J Respir Crit Care Med 151:A589 (abstract)Google Scholar
  7. 7.
    Harding SM, Schan CA, Guzzo MR, et al (1995) Gastroesphageal reflux-induced bronchoconstriction: is microaspiration a factor? Chest 108:1220–1227PubMedCrossRefGoogle Scholar
  8. 8.
    Jack CIA, Calverley PMA, Donnelly RJ, et al (1995) Simultaneous tracheal and oesophageal pH measurement in asthmatic patients with gastro-oesophageal reflux. Thorax 50:201–204PubMedCrossRefGoogle Scholar
  9. 9.
    Ekstrom T, Tibbling L (1989) Esophageal acid perfusion, airway function, and symptoms in asthmatic patients with marked bronchial hyperreactivity. Chest 96:995–998PubMedCrossRefGoogle Scholar
  10. 10.
    Herve P, Denjean A, Jian R, et al (1986) Intraesophageal perfusion of acid increases the bronchomotor response to methacholine and to isocapnic hyperventilation in asthmatic subjects. Am Rev Respir Dis 134:986–989PubMedGoogle Scholar
  11. 11.
    Wright RA, Miller SA, Corsello BF (1991) Acid-induced esophago-bronchial cardiac reflexes in humans. Gastroenterology 99:71–73Google Scholar
  12. 12.
    Holmes PW, Campbell AM, Barter CE (1975) Changes of lung volumes and lung mechanics in asthma and normal subjects. Thorax 33:394–400CrossRefGoogle Scholar
  13. 13.
    Moote W, Lioyd DA, McCourtie DR (1986) Increase in gastroesophageal reflux during methacholine-induced bronchospasm. J Allergy Clin Immunol 78:619–623PubMedCrossRefGoogle Scholar
  14. 14.
    Pomari C, Micheletto C, Dal Negro R (1997) MCH-induced broncho-constriction does not enhance gastro-esophageal reflux (GER). Eur Respir J 10(Suppl 25):58sGoogle Scholar
  15. 15.
    Pratter MR, Irwin RS (1984) The clinical value of pharmacologic bronchoprovocation challenge. Chest 85:260–66PubMedCrossRefGoogle Scholar
  16. 16.
    Dal Negro R, Allegra L (1989) Blood gas changes during and after nonspecific airway challenge. J Appl Physiol 67:2627–2630Google Scholar
  17. 17.
    Pomari C, Micheletto C, Dal Negro R (1995) The UNDW-induced PtcCO2 time-course of subjects with persistent cough due to GER proves peculiar. Am J Respir Crit Care Med l51:A412Google Scholar
  18. 18.
    Dal Negro RW, Turco P, Allegra L (1992) Blood gas exchanges in nonasthmatic rhinitics during and after nonspecific challenge. Am Rev Respir Dis 145:337–339Google Scholar
  19. 19.
    Pomari C, Micheletto C, Turco P, et al (1997) Acid drink enhances MCH response in GER only in subjects showing hypoxic response to UNDW. Eur Respir J 10:66sGoogle Scholar
  20. 20.
    Girelli-Bruni E, Tognella S, Dal Negro R (1996) Modelli di studio matematico-stati-stici. In: Dal Negro R (ed) Reattività bronchiale in salutee malattia. It J Chest Dis Publ, 55–54Google Scholar
  21. 21.
    Pomari C, Micheletto C, Dal Negro R (1996) UNDW-induced hyperventilation confirms as the peculiar hyperreactive feature in asymptomatic subjects with gastroesophageal reflux (GER). Eur Respir J 9(Suppl 23):85–86Google Scholar
  22. 22.
    Lee BP, Sant’Ambrogio G, Sant’Ambrogio FB (1992) Different innervation and receptors of the canine extrathoracic trachea. Respir Physiol 90:55–65PubMedCrossRefGoogle Scholar
  23. 23.
    Pomari C, Micheletto C, Dal Negro R (1996) Reattività bronchiale e reflusso gastroesofageo. In: Dal Negro R (ed) Reattività bronchiale in salute e malattia. It J Chest Dis Publ, 55–58Google Scholar
  24. 24.
    Dal Negro R, Pomari C, Micheletto C, Turco P (1996) Omeprazole (OM), but not placebo (P), reduces the bronchial response to methacholine (MCH) in mild non-atopic asthmatics with gastroesophageal reflux (GER). Am J Respir Crit Care Med 153:A517Google Scholar
  25. 25.
    Dal Negro R, Pomari C, Turco P, Allegra L (1994) Gastroesophageal reflux and bronchial asthma: a cross over omeprazole vs placebo comparison. Am J Respir Crit Care Med 149:A202Google Scholar
  26. 26.
    Levin TR, Sperling RM, McQuaid KR (1998) Omeprazole improves peak expiratory flow rate and quality of life in asthmatics with gastroesophageal reflux. Am J Gastroenterol 93:1060–1063PubMedCrossRefGoogle Scholar
  27. 27.
    Dal Negro R, Tognella S, Micheletto C, Turco P, Trevisan F, Pomari C (1998) Pantoprazole 40 mg, but not placebo, improves the non-specific bronchial hyperre-sponsiveness in non atopic asthmatics with GER. Chest 114:297Google Scholar
  28. 28.
    Micheletto C, Burti E, Mauroner L, Pomari C, Turco P, Dal Negro R (1997) Induced sputum and serum inflammatory markers in subjects with cough due to gastroesophageal reflux. Eur Respir J 10(Suppl 25):317sGoogle Scholar
  29. 29.
    Micheletto C, Mauroner L, Burti E, Pomari C, Dal Negro R (1997) Induced sputum examination and serum inflammatory markers in asthma due to gastro-esophageal reflux. Eur Respir J 10(Suppl 25):317Google Scholar
  30. 30.
    Venge P (1993) Serum measurements of eosinophil cationic protein (ECP) in bronchial asthma. Clin Exp Allergy 23:3–7PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • R. W. Dal Negro
    • 1
  • C. Pomari
    • 1
  1. 1.Lung DepartmentBussolengo General HospitalBussolengo (Verona)Italy

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