IL-8 and airway neutrophilia in children with gastroesophageal reflux and asthma-like symptoms.
Gastroesophageal reflux (GER) may induce respiratory symptoms (RS) through inhalation of acid gastric contents. To characterize the airway inflammation associated with this condition, 20 children [7.4 (0.9) yr old] with "difficult to treat" RS and a positive 24-h oesophageal pH monitoring (pHm) were studied and bronchoalveolar lavage (BAL) performed. The control group included 10 children [7.3 (1.3) yr], non-atopics, with a respiratory clinical history similar to the cases but no reflux, as demonstrated by a negative 24-h oesophageal pHm. On BAL samples, in addition to inflammatory indexes, the lipid-laden macrophage (LLM) index was determined as index of gastric content inhalation. As compared to controls, GER children had higher neutrophil proportion (P=0.002), higher LLM index (P=0.004) and higher concentrations of interleukin (IL)-8 (P=0.005), myeloperoxidase (MPO) (P=0.001) and elastase (P=0.045) in BAL fluid. In GER children, but not in controls, neutrophil proportion significantly correlated with LLM index (r=0.65, P=0.002), with IL-8 (r=0.62, P=0.003) and MPO levels (r=0.54, P=0.014) but not with elastase concentrations. These results suggest an active pathogenetic role of IL-8 in the recruitment and activation of neutrophils in the airways of children with GER, respiratory symptoms and BAL findings suggestive of gastric content aspiration.
Sacco
Oliviero
O
U.O.C. di Pneumologia, Istituto G. Gaslini, Largo G. Gaslini 5, Genova 16147, Italy.
Silvestri
Michela
M
Sabatini
Federica
F
Sale
Rosa
R
Moscato
Gianna
G
Pignatti
Patrizia
P
Mattioli
Girolamo
G
Rossi
Giovanni A
GA
D001249:Asthma / Q000209:etiology* / Q000473:pathology; D001991:Bronchitis / Q000209:etiology* / Q000473:pathology; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000473:pathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016209:Interleukin-8 / Q000502:physiology*; D007964:Leukocytosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D018375:Neutrophil Activation; D009504:Neutrophils; D009195:Peroxidase / Q000378:metabolism; D012129:Respiratory Function Tests
D016209:Interleukin-8; D009195:Peroxidase