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.
U.O.C. di Pneumologia, Istituto G. Gaslini, Largo G. Gaslini 5, Genova 16147, Italy.
Oliviero
O
Sacco
Michela
M
Silvestri
Federica
F
Sabatini
Rosa
R
Sale
Gianna
G
Moscato
Patrizia
P
Pignatti
Girolamo
G
Mattioli
Giovanni A
GA
Rossi
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