title: Lipid-laden macrophage index is not an indicator of gastroesophageal reflux-related respiratory disease in children.
abstract: BACKGROUND
  The lipid-laden macrophage index has been used to evaluate for gastroesophageal reflux-related respiratory disease, but the relationship between reflux detected by pH probe and the lipid-laden macrophage index is uncertain despite widespread use of the lipid-laden macrophage index in clinical decision-making. It was the aim of this study to correlate reflux as detected by multichannel intraluminal impedance with the lipid-laden macrophage index.
  
  
  METHODS
  Patients undergoing both pH multichannel intraluminal impedance testing and bronchoscopy between January 2002 and January 2006 were identified. Baseline characteristics were compared by using parametric and nonparametric testing. Reflux profiles were correlated with the lipid-laden macrophage index by using Spearman correlations.
  
  
  RESULTS
  There was no significant correlation between the lipid-laden macrophage index and the number of acid or nonacid reflux events. There also was no significant correlation between the lipid-laden macrophage index and the amount of full-column reflux. There was no significant difference between the mean lipid-laden macrophage index in patients with and without esophagitis. Finally, in patients who underwent fundoplication (n = 13) for intractable respiratory disease, there was no significant difference in any of the reflux parameters between patients who did and did not experience clinical improvement after fundoplication. There was, however, a higher lipid-laden macrophage index in patients with no symptomatic improvement compared with patients with symptomatic improvement.
  
  
  CONCLUSIONS
  Lipid-laden macrophage index lacks the specificity necessary to detect reflux-related respiratory disease.
authors: Center for Aerodigestive Disorders, Department of Pediatric Gastroenterology and Nutrition, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. rachel.rosen@childrens.harvard.edu
authors: Rachel
authors: R
authors: Rosen
authors: Julia
authors: J
authors: Fritz
authors: Ariela
authors: A
authors: Nurko
authors: Dawn
authors: D
authors: Simon
authors: Samuel
authors: S
authors: Nurko
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005260:Female; D018662:Fundoplication; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism* / Q000601:surgery; D006801:Humans; D007223:Infant; D050356:Lipid Metabolism; D016676:Macrophages, Alveolar / Q000737:chemistry / Q000166:cytology / Q000378:metabolism*; D008297:Male; D011336:Probability; D012016:Reference Values; D012140:Respiratory Tract Diseases / Q000175:diagnosis* / Q000209:etiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers