[Possible connection between gastroesophageal reflux and interstitial pulmonary fibrosis in patients with systemic sclerosis].
Interstitial lung disease represents the main cause of morbidity and mortality in patients with systemic sclerosis. The mechanisms leading to interstitial lung disease are poorly understood and thus current strategies have little effect on this progressive and fatal disease. Therefore, it appears relevant the importance to assess the possible risk factors involved in its pathogenesis. Previous studies in vivo and in vitro suggested that pulmonary fibrosis can occur after repeated aspiration of small amounts of gastric contents over long periods of time. Recently, our group observed that patients with systemic sclerosis and pulmonary fibrosis have a more severe degree of gastroesophageal reflux with a greater number of reflux events and a higher percentage of reflux episodes reaching the proximal esophagus, causing an increasing risk of microaspiration, compared to patients with systemic sclerosis without lung involvement. Further larger controlled studies are necessary to evaluate whether or not the development of interstitial lung disease in systemic sclerosis patients can be prevented by treating gastroesophageal reflux.
Savarino
Edoardo
E
Di.M.I., Dipartimento di Medicina Interna, Unità di Gastroenterologia con Endoscopia Digestiva, Università Genova. edoardo.savarino@unige.it
Ghio
Massimo
M
Marabotto
Elisa
E
Zentilin
Patrizia
P
Sammito
Giorgio
G
Cittadini
Giuseppe
G
Sconfienza
Luca
L
Murolo
Carmelina
C
Gemignani
Lorenzo
L
Indiveri
Francesco
F
Savarino
Vincenzo
V
D000367:Age Factors; D000368:Aged; D000818:Animals; D004195:Disease Models, Animal; D050782:Esophageal pH Monitoring; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000209:etiology; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000150:complications / Q000209:etiology*; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications* / Q000401:mortality