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Gastroesophageal reflux and asthma: when, how, and why
Giovanni Paoletti1,2, Giulio Melone1, Sebastian Ferri1,2
1Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano.
Current Opinion in Allergy and Clinical Immunology
|December 28, 2020
Summary
Gastro-esophageal reflux disease (GERD) significantly impacts asthma control. Investigating and treating GERD is crucial for managing asthma symptoms before initiating advanced therapies.
Area of Science:
- Gastroenterology and Pulmonology
- Inflammatory Mechanisms in Disease
Background:
- Gastro-esophageal reflux (GER) is increasingly recognized as a contributing factor to uncontrolled asthma symptoms.
- The interplay between GER and asthma necessitates a deeper understanding of shared pathophysiological mechanisms.
Purpose of the Study:
- To review the current understanding of the link between GER and asthma.
- To highlight the importance of investigating and treating GER in asthmatic patients.
Main Methods:
- Review of recent investigations on esophageal function and tissue biomarkers in asthma patients with GERD.
- Analysis of studies characterizing inflammatory substrates in GERD-associated asthma.
Main Results:
- Esophageal motility and neuronal sensory abnormalities are key links between asthma and GERD.
- Inflammatory patterns in GERD-associated asthma are diverse, including neutrophilic and eosinophilic type 2 inflammation.
- New diagnostic tools and understanding of inflammatory mechanisms offer potential treatable traits.
Conclusions:
- Active investigation and treatment of GER are essential before diagnosing severe asthma or starting biological therapy.
- Identifying and managing GER-specific traits can improve clinical outcomes for asthmatic patients with GERD.
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