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Gastro-oesophageal reflux is common in patients with cystic fibrosis and can lead to poor lung function
Increased acid gastro-oesophageal reflux (GOR) has been reported in patients with cystic fibrosis (CF). However, its prevalence, characteristics, association with gastric aspiration and impact on respiration are not completely understood. In the study by Blondeau and colleagues, patients with CF underwent: impedance-pH measurement for reflux detection; assessment of the association between reflux and cough; and measurement of bile acids in saliva and bronchoalveolar lavage as surrogate markers for gastric aspiration. Increased GOR was present in 28/33 patients and this was mainly due to acid reflux. However, a small proportion of the patients demonstrated a reflux pattern of mixed acid and weakly acidic reflux, whereas some had mainly weakly acidic reflux. Importantly, reflux did not seem to be secondary to cough because most of the time reflux preceded cough and not the opposite. Gastric aspiration was common, as evidenced by bile acids in saliva in 16/38 patients and in bronchoalveolar lavage fluid in 6/10 patients. Reflux was associated with cough (see fig) and also with poorer lung function. Outcome studies in patients with CF using anti-reflux treatment seem warranted. See page 1044
Clearance of Helicobacter pylori infection in man after vaccination: role of T helper cells
H pylori infection remains a major world health problem and an effective vaccine remains an attractive but as yet unattainable option. Protection against H pylori infection in animal models depends on the induction of T helper cells, while natural infection in man …
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