Research On Correlation Of Gastroesophageal Reflux And Asthma

Objective: investigation whether gastroesophageal reflux can cause asthma-like pathophysiological changes and its mechanismMethods: Selected60BALB/c of mice6to8weeks age, were randomly divided into4groups, in each group15mice (n=15):A group (gastroesophageal reflux control group), B group (asthma control group), C group(gastroesophageal reflux model group),B group (asthma model group). In C group, on the first day started slow perfusion0.1mmol/L+0.5%hydrochloric acid solution pepsin, Ph3, once A day, continuous21days. In D group, using freshly prepared20μg ova albumin(OVA)+1mg aluminum hydroxide intraperitoneal on the1,8,15days sensitized, on22day started OVA (10mg/ml) inhalation30minutes,1time every day for7days, In A groups, normal saline aerosol slow perfusion used instead of0.1mmol/L+0.5%hydrochloric acid solution pepsin for21days,, In B groups, normal saline aerosol inhalation used instead of intraperitoneal ovalbumin injection respectively.One week later, B groups were sensitized with2%OVA for30minute and gavage to mice after intragastric administration, then test the change of airway resistance were observed for3min and counted eosinophils and neutrophilic granulocyte in bronchial lavage fluid.Using flow cytometry determination of spleen cell of IL-4, IFN-γ, Thl/Th2ratio changes; Lung tissue and esophagus sections were stained with HE, pathological changes of lung tissue and esophagus observed. Results:①Airway hyper-responsiveness did not occur in mice in A group and B group after airway resistance detection. In the C,D, groups, significantly increased compared to A groups and B groups, the difference was statistically significant (P <0.05). C, D between the two groups no significant difference (P>0.05).②The4groups of mice IL-4worthy of comparison in, the C,D, groups significantly increased compared to A,B group, the difference was statistically significant (P<0.05). C, D between the two groups no significant difference (P>0.05).④IFN-γ worthy of caparison the C,D groups, significantly increased compared to A,B group, the difference was statistically significant (P<0.05). C, D between the two groups no significant difference (P>0.05).C、D groups Th1/Th2ratio than the A, B groups were significantly decreased, the difference was statistically significant (P<0.05), A, B between the two groups no significant difference (P>0.05).⑤The4groups of mice BALF EOS number occupies total cells. In bronchial lavage fluid of A,B group there were a small number of eosinophils (EOS). EOS of C, D groups accounted for a percentage of total cells were significantly higher than the A, B group, the differences were statistically significant (P<0.05). EOS of A、B groups accounted for a percentage of total cells had increased, but no statistical differences (P>0.05) between C and D group. In A、B、C and D group between the four groups are compared with each other the neutrophil percentage had no statistical significance(P>0.05)⑥Lung tissue biopsy can be observed in the C, D group of the bronchial lumen deformation, infiltration of inflammatory cells around the wall, basement membrane thickening, around the wall were a larger number of inflammatory cell infiltration, peripheral vascular edema, alveolar cavity change big, alveolar wall thinning, fracture, part of alveolar fusion into bullace of lung. The lung pathological section showed that the endothelial cells in A, B group were integrated, and had no denaturation or necrosis, stroma did not see of inflammation cell infiltrate, periviascular did not see edema. Esophageal biopsy can be observed in A, B group of lower esophagus markedly submucosal edema, submucosal inflammatory cell infiltrating, horny hyperfunction, visible bacteria group. A, B, D group is basic and normal, no pathological changes.Conclusion: gastroesophageal reflux can induce asthma of similar kind of pathophysiological changes.