Airway cellularity, lipid laden macrophages and microbiology of gastric juice and airways in children with reflux oesophagitis

Chang, A. B., Cox, N. C., Purcell, J., Marchant, J. M., Lewindon, P. J., Cleghorn, Geoffrey J., Ee, L. C., Withers, G. D., Patrick, M. K., & Faoagali, J. (2005) Airway cellularity, lipid laden macrophages and microbiology of gastric juice and airways in children with reflux oesophagitis. Respiratory Research, 6, p. 72.

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Background: Gastroesophageal reflux disease (GORD) can cause respiratory disease in children from recurrent aspiration of gastric contents. GORD can be defined in several ways and one of the most common method is presence of reflux oesophagitis. In children with GORD and respiratory disease, airway neutrophilia has been described. However, there are no prospective studies that have examined airway cellularity in children with GORD but without respiratory disease. The aims of the study were to compare (1) BAL cellularity and lipid laden macrophage index (LLMI) and, (2) microbiology of BAL and gastric juices of children with GORD (G+) to those without (G-). Methods: In 150 children aged <14-years, gastric aspirates and bronchoscopic airway lavage (BAL) were obtained during elective flexible upper endoscopy. GORD was defined as presence of reflux oesophagitis on distal oesophageal biopsies. Results: BAL neutrophil% in G- group (n = 63) was marginally but significantly higher than that in the G+ group (n = 77), (median of 7.5 and 5 respectively, p = 0.002). Lipid laden macrophage index (LLMI), BAL percentages of lymphocyte, eosinophil and macrophage were similar between groups. Viral studies were negative in all, bacterial cultures positive in 20.7% of BALs and in 5.3% of gastric aspirates. BAL cultures did not reflect gastric aspirate cultures in all but one child. Conclusion: In children without respiratory disease, GORD defined by presence of reflux oesophagitis, is not associated with BAL cellular profile or LLMI abnormality. Abnormal microbiology of the airways, when present, is not related to reflux oesophagitis and does not reflect that of gastric juices. © 2005 Chang et al; licensee BioMed Central Ltd.

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ID Code: 89443
Item Type: Journal Article
Refereed: No
Additional Information: Cited By :20
Export Date: 1 September 2015
Correspondence Address: Chang, A.B.; Department of Paediatrics, University of Queensland, Brisbane, QLD, Australia; email:
Keywords: airway, article, aspiration, bacterium culture, cell count, child, controlled study, endoscopy, eosinophil, esophagus biopsy, female, gastroesophageal reflux, human, infant, lung lavage, lymphocyte, macrophage, major clinical study, male, microbiological examination, microflora, neutrophil, reflux esophagitis, respiratory tract examination, stomach juice, adolescent, blood cell count, controlled clinical trial, cytology, metabolism, microbiology, pathology, preschool child, lipid, Bronchoalveolar Lavage Fluid, Child, Preschool, Gastric Juice, Humans, Lipids, Macrophages
DOI: 10.1186/1465-9921-6-72
ISSN: 1465-993X
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Deposited On: 26 Oct 2015 01:18
Last Modified: 15 May 2017 03:19

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