Document Detail


Dilated intercellular spaces and chronic cough as an extra-oesophageal manifestation of gastrooesophageal reflux disease.
MedLine Citation:
PMID:  20970514     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Chronic cough is one of the extra-oesophageal manifestations of gastrooesophageal reflux disease (GORD). It is presumed to occur either directly by microaspiration of acidic gastric contents into the airway or indirectly by a reflex triggered by contact of acidic refluxates with the oesophageal epithelium in GORD. How contact of the oesophageal epithelium with acidic refluxates promotes sensitization for chronic cough is unknown, but like heartburn, which is a necessary accompaniment, it requires acid activation of nociceptors within the oesophageal mucosa. Dilated intercellular spaces within the oesophageal epithelium, a reflection of an increase in paracellular permeability, is a histopathologic feature of both erosive and non-erosive forms of GORD. Since it correlates with the symptom of heartburn, it is hypothesized herein that the increase in paracellular permeability to acid reflected by dilated intercellular spaces in oesophageal epithelium also serves as mediator of the signals that produce the reflex-induced sensitization for cough - a sensitization that can occur centrally within the medullary Nucleus Tractus Solitarius or peripherally within the tracheobronchial tree.
Authors:
Roy C Orlando
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Publication Detail:
Type:  Journal Article     Date:  2010-10-21
Journal Detail:
Title:  Pulmonary pharmacology & therapeutics     Volume:  24     ISSN:  1522-9629     ISO Abbreviation:  Pulm Pharmacol Ther     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715279     Medline TA:  Pulm Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  272-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Affiliation:
University of North Carolina School of Medicine, 103 Mason Farm Road, CB#7032; MBRB, Rm 7312c, Chapel Hill, NC 27599, USA.
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