Document Detail


Omeprazole reduces the response to capsaicin but not to methacholine in asthmatic patients with proximal reflux.
MedLine Citation:
PMID:  17354108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the relationships between airway responsiveness to methacholine and capsaicin, proximal or distal reflux and the effects of short-term acid inhibition. MATERIAL AND METHODS: Twenty-nine asthmatics, not taking steroids regularly, underwent respiratory symptom measurements, 24-h dual-probe pH monitoring, and challenges with methacholine and capsaicin. Challenges and symptom measurements were repeated after 12 days' omeprazole treatment (20 mg b.i.d.). The results (median and range) were expressed as PD20 methacholine (mg) and PD5 capsaicin (dose causing five coughs, nmol). RESULTS: Seventeen patients presented pathological reflux in the distal esophagus, and 17 in the proximal esophagus. At baseline no correlation was found between PD20 or PD5 and reflux. Treatment with omeprazole did not change bronchial responsiveness to methacholine (basal: 0.16 mg, 0.02-1.27; omeprazole: 0.15 mg, 0.02-1.60); omeprazole decreased the tussive response to capsaicin (basal: 0.08 nmol, 0.08-2.46; omeprazole: 0.61 nmol, 0.08-9.84, p<0.001) only in patients with pathological reflux. The decrease was positively correlated with proximal acid exposure (r2=0.70, p<0.001). Omeprazole reduced asthma symptoms in patients with proximal reflux, cough in those with proximal or distal reflux. CONCLUSIONS: In asthmatics, inhibition of gastric acid secretion does not influence bronchial hyperresponsiveness but decreases tussive sensitivity and this effect is related to proximal reflux.
Authors:
Marcello Ferrari; Luigi Benini; Emanuele Brotto; Francesca Locatelli; Fosca De Iorio; Francesco Bonella; Naika Tacchella; Giuliano Corradini; Vincenzo Lo Cascio; Italo Vantini
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  42     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-13     Completed Date:  2007-08-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  299-307     Citation Subset:  IM    
Affiliation:
Dipartimento di Scienze Biomediche e Chirurgiche, Università di Verona, Italy. marcello.ferrari@univr.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Airway Resistance / drug effects
Analgesics, Non-Narcotic / diagnostic use*
Anti-Ulcer Agents / therapeutic use*
Asthma / etiology,  physiopathology*
Bronchial Hyperreactivity / etiology,  physiopathology
Bronchial Provocation Tests
Bronchoconstriction / drug effects
Bronchoconstrictor Agents / diagnostic use*
Capsaicin / diagnostic use*
Esophageal pH Monitoring
Female
Forced Expiratory Volume / drug effects
Gastroesophageal Reflux / complications,  drug therapy*,  physiopathology
Humans
Hydrogen-Ion Concentration / drug effects
Male
Methacholine Chloride / diagnostic use*
Middle Aged
Omeprazole / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Anti-Ulcer Agents; 0/Bronchoconstrictor Agents; 404-86-4/Capsaicin; 62-51-1/Methacholine Chloride; 73590-58-6/Omeprazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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