Effect of gastroesophageal reflux on cilia in upper respiratory tract in children

Czech version

Authors: J. Kvaššayová ^1,2; P. Ďurdík ^1,2; V. Kučeravá ¹; D. Oppová ^1,2; D. Šutvajová ¹
Authors‘ workplace: Klinika detí a dorastu, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin, Slovensko ¹; Centrum experimentálnej a klinickej respirológie, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin, Slovensko ²
Published in: Čes-slov Pediat 2021; 76 (6): 296-303.
Category: Original Papers

Overview

Introduction: Cilia are complex cellular organelles located on the surface of most cells in the body. They are an important component of mucocular transport, which provides cleansing of the airways. Gastroesophageal reflux disease (GER) is very often associated with typical extraesophageal symptomatology (rhinitis, sinusitis, cough, wheezing, etc.) in childhood, which is often a manifestation of impaired mucoliary clearance of the airways.

Objective: Influence gastroesophageal reflux of the ciliary kinematics.

Methodology: Prospective study from 2017–2019 realised at the Department of Children and Adolescents of University Hospital in Martin, pediatric patients aged 4 to 18 years were included, with suspected suspicion of gastroesophageal or extraesophageal reflux with extraesophageal symptomatology. All patients underwent a 24-hour multichannel intraluminal impedance with pH-metry and a sample of the upper airway respiratory epithelial mucosa was taken from the concha nasalis inferior. The sample was seen under a light microscope, short videos were recorded, and the frequency of cilia oscillations was evaluated using special software. Evaluated 24-hour MII with pH-metrics manually, results compared with ciliary frequency measurements in patients with GERD. The control group for comparing the frequency of ciliary kinematics consisted of healthy individuals.

Results: 40 patients with GERD were enrolled. Male prevalence was higher (55%). The ciliary kinematics in patients with GERD was significantly lower than in the control group (4.43 Hz±2.2 Hz vs. 6.86 Hz±0.96 Hz, p<0.001). In 6 patients, a control sample of cilia was performed after 6 months, where there was a significant increase in ciliary kinematics on GERD treatment (4.08 Hz±1.7 Hz vs. 5.39 Hz±0.69 Hz).

Conclusion: Based on our results to date, it can be stated that in patients with GERD/EER there is a decrease in ciliary kinematics compared to the control group. We consider the low number of individuals to be a limitation.

Keywords:

gastroesophageal reflux – Pediatrics – secondary targetiopathy – ciliary kinematics – multichannel intraluminal impedance – GERD – EER

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