ArticleNeurogastroenterology and motility2012
The presence of pepsin in the lung and its relationship to pathologic gastro-esophageal reflux.
Article in Neurogastroenterology and motility, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Guidelines on diagnosis and management of gastroesophageal reflux disease in infants, children and adolescents: a joint consensus from Italian pediatric societies (SIP and SIGENP) -part I. diagnosis.Italian journal of pediatrics · 2026Guideline
- Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.Journal of pediatric gastroenterology and nutrition · 2018Guideline
- Unravelling the Links Between Gastroesophageal Reflux and Lung Disease: New Insights.Digestive diseases and sciences · 2026Review
- The Impact of Inhaled Corticosteroids on Lung Inflammation and Clinical Outcomes in Children with Oropharyngeal Dysphagia.The Journal of pediatrics · 2025Article
- Alarmin Levels and Gastroesophageal Reflux Disease in Children: Significant Elevation of Thymic Stromal Lymphopoietin.Pediatric reports · 2025Article
- Diagnostic value of the pepsin concentration in saliva and induced sputum for gastroesophageal reflux-induced chronic cough: a prospective clinical study.ERJ open research · 2024Article
- Gastroesophageal reflux disease in children: What's new right now?World journal of gastrointestinal endoscopy · 2023Review
- Pepsin and the Lung-Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease.Journal of personalized medicine · 2022Review
- Different clinical symptom patterns in patients with reflux micro-aspiration.ERJ open research · 2022Article
- Limited Clinical Utility of Lipid-Laden Macrophage Index of Induced Sputum in Predicting Gastroesophageal Reflux-Related Cough.Allergy, asthma & immunology research · 2021Article
- Metabolomic profiling of extraesophageal reflux disease in children.Clinical and translational science · 2021Observational
- Positive bronchoalveolar lavage pepsin assay associated with viral and fungal respiratory infections in children with chronic cough.Pediatric pulmonology · 2021Article
- The panoramic picture of pepsinogen gene family with pan-cancer.Cancer medicine · 2020Article
- Pepsin as a Marker of Reflux Aspiration in Children With Esophageal Atresia: A Pilot Study.Frontiers in pediatrics · 2020Article
- Pepsin Triggers Neutrophil Migration Across Acid Damaged Lung Epithelium.Scientific reports · 2019Article
- Size and Prevalence of Pediatric Aerodigestive Programs in 2017.Journal of pediatric gastroenterology and nutrition · 2019Article
- Diagnosis and Management of Gastroesophageal Reflux Disease in Infants and Children: from Guidelines to Clinical Practice.Pediatric gastroenterology, hepatology & nutrition · 2019Review
- Detection of pepsin and IL-8 in saliva of adult asthmatic patients.Journal of asthma and allergy · 2019Article
- Managing patients with chronic cough: challenges and solutions.Therapeutics and clinical risk management · 2018Article
- Gastroesophageal Reflux Disease.Pediatric clinics of North America · 2017Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPepsin has been proposed as a biomarker of reflux-related lung disease. The goal of this study was to determine (i) if there is a higher reflux burden as measured by pH-MII in patients that are pepsin positive in the lung, and (ii) the sensitivity of pepsin in predicting pathologic reflux by pH, MII, and EGD.
methodsWe recruited children between the ages of 1-21 with chronic cough or asthma undergoing bronchoscopy, esophagogastroduodenoscopy (EGD), and multichannel intraluminal impedance (pH-MII) probe placement. The reflux profiles were compared between those patients who were pepsin positive and negative; proportions were compared using Chi-squared analyses and means were compared using t-testing. KEY
resultsOnly the mean number of non-acid reflux events was associated with pepsin positivity (0.04). The sensitivity and specificity of pepsin in predicting pathologic reflux by pH-MII or EGD was 57% and 65%, respectively. The positive predictive value of pepsin in predicting pathologic reflux by pH, MII or EGD was 50% (11/22), and the negative predictive value was 71% (20/28). There was a significantly higher mean LLMI in patients who were pepsin positive compared with pepsin negative patients (81 ± 54 vs 47 ± 26, P = 0.001). CONCLUSIONS & INFERENCES: Lung pepsin cannot predict pathologic reflux in the esophagus, but its correlation with lung inflammation suggests that pepsin may be an important biomarker for reflux-related lung disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.