Risk factors for lung disease progression in children with cystic fibrosis. Issue 4 (4th October 2018)

• Record Type: Journal Article
• Authors: Al Momani, Hafez; Perry, Audrey; Jones, Rhys; McDonnell, Melissa; Krishnan, Amaran; Robertson, Andrew; Griffin, Mike; Rutherford, Robert; Brodlie, Malcolm; Pearson, Jeff; Bourke, Steve; Ward, Chris
• Is Part Of: European respiratory journal. Volume 52:Issue 4(2018)
• Publication Date: 2018-10-04
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01492-2018
• Languages: English
• ISSNs: 0903-1936

Abstract

We read with interest the recent paper byvan Horck et al . [1], which studied 545 children followed for 5 years with longitudinal data from the Dutch Cystic Fibrosis registry. Data from 2009 to 2014 showed that proton pump inhibitor (PPI) use was associated with annual decline of % predicted forced expiratory volume in 1 s and future pulmonary exacerbation rates. In a discussion of potential mechanisms, the authors considered that bacteria are normally killed by acid conditions in the stomach but that gastric pH is raised following PPI use. It was therefore hypothesised that with extra-oesophageal reflux, surviving pathogens could reach the upper airway and be aspirated. We call for studies of widespread use of proton pump inhibitor therapy in people with cystic fibrosis and chronic lung disease; these should evaluate patient benefit and potential iatrogenic effects, including dysregulation of aerodigestive homeostasis http://ow.ly/ym6H30lxxZu