Author/Authors :
Ghanei, Mostafa Research Center of Chemical Injuries - Baqiyatallah University of Medical Sciences, Tehran , Jafari, Mahvash Research Center of Chemical Injuries - Baqiyatallah University of Medical Sciences, Tehran , Aslani, Jafar Research Center of Chemical Injuries - Baqiyatallah University of Medical Sciences, Tehran , Salehi, Maryam Research Center of Chemical Injuries - Baqiyatallah University of Medical Sciences, Tehran , Aliannejad, Rasoul Respiratory Diseases and TB Research Center of Guilan University of Medical Science, Razi Hospital, Rasht, , Hashemi-Bajgani, Mehdi Department of Pulmonology, Kerman University of Medical Sciences, Kerman , Karbasi, Asharaf Baqiyatallah Research Center for Gastroenterology and Liver Diseases - Baqiyatallah University of Medical sciences, Tehran
Abstract :
Bronchiolitis obliterans (BO) is the main pulmonary involvement resulting from sulfur mustard (SM) gas
exposure that was used against Iranian civilians and military forces during the Iran-Iraq war. The present study aimed to investigate
the prevalence of gastro-esophageal reflux (GER) and gastric micro-aspiration in SM gas injured patients with chronic pulmonary
diseases and recurrent episodes of exacerbations. Materials and Methods: This cross-sectional study was done at Baqiyatallah
University of Medical Sciences, Tehran, Iran. Gastric micro-aspiration and GER were assessed in the enrolled patients by assessing
bile acids, pepsin and trypsin in their bronchoalveolar lavage fluid. Results: Our result showed that bile acids were found to be high in
21.4% patients, and low in 53.6% of patients. Only in 16% patients, no bile was detected in the BALF. Trypsin and pepsin were detected
in BAL fluid of all patients. Conclusion: Most of BO patients after exposure to SM suffer GER, while none the etiologic factors of
GER in post lung transplant BO are present. It would be hypothesized that GER per se could be considered as an aggregative factor
for exacerbations in patients. Further studies will provide more advances to better understanding of pathophysiological mechanism
regarding GER and BO and treatment.
