Abstract
The role of acidic gastro-oesophageal reflux (GER) in priming non-specific bronchial hyper-responsiveness (BHR) still represents a quite challenging topic of investigation (1, 2). Aim of the study: to investigate the role of a PPI single-dose, namely esomeprazole 80mg, in affecting BHR. Methods: after written consent, the BHR to MCh was checked in baseline and 24h following Esomeprazole (ESO) 80mg single-dose in 18 non-smokers (9 m.; 18-60y; basal FEV1>80%pred; PD20 MCh <400mcg) with mild atopic (n=8) and non-atopic GER-related (n=10) asthma. GER was assessed by a 24h gastro-oesophageal pH monitoring), Statistics: Wilcoxon test, and p<0.05 assumed. Results in tab.1 (means±sd; PD20 MCh in mcg). Results: subjects were well matched for age, weight, height, basal FEV1, and basal PD20 MCh. ESO 80mg single-dose induced a significant increase in PD20 FEV1 MCh (p< 0.01) only in non-atopic GER-related asthmatics. Conclusions: 1) in the presence of acidic GER, the non specific BHR is affected by the PPI‘s gastric acidity blockade; 2) a single-dose of Esomeprazole 80mg assumed 24h before the bronchial challenge is effective in improving BHR; 3) the role of acidic GER in priming BHR is further emphasized in non-atopic asthma. References: 1) Ayres JG et al. Eur Respir J 1996; 9: 1073-78. 2) Dal Negro et al. Eur.Respir.Mon., 2003 ;23 :260-277

tab.1
PD20 bslnPD20 ESOP
ger-induced asthma138.6±99.8375.5±398.00.001
atopic asthma106.4±91.598.7±71.7ns