CHEST Guidelines-Could-Aspiration-Pepsin-Be-Used-as-a-Marker-of-Gas

Could-Aspiration-Pepsin-Be-Used-as-a-Marker-of-Gas

Pdf Summary

The letter from Jian-jun Ren and colleagues addresses findings from a study on the potential role of aspiration in asthma, questioning whether pepsin present in aspiration samples is linked to asthma control. The original study indicated no significant association between pepsin levels in aspirations and asthma exacerbations. Ren et al.'s critique focuses on the type of pepsin analyzed, suggesting a distinction between Pepsin A and Pepsinogen A (PGA) should be made. They propose that PGA may be the correct form, as Pepsin A becomes inactive in non-acidic environments. Furthermore, they question whether the original study considered serum PGA levels alongside aspiration PGA. Citing other studies, they note that serum PGA is a known marker for stomach health and speculate that the aspirated PGA concentrations reported are insufficient to definitively indicate gastric reflux, which could explain the lack of correlation with asthma found in the study. Ren et al. express interest in whether serum measurements were simultaneous with aspiration measurements to effectively evaluate this relationship, emphasizing that serum PGA is generally higher than the concentrations found in aspirations.<br /><br />In response, the initial authors welcome the attention to their research and emphasize their aim to explore aspiration's pathological role in asthma. They acknowledge the critique and the need for careful identification of pepsin types to further clarify the study findings, although the specifics of their response are not fully provided in the summary. Thus, while Ren et al.'s letter highlights important considerations in the study of aspiration and asthma, it invites further exploration and validation of findings, particularly concerning pepsin's role and measurement.

Keywords

asthma

aspiration

pepsin

Pepsin A

Pepsinogen A

PGA

asthma control

serum PGA

gastric reflux

asthma exacerbations