Pepsin and bile acid concentrations in sputum of mustard gas exposed patients

Ashraf Karbasi; Hassan Goosheh; Rasoul Aliannejad; Hamid Saber; Maryam Salehi; Mahvash Jafari; Saber Imani; Amin Saburi; Mostafa Ghanei

doi:10.4103/1319-3767.111954

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ORIGINAL ARTICLE

Year : 2013 | Volume : 19 | Issue : 3 | Page : 121-125

Pepsin and bile acid concentrations in sputum of mustard gas exposed patients

Ashraf Karbasi¹, Hassan Goosheh², Rasoul Aliannejad³, Hamid Saber⁴, Maryam Salehi², Mahvash Jafari⁵, Saber Imani⁶, Amin Saburi⁷, Mostafa Ghanei²
¹ Baqiyatallah Research Center of Gastroentrology and Liver diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
² Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
³ Respiratory Diseases and TB Research Center of Guilan University of Medical Science, Razi Hospital, Rasht; Advanced Thoracic Research Centre, Tehran University of Medical Sciences, Iran
⁴ Pulmonary Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
⁵ Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
⁶ Young Researchers Club and Elites, Central Tehran Branch, Islamic Azad University, Tehran, Iran
⁷ Health Research Center, Baqiyatallah university of medical sciences, Tehran, Iran

Correspondence Address:
Mostafa Ghanei
Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran
Iran

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/1319-3767.111954

Background/Aim: Gastro-esophageal reflux has been suggested to be associated with several pulmonary complications such as asthma, and post-transplant bronchiolitis obliterans (BO). Pepsin or bile salts in the sputum is shown to be an optimal molecular marker of gastric contents macro/micro aspiration. In this study, we investigated sputum pepsin as a marker of micro-aspiration in sulfur mustard (SM) exposed cases compared to healthy controls. Materials and Methods: In a case controlled study, 26 cases with BO and 12 matched healthy controls were recruited and all cases were symptomatic and their exposure to SM was previously documented during Iran-Iraq conflict. Pepsin levels in sputum and total bile acids were measured using enzymatic assay. The severity of respiratory disorder was categorized based upon the spirometric values. Result: The average concentration of pepsin in sputum was higher in the case group (0.29 ± 0.23) compared with healthy subjects (0.13 ± 0.07; P ± 0.003). Moreover, the average concentration of bile acids in the sputum cases was not significantly different in comparison to the controls ( P = 0.5). Conclusion: Higher pepsin concentrations in sputum of SM exposed patients compared with healthy control subjects indicate the occurrence of significantly more gastric micro-aspiration in SM exposed patients.

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