therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-8156РостГМУ10.21886/2712-8156-2023-4-2-25-34therapeutic-398Research ArticleОБЗОРЫREVIEWSСинтропия бронхиальной астмы и гастроэзофагеальной рефлюксной болезни: патогенетические особенности и возможности малоинвазивной диагностики на амбулаторном этапеSyntropy of bronchial asthma and gastroesophageal reflux disease: pathogenetic features and possibilities of minimally invasive diagnostics at the outpatient stagehttps://orcid.org/0000-0001-8665-6796ГорбаньВ. В.GorbanV. V.

Горбань Виталий Васильевич – доктор медицинских наук, заведующий кафедрой поликлинической терапии с курсом общей врачебной практики (семейной медицины) ФПК и ППС.

Краснодар

Vitaly V. Gorban - Dr. Sci. (Med.), Head of the chair of polyclinic therapy with course of general medical practice (family medicine) FPK and PPS, Kuban State Medical University.

Krasnodar

gorbanvv@mail.ruhttps://orcid.org/0000-0001-9966-8905КовригинаИ. В.KovriginaI. V.

Ковригина Ирина Валерьевна – кандидат медицинских наук, ассистент кафедры поликлинической терапии с курсом общей врачебной практики (семейной медицины) ФПК и ППС.

Краснодар

Irina V. Kovrigina - Cand. Sci. (Med.), assistant of the Department polyclinic therapy with course of general medical practice (family medicine) FPK and PPS., Kuban State Medical University.

Krasnodar

kovriginairina2010@mail.ruhttps://orcid.org/0000-0002-5026-5053ГорбаньЕ. В.GorbanE. V.

Горбань Елена Витальевна - кандидат медицинских наук, ассистент кафедры поликлинической терапии с курсом общей врачебной практики (семейной медицины) ФПК и ППС.

Краснодар

Еlena V. Gorban - Cand. Sci. (Med.), assistant of the Department polyclinic therapy with course of general medical practice (family medicine) FPK and PPS., Kuban State Medical University.

Krasnodar

msgorban@mail.ruhttps://orcid.org/0000-0002-3720-1346КаменеваЕ. С.KamenevaE. S.

Каменева Елена Сергеевна - кандидат медицинских наук, ассистент кафедры поликлинической терапии с курсом общей врачебной практики (семейной медицины) ФПК и ППС.

Краснодар

Еlena S. Kameneva - Cand. Sci. (Med.),аssistant of the Department polyclinic therapy with course of general medical practice (family medicine) FPK and PPS, Kuban State Medical University.

Krasnodar

Kamenevaes@mail.ruhttps://orcid.org/0000-0003-2765-6328СвистунО. В.SvistunO. V.

Свистун Олеся Владимировна - ассистент кафедры поликлинической терапии с курсом общей врачебной практики (семейной медицины) ФПК и ППС.

Краснодар

Olesya V. Svistun - Assistant of the Department  polyclinic therapy with course of general medical practice (family medicine) FPK and PPS, Kuban State Medical University.

Krasnodar

osvistun83@gmail.comФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава РоссииРоссияKuban State Medical UniversityRussian Federation202304072023422534Copyright © Горбань В.В., Ковригина И.В., Горбань Е.В., Каменева Е.С., Свистун О.В., 20232023Горбань В.В., Ковригина И.В., Горбань Е.В., Каменева Е.С., Свистун О.В.Gorban V.V., Kovrigina I.V., Gorban E.V., Kameneva E.S., Svistun O.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/398

В обзоре освещены вопросы распространенности, патогенеза и клинических проявлений бронхиальной астмы (БА), коморбидной с гастроэзофагеальной рефлюксной болезнью (ГЭРБ). Отмечены трудности диагностики триггеров экстраэзофагеальных симптомов. На основании большого количества клинических исследований в обзоре оценены возможности малоинвазивных методик выявления биомаркеров гастроэзофагеального рефлюкса (ГЭР) и дуоденогастроэзофагеального рефлюкса (ДГЭР) в ротовой жидкости. При синтропии ГЭРБ и БА отмечена значительная роль и связь параметров респираторного оксидативного воспаления с нарушениями функций внешнего дыхания. Для подтверждения рефлюксного происхождения экстраэзофагеальных респираторных  симптомов актуально применение малоинвазивных методик выявления билирубина и пепсина в ротовой жидкости, а для оценки активности респираторного стресса - определение его субстратов в крови. Дальнейшие исследования, направленные на определение нормативных концентраций субстратов ДГЭР в ротовой жидкости и маркеров оксидативного респираторного воспаления в крови, будут способствовать  улучшению диагностики и терапии при синтропии БА и ГЭРБ в амбулаторной практике.

The review highlights the prevalence, pathogenesis and clinical manifestations of bronchial asthma (BA), comorbid with gastroesophageal reflux disease (GERD). Difficulties in diagnosing triggers of extraesophageal symptoms were noted. Based on a large number of clinical studies, the review assesses the possibilities of minimally invasive methods for detecting biomarkers of gastroesophageal  reflux (GER) and duodenogastroesophageal reflux (DGER) in the oral fluid. With syntropy of GERD and BA, a significant role and relationship between the parameters of respiratory oxidative inflammation and impaired functions of external respiration was noted. To confirm the reflux origin of extraesophageal respiratory symptoms, it is important to use minimally invasive methods for detecting bilirubin and pepsin in the oral fluid, and to assess the activity of respiratory stress, the determination of its substrates in the blood. Further studies aimed at determining the normative concentrations of DGER substrates in the oral fluid and markers of oxidative respiratory inflammation in the blood will help improve the diagnosis and treatment of BA and GERD syntropy in outpatient practice.

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The authors declare that there are no conflicts of interest present.