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The aim of this study was to evaluate the metabolite profile in bronchoalveolar (BAL) fluid from children with suspected EERD and assess the impact of reflux treatment on these metabolites. In this prospective pilot study, we performed nontargeted global metabolomic profiling on BAL fluid from 43 children undergoing testing with bronchoscopy, upper endoscopy, and multichannel intraluminal impedance with pH (pH\u2010MII) for evaluation of chronic respiratory symptoms. Twenty\u2010three (54%) patients had an abnormal pH\u2010MII study. Seventeen (40%) patients were on proton pump inhibitors (PPIs) for testing. Levels of histamine, malate, adenosine 5\u2032\u2010monophosphate, and ascorbate were significantly lower in subjects with abnormal pH\u2010MII studies compared to those normal studies. Furthermore, in children off PPI therapy, those with abnormal pH\u2010MII studies had robust increases in a number of glycerophospholipids within phospholipid metabolic pathways, including derivatives of glycerophosphorylcholine, glycerophosphoglycerol, and glycerophosphoinositol, compared to those with normal pH\u2010MII studies. These findings offer insight into the impact of reflux and PPIs on the lungs and provide a foundation for future studies using targeted metabolomic analysis to identify potential biomarkers of EERD.<\/jats:p>","DOI":"10.1111\/cts.13064","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T04:18:58Z","timestamp":1622521138000},"page":"2025-2033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Metabolomic profiling of extraesophageal reflux disease in children"],"prefix":"10.1111","volume":"14","author":[{"given":"Lisa B.","family":"Mahoney","sequence":"first","affiliation":[{"name":"Aerodigestive Center Division of Gastroenterology, Hepatology and Nutrition Boston Children\u2019s Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Charles R.","family":"Esther","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonology University of North Carolina School of Medicine Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara","family":"May","sequence":"additional","affiliation":[{"name":"Aerodigestive Center Division of Gastroenterology, Hepatology and Nutrition Boston Children\u2019s Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Rosen","sequence":"additional","affiliation":[{"name":"Aerodigestive Center Division of Gastroenterology, Hepatology and Nutrition Boston Children\u2019s Hospital Boston Massachusetts 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