{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:50:55Z","timestamp":1777891855512,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T00:00:00Z","timestamp":1422748800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Acid gastroesophageal reflux is a common problem in non-cystic fibrosis bronchiectasis and COPD. Invasive methods are used to diagnose gastroesophageal reflux, but the ability to detect pulmonary microaspiration of gastric contents using this method is unclear. A noninvasive option to detect pulmonary microaspiration is to measure pepsin in exhaled breath condensate (EBC), but this has not been related to esophageal pH monitoring in these lung conditions. This study aimed to measure pepsin concentrations and pH in EBC and to determine the relationship to gastroesophageal reflux in bronchiectasis or COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Subjects with bronchiectasis (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10) or COPD (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10) and control subjects (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10) completed 24-h esophageal pH monitoring for detection of acid gastroesophageal reflux, measuring the percentage of reflux time in the proximal esophagus and the DeMeester score (DMS). Concurrently, 3 samples of EBC were collected from each subject, and pH was measured and pepsin concentrations were analyzed by enzyme-linked immunosorbent assay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      EBC pepsin was detected in subjects with bronchiectasis (44%) or COPD (56%) and in control subjects (10%). A diagnosis of gastroesophageal reflux was not associated with a higher concentration of EBC pepsin in bronchiectasis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .21) or COPD (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .11). EBC pepsin concentration did not correlate with DMS (r\n                      <jats:sub>s<\/jats:sub>\n                      = 0.36) or proximal reflux index (r\n                      <jats:sub>s<\/jats:sub>\n                      = 0.25) in subjects with bronchiectasis or with DMS (r\n                      <jats:sub>s<\/jats:sub>\n                      = 0.28) or proximal reflux index (r\n                      <jats:sub>s<\/jats:sub>\n                      = 0.21) in patients with COPD. EBC and sputum pepsin concentrations were moderately correlated in bronchiectasis (r\n                      <jats:sub>s<\/jats:sub>\n                      = 0.56) and in COPD (r\n                      <jats:sub>s<\/jats:sub>\n                      = 0.43).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Pepsin is detectable in EBC samples in bronchiectasis and COPD. Although no association was found between pepsin concentrations and a diagnosis of gastroesophageal reflux, a moderate relationship between sputum and EBC pepsin concentrations suggests that EBC pepsin may be a useful noninvasive marker of pulmonary microaspiration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.03570","type":"journal-article","created":{"date-parts":[[2014,10,29]],"date-time":"2014-10-29T00:29:25Z","timestamp":1414542565000},"page":"244-250","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Exhaled Breath Condensate Pepsin: Potential Noninvasive Test for Gastroesophageal Reflux in COPD and Bronchiectasis"],"prefix":"10.1177","volume":"60","author":[{"given":"Annemarie L","family":"Lee","sequence":"first","affiliation":[{"name":"Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia."},{"name":"Physiotherapy Department"},{"name":"Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda M","family":"Button","sequence":"additional","affiliation":[{"name":"Physiotherapy Department"},{"name":"Department of Allergy, Immunology and Respiratory Medicine"},{"name":"Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Denehy","sequence":"additional","affiliation":[{"name":"Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia."},{"name":"Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany","family":"Bamford","sequence":"additional","affiliation":[{"name":"Department of Medicine"},{"name":"Janssen Pharmaceuticals, Johnson &amp; Johnson, Melbourne, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fi-Tjen","family":"Mu","sequence":"additional","affiliation":[{"name":"Department of Immunology, Monash University, Melbourne, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Mifsud","sequence":"additional","affiliation":[{"name":"Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Stirling","sequence":"additional","affiliation":[{"name":"Department of Allergy, Immunology and Respiratory Medicine"},{"name":"Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Allergy, Immunology and Respiratory Medicine"},{"name":"Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,2,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.03.106"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2264"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2280"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.082719"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00107004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12182"},{"issue":"1110","key":"e_1_3_2_8_2","first-page":"178","article-title":"Prevalence, severity and associated features of gastro-oesophageal reflux and dyspepsia: a population-based study","volume":"113","author":"Haque M","year":"2000","unstructured":"Haque M, , Wyeth JW, , Stace NH, , Talley NJ, , Green R. Prevalence, severity and associated features of gastro-oesophageal reflux and dyspepsia: a population-based study. N Z Med J, 2000; 113(1110):178\u2013181.","journal-title":"N Z Med J"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.1101982"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1025467600662"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2004.036426"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200610-1485OC"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-0316"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2005.11.002"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00064807"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2512001"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/1745-9974-2-3"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00085804"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-10-78"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200111-068OC"},{"key":"e_1_3_2_21_2","first-page":"TP120","article-title":"Exhaled breath condensate pepsin before and after Nissen fundoplication: a non-invasive marker of GORD after lung transplantation?","volume":"59","author":"Krishnan A","year":"2007","unstructured":"Krishnan A, , Chow S, , Glanville A, , Thomas P, , Yates D. Exhaled breath condensate pepsin before and after Nissen fundoplication: a non-invasive marker of GORD after lung transplantation?. Respirology, 2007; A59:TP120.","journal-title":"Respirology"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1088\/1752-7155\/6\/1\/016003"},{"key":"e_1_3_2_23_2","unstructured":"Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis management and prevention of chronic obstructive pulmonary disease (revised 2011). http:\/\/www.goldcopd.org\/uploads\/users\/files\/GOLD_Report_2011_Feb21.pdf. Accessed May 20 2014."},{"key":"e_1_3_2_24_2","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention. http:\/\/www.ginasthma.org\/documents\/4. Accessed March 1 2013."},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.179.3.2027992"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-198206000-00001"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(00)70004-7"},{"issue":"9","key":"e_1_3_2_28_2","first-page":"1102","article-title":"Ambulatory 24-H esophageal pH monitoring: normal values, optimal thresholds, specificity, sensitivity and reproducibility","volume":"87","author":"Jamieson JR","year":"1992","unstructured":"Jamieson JR, , Stein HJ, , DeMeester TR, , Bonavina L, , Schwizer W, , Hinder RA, , Albertucci M. Ambulatory 24-H esophageal pH monitoring: normal values, optimal thresholds, specificity, sensitivity and reproducibility. Am J Gastroenterol, 1992; 87(9):1102\u20131111.","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"e_1_3_2_29_2","first-page":"25","article-title":"Normal and abnormal proximal esophageal acid exposure: results of ambulatory dual-probe pH monitoring","volume":"88","author":"Dobhan R","year":"1993","unstructured":"Dobhan R, , Castell D. Normal and abnormal proximal esophageal acid exposure: results of ambulatory dual-probe pH monitoring. Am J Gastroenterol, 1993; 88(1):25\u201329.","journal-title":"Am J Gastroenterol"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1080\/003655298750026697"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00038803"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00029705"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07665-1"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2011.02.009"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-12-67"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.092858"},{"issue":"10","key":"e_1_3_2_37_2","first-page":"1785","article-title":"Effect of cigarette smoking on gastroesophageal reflux measured by 24-h ambulatory esophageal pH monitoring","volume":"90","author":"Kadakia SC","year":"1995","unstructured":"Kadakia SC, , Kikendall JW, , Maydonovitch C, , Johnson LF. Effect of cigarette smoking on gastroesophageal reflux measured by 24-h ambulatory esophageal pH monitoring. Am J Gastroenterol, 1995; 90(10):1785\u20131790.","journal-title":"Am J Gastroenterol"},{"issue":"4","key":"e_1_3_2_38_2","first-page":"491","article-title":"The prevalence of distal and proximal gastroesophageal reflux in patients awaiting lung transplantation","volume":"244","author":"Sweet MP","year":"2006","unstructured":"Sweet MP, , Herbella FA, , Leard L, , Hoopes C, , Golden J, , Hays S, , Patti MG. The prevalence of distal and proximal gastroesophageal reflux in patients awaiting lung transplantation. Ann Surg, 2006; 244(4):491\u2013497.","journal-title":"Ann Surg"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2012.02285.x"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.02.100"},{"issue":"4","key":"e_1_3_2_41_2","first-page":"325","article-title":"Twenty-four pH monitoring of the distal esophagus: a quantitative measure of gastroesophageal reflux","volume":"62","author":"Johnson LF","year":"1974","unstructured":"Johnson LF, , DeMeester TR. Twenty-four pH monitoring of the distal esophagus: a quantitative measure of gastroesophageal reflux. Am J Gastroenterol, 1974; 62(4):325\u2013332.","journal-title":"Am J Gastroenterol"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1088\/1752-7155\/5\/2\/024001"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2006.11.239"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000172043.51871.d9"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2010.01777.x"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-15-62"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.03570","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.03570","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.03570","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:13:06Z","timestamp":1777615986000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.03570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.4187\/respcare.03570"],"URL":"https:\/\/doi.org\/10.4187\/respcare.03570","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2015,2]]}}}