Tuberculosis and Respiratory Diseases

  • 제87권2호
  • /
  • Pages.185-193
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  • 2024
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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Association between Antacid Exposure and Risk of Interstitial Lung Diseases

  • Soohyun Bae (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Gjustina Loloci (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Dong Yoon Lee (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Hye Jin Jang (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Jihyeon Jeong (Department of Statistics, Kyungpook National University) ;
  • Won-Il Choi (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine)
  • 투고 : 2023.07.11
  • 심사 : 2023.12.17
  • 발행 : 2024.04.30
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초록

Background: The mechanisms leading to lung fibrosis are still under investigation. This study aimed to demonstrate whether antacids could prevent the development of interstitial lung disease (ILD). Methods: This population-based longitudinal cohort study was conducted between January 2006 and December 2010 in South Korea. Eligible subjects were ≥40 years of age, exposed to proton pump inhibitors (PPI)±histamine-2 receptor antagonists (H-2 blockers) or H-2 blockers only, and had no history of ILD between 2004 and 2005. Exposure to antacids was defined as the administration of either PPI or H-2 receptor antagonists for >14 days, whereas underexposure was defined as antacid treatment administered for less than 14 days. Newly developed ILDs, including idiopathic pulmonary fibrosis (IPF), were counted during the 5-year observation period. The association between antacid exposure and ILD development was evaluated using adjusted Cox regression models with variables, such as age, sex, smoking history, and comorbidities. Results: The incidence rates of ILD with/without antacid use were 43.2 and 33.8/100,000 person-years, respectively and those of IPF were 14.9 and 22.9/100,000 person-years, respectively. In multivariable analysis, exposure to antacid before the diagnosis of ILD was independently associated with a reduced development of ILD (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.45 to 0.71; p<0.001), while antacid exposure was not associated with development of IPF (HR, 0.88; 95% CI, 0.72 to 1.09; p=0.06). Conclusion: Antacid exposure may be independently associated with a decreased risk of ILD development.

키워드

과제정보

We thank the participants of the Korean Health Insurance Cohort study and the National Health Insurance Service (NHIS) who developed the NHIS-NSC database. The views expressed in this article are those of the authors and do not necessarily represent the official position of the Korean NHIS.

참고문헌

  1. American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med 2000;161(2 Pt 1):646-64. https://doi.org/10.1164/ajrccm.161.2.ats3-00
  2. Hubbard R, Johnston I, Britton J. Survival in patients with cryptogenic fibrosing alveolitis: a population-based cohort study. Chest 1998;113:396-400. https://doi.org/10.1378/chest.113.2.396
  3. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011;183:788-824. https://doi.org/10.1164/rccm.2009-040GL
  4. Camelo A, Dunmore R, Sleeman MA, Clarke DL. The epithelium in idiopathic pulmonary fibrosis: breaking the barrier. Front Pharmacol 2014;4:173.
  5. Choi WI, Dauti S, Kim HJ, Park SH, Park JS, Lee CW. Risk factors for interstitial lung disease: a 9-year Nationwide population-based study. BMC Pulm Med 2018;18:96.
  6. Ghisa M, Marinelli C, Savarino V, Savarino E. Idiopathic pulmonary fibrosis and GERD: links and risks. Ther Clin Risk Manag 2019;15:1081-93. https://doi.org/10.2147/TCRM.S184291
  7. Chakraborty A, Mastalerz M, Ansari M, Schiller HB, Staab-Weijnitz CA. Emerging roles of airway epithelial cells in idiopathic pulmonary fibrosis. Cells 2022;11:1050.
  8. Raghu G, Freudenberger TD, Yang S, Curtis JR, Spada C, Hayes J, et al. High prevalence of abnormal acid gastro-oesophageal reflux in idiopathic pulmonary fibrosis. Eur Respir J 2006;27:136-42. https://doi.org/10.1183/09031936.06.00037005
  9. Raghu G, Amatto VC, Behr J, Stowasser S. Comorbidities in idiopathic pulmonary fibrosis patients: a systematic literature review. Eur Respir J 2015;46:1113-30. https://doi.org/10.1183/13993003.02316-2014
  10. Ing AJ. Interstitial lung disease and gastroesophageal reflux. Am J Med 2001;111 Suppl 8A:41S-4S. https://doi.org/10.1016/S0002-9343(01)00847-6
  11. Reynolds CJ, Del Greco MF, Allen RJ, Flores C, Jenkins RG, Maher TM, et al. The causal relationship between gastro-oesophageal reflux disease and idiopathic pulmonary fibrosis: a bidirectional two-sample Mendelian randomisation study. Eur Respir J 2023;61:2201585.
  12. Baqir M, Vasirreddy A, Vu AN, Moua T, Chamberlain AM, Frank RD, et al. Idiopathic pulmonary fibrosis and gastroesophageal reflux disease: a population-based, case-control study. Respir Med 2021;178:106309.
  13. Fahim A, Crooks M, Hart SP. Gastroesophageal reflux and idiopathic pulmonary fibrosis: a review. Pulm Med 2011;2011:634613.
  14. Downing TE, Sporn TA, Bollinger RR, Davis RD, Parker W, Lin SS. Pulmonary histopathology in an experimental model of chronic aspiration is independent of acidity. Exp Biol Med (Maywood) 2008;233:1202-12. https://doi.org/10.3181/0801-RM-17
  15. Savarino E, Carbone R, Marabotto E, Furnari M, Sconfienza L, Ghio M, et al. Gastro-oesophageal reflux and gastric aspiration in idiopathic pulmonary fibrosis patients. Eur Respir J 2013;42:1322-31. https://doi.org/10.1183/09031936.00101212
  16. Mertens V, Blondeau K, Vanaudenaerde B, Vos R, Farre R, Pauwels A, et al. Gastric juice from patients "on" acid suppressive therapy can still provoke a significant inflammatory reaction by human bronchial epithelial cells. J Clin Gastroenterol 2010;44:e230-5. https://doi.org/10.1097/MCG.0b013e3181d47dc4
  17. Kreuter M, Wuyts W, Renzoni E, Koschel D, Maher TM, Kolb M, et al. Antacid therapy and disease outcomes in idiopathic pulmonary fibrosis: a pooled analysis. Lancet Respir Med 2016;4:381-9. https://doi.org/10.1016/S2213-2600(16)00067-9
  18. Wuyts WA, Bonella F, Costabel U, Cottin V, Kreuter M, Poletti V, et al. An important step forward, but still a way to go. Am J Respir Crit Care Med 2016;193:340-1. https://doi.org/10.1164/rccm.201509-1763LE
  19. Raghu G, Rochwerg B, Zhang Y, Garcia CA, Azuma A, Behr J, et al. An official ATS/ERS/JRS/ALAT Clinical Practice Guideline: treatment of idiopathic pulmonary fibrosis: an update of the 2011 Clinical Practice Guideline. Am J Respir Crit Care Med 2015;192:e3-19. https://doi.org/10.1164/rccm.201506-1063ST
  20. Ghebre YT, Raghu G. Idiopathic pulmonary fibrosis: novel concepts of proton pump inhibitors as antifibrotic drugs. Am J Respir Crit Care Med 2016;193:1345-52. https://doi.org/10.1164/rccm.201512-2316PP
  21. Lee JS, Collard HR, Anstrom KJ, Martinez FJ, Noth I, Roberts RS, et al. Anti-acid treatment and disease progression in idiopathic pulmonary fibrosis: an analysis of data from three randomised controlled trials. Lancet Respir Med 2013;1:369-76. https://doi.org/10.1016/S2213-2600(13)70105-X
  22. Lee JS, Ryu JH, Elicker BM, Lydell CP, Jones KD, Wolters PJ, et al. Gastroesophageal reflux therapy is associated with longer survival in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2011;184:1390-4. https://doi.org/10.1164/rccm.201101-0138OC
  23. Tran T, Suissa S. The effect of anti-acid therapy on survival in idiopathic pulmonary fibrosis: a methodological review of observational studies. Eur Respir J 2018;51:1800376.
  24. Jo HE, Corte TJ, Glaspole I, Grainge C, Hopkins PM, Moodley Y, et al. Gastroesophageal reflux and antacid therapy in IPF: analysis from the Australia IPF Registry. BMC Pulm Med 2019;19:84.
  25. Tran T, Assayag D, Ernst P, Suissa S. Effectiveness of proton pump inhibitors in idiopathic pulmonary fibrosis: a population-based cohort study. Chest 2021;159:673-82. https://doi.org/10.1016/j.chest.2020.08.2080
  26. Lo SK, Li IT, Tsou TS, See L. Non-significant in univariate but significant in multivariate analysis: a discussion with examples. Changgeng Yi Xue Za Zhi 1995;18:95-101.
  27. Mehio-Sibai A, Feinleib M, Sibai TA, Armenian HK. A positive or a negative confounding variable?: a simple teaching aid for clinicians and students. Ann Epidemiol 2005;15:421-3. https://doi.org/10.1016/j.annepidem.2004.10.004
  28. Esposito DB, Lanes S, Donneyong M, Holick CN, Lasky JA, Lederer D, et al. Idiopathic pulmonary fibrosis in United States automated claims: incidence, prevalence, and algorithm validation. Am J Respir Crit Care Med 2015;192:1200-7. https://doi.org/10.1164/rccm.201504-0818OC
  29. Raghu G, Chen SY, Hou Q, Yeh WS, Collard HR. Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old. Eur Respir J 2016;48:179-86. https://doi.org/10.1183/13993003.01653-2015
  30. Abramowitz J, Thakkar P, Isa A, Truong A, Park C, Rosenfeld RM. Adverse event reporting for proton pump inhibitor therapy: an overview of systematic reviews. Otolaryngol Head Neck Surg 2016;155:547-54. https://doi.org/10.1177/0194599816648298
  31. Andersson M, Blanc PD, Toren K, Jarvholm B. Smoking, occupational exposures, and idiopathic pulmonary fibrosis among Swedish construction workers. Am J Ind Med 2021;64:251-7. https://doi.org/10.1002/ajim.23231
  32. Bae W, Lee CH, Lee J, Kim YW, Han K, Choi SM. Impact of smoking on the development of idiopathic pulmonary fibrosis: results from a nationwide population-based cohort study. Thorax 2022;77:470-6. https://doi.org/10.1136/thoraxjnl-2020-215386
  33. Evans GW, Kantrowitz E. Socioeconomic status and health: the potential role of environmental risk exposure. Annu Rev Public Health 2002;23:303-31. https://doi.org/10.1146/annurev.publhealth.23.112001.112349