PDF(Pubmed)
Abstract：
OBJECTIVE: Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder that may complicate conditions such as obstructive airway disease. Our group has identified predictive biomarkers of GERD in particulate exposed first responders with obstructive airway disease. In addition, GERD diagnosis and treatment is costly and invasive. In light of these clinical concerns, we aimed to systematically review studies identifying noninvasive, multiOmic, and multicompartmental biomarkers of GERD.
METHODS: A systematic review of PubMed and Embase was performed using keywords focusing on reflux disease and biomarkers and registered with PROSPERO. We included original human studies in English, articles focusing on noninvasive biomarkers of GERD published after December 31, 2009. GERD subtypes (non-erosive reflux disease and erosive esophagitis) and related conditions (Barrett\'s Esophagus [BE] and Esophageal Adenocarcinoma). Predictive measures were synthesized and risk of bias assessed (Newcastle-Ottawa Scale).
RESULTS: Initial search identified n = 238 studies andn 13 articles remained after applying inclusion/exclusion criteria. Salivary pepsin was the most studied biomarker with significant sensitivity and specificity for GERD. Serum assessment showed elevated levels of Tumor Necrosis Factor-alpha in both GERD and Barrett\'s. Exhaled breath volatile sulfur compounds and acetic acid were associated with GERD. Oral Microbiome: Models with Lautropia, Streptococcus, and Bacteroidetes showed the greatest discrimination between BE and controls vs Lautropia; ROCAUC 0.94 (95% confidence interval; 0.85-1.00).
CONCLUSIONS: Prior studies identified significant multiOmic, multicompartmental noninvasive biomarker risks for GERD and BE. However, studies have a high risk of bias and the reliability and accuracy of the biomarkers identified are greatly limited, which further highlights the need to discover and validate clinically relevant noninvasive biomarkers of GERD.
METHODS: A systematic review of PubMed and Embase was performed using keywords focusing on reflux disease and biomarkers and registered with PROSPERO. We included original human studies in English, articles focusing on noninvasive biomarkers of GERD published after December 31, 2009. GERD subtypes (non-erosive reflux disease and erosive esophagitis) and related conditions (Barrett\'s Esophagus [BE] and Esophageal Adenocarcinoma). Predictive measures were synthesized and risk of bias assessed (Newcastle-Ottawa Scale).
RESULTS: Initial search identified n = 238 studies andn 13 articles remained after applying inclusion/exclusion criteria. Salivary pepsin was the most studied biomarker with significant sensitivity and specificity for GERD. Serum assessment showed elevated levels of Tumor Necrosis Factor-alpha in both GERD and Barrett\'s. Exhaled breath volatile sulfur compounds and acetic acid were associated with GERD. Oral Microbiome: Models with Lautropia, Streptococcus, and Bacteroidetes showed the greatest discrimination between BE and controls vs Lautropia; ROCAUC 0.94 (95% confidence interval; 0.85-1.00).
CONCLUSIONS: Prior studies identified significant multiOmic, multicompartmental noninvasive biomarker risks for GERD and BE. However, studies have a high risk of bias and the reliability and accuracy of the biomarkers identified are greatly limited, which further highlights the need to discover and validate clinically relevant noninvasive biomarkers of GERD.
摘要：
目的：胃食管反流病（GERD）是一种常见的胃肠道疾病，可能会使阻塞性气道疾病等疾病复杂化。我们的小组已经在阻塞性气道疾病的颗粒暴露的第一反应者中确定了GERD的预测性生物标志物。此外,GERD的诊断和治疗是昂贵且侵入性的。鉴于这些临床问题，我们的目的是系统地回顾确定非侵入性的研究，multiOmic,和GERD的多房室生物标志物。
方法：使用关注反流病和生物标志物的关键词对PubMed和Embase进行系统评价，并在PROSPERO注册。我们用英语纳入了原始的人类研究，2009年12月31日之后发表的有关GERD非侵入性生物标志物的文章.GERD亚型（非糜烂性反流病和糜烂性食管炎）和相关疾病（Barrett食管[BE]和食管腺癌）。综合预测指标并评估偏倚风险(纽卡斯尔-渥太华量表)。
结果：初步搜索确定了n=238项研究，在应用纳入/排除标准后仍有13篇文章。唾液胃蛋白酶是研究最多的生物标志物，对GERD具有显着的敏感性和特异性。血清评估显示GERD和Barrett的肿瘤坏死因子-α水平升高。呼出气挥发性硫化合物和乙酸与GERD有关。口腔微生物组：Lautropia模型，链球菌,与Lautropia;ROCAUC0.94（95％置信区间;0.85-1.00）相比，Bacteroides在BE和对照组之间显示出最大的区别。
结论：先前的研究发现，GERD和BE的多室非侵入性生物标志物风险。然而,研究具有较高的偏倚风险，识别的生物标志物的可靠性和准确性受到极大限制，这进一步凸显了发现和验证GERD临床相关非侵入性生物标志物的必要性.
方法：使用关注反流病和生物标志物的关键词对PubMed和Embase进行系统评价，并在PROSPERO注册。我们用英语纳入了原始的人类研究，2009年12月31日之后发表的有关GERD非侵入性生物标志物的文章.GERD亚型（非糜烂性反流病和糜烂性食管炎）和相关疾病（Barrett食管[BE]和食管腺癌）。综合预测指标并评估偏倚风险(纽卡斯尔-渥太华量表)。
结果：初步搜索确定了n=238项研究，在应用纳入/排除标准后仍有13篇文章。唾液胃蛋白酶是研究最多的生物标志物，对GERD具有显着的敏感性和特异性。血清评估显示GERD和Barrett的肿瘤坏死因子-α水平升高。呼出气挥发性硫化合物和乙酸与GERD有关。口腔微生物组：Lautropia模型，链球菌,与Lautropia;ROCAUC0.94（95％置信区间;0.85-1.00）相比，Bacteroides在BE和对照组之间显示出最大的区别。
结论：先前的研究发现，GERD和BE的多室非侵入性生物标志物风险。然而,研究具有较高的偏倚风险，识别的生物标志物的可靠性和准确性受到极大限制，这进一步凸显了发现和验证GERD临床相关非侵入性生物标志物的必要性.
