The gastroesophageal junction is the first portal through which noxious gastric contents must pass if they are to cause injury to the upper aerodigestive tract. When reflux occurs excessively and clearance of reflux is impaired, patients can develop esophagitis, ulcers, stricture, adenocarcinoma, laryngitis, and aspiration pneumonia. Unfortunately, the mechanisms for initiating and suppressing reflux and the factors contributing to the altered clearance of the refluxate are poorly understood. The specific objectives of this subproject are to explore the following hypotheses: 1). Intragastric pressure is a major determination of whether reflux occurs, with reflux patients having lower threshold pressures for triggering reflux. 2). Afferent sensory pathways in the cardia of the stomach are important in triggering GERD. Agents can be delivered endoscopically to block these pathways and inhibit GER. 3). Esophageal longitudinal muscles play an active role in the reflux event. 4). Esophageal acidification alters the function of longitudinal esophageal muscles, so as to contribute to forming a hiatal hernia. 5). Longitudinal esophageal muscle function during primary and secondary peristalsis is abnormal in patients with reflux disease, and these abnormalities contribute to disturbances in esophageal bolus clearance.
| Massey, Benson T; Simuncak, Chelsey; LeCapitaine-Dana, Nicole J et al. (2006) Transient lower esophageal sphincter relaxations do not result from passive opening of the cardia by gastric distention. Gastroenterology 130:89-95 |
| Effros, Richard M; Peterson, Barry; Casaburi, Richard et al. (2005) Epithelial lining fluid solute concentrations in chronic obstructive lung disease patients and normal subjects. J Appl Physiol 99:1286-92 |
| Effros, Richard M; Su, Jennifer; Casaburi, Richard et al. (2005) Utility of exhaled breath condensates in chronic obstructive pulmonary disease: a critical review. Curr Opin Pulm Med 11:135-9 |
| Effros, Richard M; Dunning 3rd, Marshall B; Biller, Julie et al. (2004) The promise and perils of exhaled breath condensates. Am J Physiol Lung Cell Mol Physiol 287:L1073-80 |
| Kawamura, Osamu; Easterling, Caryn; Aslam, Muhammad et al. (2004) Laryngo-upper esophageal sphincter contractile reflex in humans deteriorates with age. Gastroenterology 127:57-64 |
| Effros, R M; Olson, L; Lin, W et al. (2003) Resistance of the pulmonary epithelium to movement of buffer ions. Am J Physiol Lung Cell Mol Physiol 285:L476-83 |
| Effros, Richard M; Bosbous, Mark; Foss, Bradley et al. (2003) Exhaled breath condensates: a potential novel technique for detecting aspiration. Am J Med 115 Suppl 3A:137S-143S |
| Effros, Richard M; Biller, Julie; Foss, Bradley et al. (2003) A simple method for estimating respiratory solute dilution in exhaled breath condensates. Am J Respir Crit Care Med 168:1500-5 |
| Effros, Richard M; Hoagland, Kelly W; Bosbous, Mark et al. (2002) Dilution of respiratory solutes in exhaled condensates. Am J Respir Crit Care Med 165:663-9 |
| Crandall, Edward D; Effros, Richard M (2002) Historical perspectives on lung edema clearance. J Appl Physiol 93:1527-32 |
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