Abstract
GER is frequently observed during the first months of life and is now considered as a significant risk factor for ALTE or SIDS. To evaluate the potential role of Beta endorphins in the pathogenesis of ALTE in the presence of GER, 2 groups of babies are studied. Fifteen babies admitted for ALTE and presenting a GER (Gr 1) are compared to 15 siblings of SIDS patients also having a GER diagnosed at 1 month of age when investigated for risk factors (Gr 2). GER was evaluated by oesophageal pH recordings. Plasma Beta endorphins levels were measured with radioimmunologic method ( Allegro Beta endorphins Reagents - Nichols Institute Diagnostics USA) following ALTE in Gr 1 and on the day of evaluation at 1 month of age in Gr 2. The 2 groups were comparable for birth weight. gestationnal age and sex ratio. The severity of GER assessed by oesophageal pH was also similar in the 2 groups : acidity index ( % of the recording period with pH below 4) was respectively of 10,6% + 3.5% in gr 1 and 13,9% + 5,(>% in gr 2. The number of reflux per hour was 11 + 6 and 16 + 5. Plasma B endorphin levels was 84.5 + 80 pg/ml in gr 1 (15-312, median 47 pg/ml) and 25,9 + 31 pg/ml in gr 2 (5-91 pg/ml, median 14 pg/ml) p < 0,01. In group 1,4 babies had levels above 125 pg/ml (normal mean plasma level :29 pg/ml).
These data suggest
1) GER can be associated to an increased production of Beta endorphins probably in response to the oesophageal insult induced by acidity.
2) the depressive effect of B endorphins on respiration might increase the vulnerability of babies with GER to ALTE.
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Serre, M., Monin, P., Feillet, F. et al. Gastro-oesophageal reflux (GER) and ALTE in babies: Role of Beta Endorphins?. Pediatr Res 35, 268 (1994). https://doi.org/10.1203/00006450-199402000-00080
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DOI: https://doi.org/10.1203/00006450-199402000-00080