Mediators of the association between gastro-oesophageal reflux disease and idiopathic pulmonary fibrosis

The causal relationship between idiopathic pulmonary fibrosis (IPF) and gastroesophageal reflux disease (GERD) has long been a subject of debate. However, it was only in the last two months that two studies utilising Mendelian randomisation (MR) provided evidence of a significant causality between GERD and IPF, indicating that GERD indeed increases the risk of IPF. This finding has partially helped resolve the debate [1, 2]. Nevertheless, it should not be overlooked that previous meta-analyses have shown that treating GERD does not significantly improve the outcomes of IPF, contrary to expectations [3, 4]. This prompts us to consider the involvement of other intermediate variables, such as smoking, obesity, and telomere length, in the process of GERD-induced IPF [5]. In the present study, network MR will be employed to assess the potential mediating effect between GERD and IPF. This will help providing valuable insights into their underlying mechanisms and informing future therapeutic interventions. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: The authors declare that they have no competing interests.