While acid reflux primarily affects the digestive system, it can indirectly impact cellular respiration. The damage to the esophagus caused by acid reflux can lead to inflammation and scarring, which may affect the passage of food and potentially hinder the intake of nutrients. Since cellular respiration relies on the nutrients obtained from food, any difficulty in swallowing and nutrient absorption could potentially impact the availability of fuel for cellular respiration. However, it's important to note that the direct impact on cellular respiration would likely be secondary to the effects on the digestive system.