The study of salivary pepsin content and laryngopharyngeal reflux scale in 91 asymptomatic volunteers / 临床耳鼻咽喉头颈外科杂志

OBJECTIVES@#To investigate the content of pepsin in salivary, and to assess the laryngophargeal lesions based on the reflux founding score (RFS) scale in asymptomatic volunteers, in order to provide a reference for the diagnosis of laryngopharyngeal reflux.@*METHODS@#A total of 91 asymptomatic subjects were recruited in this study. Participants provided a fasting saliva specimen for pepsin measurement using enzyme-linked immunoadsorbent assay, completed the reflux symptom index (RSI) assessment and underwent laryngostroboscopic examination using a rigid endoscope. Their RFS were graded according to the laryngeal findings.@*RESULTS@#The median concentration of pepsin in 91 asymptomatic volunteers was 55.5 μg/L (range 3.53-191.64 μg/L). The mean individuals RSI was 2.24±2.34, and the mean individuals RFS was 5.78±1.74.@*CONCLUSIONS@#Our data demonstrate that certain concentration of pepsin was detected and showed a higher RFS score in asymptomatic volunteers.

Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease

BACKGROUND/AIMS: Increased salivary pepsin could indicate an increase in gastro-esophageal reflux, however, previous studies failed to demonstrate a correlation between salivary pepsin concentrations and 24-hour esophageal acid exposure. This study aims to detect the salivary pepsin and to evaluate the relationship between salivary pepsin concentrations and intercellular spaces (IS) in different gastroesophageal reflux disease phenotypes in patients. METHODS: A total of 45 patients and 11 healthy volunteers were included in this study. All subjects underwent upper gastrointestinal endoscopy, 24-hour ambulatory multichannel impedance-pH (MII-pH) monitoring, and salivary sampling at 3-time points during the 24-hour MII-pH monitoring. IS were measured by transmission electron microscopy, and salivary pepsin concentrations were determined by enzyme-linked immunosorbent assay. RESULTS: The IS measurements were greater in the esophagitis (EE), non-erosive reflux disease (NERD), and hypersensitive esophagus (HO) groups than in the functional heartburn (FH) and healthy volunteer groups, and significant differences were indicated. Patients with NERD and HO had higher average pepsin concentrations compared with FH patients. A weak correlation was determined between IS and salivary pepsin among patients with NERD (r = 0.669, P = 0.035). CONCLUSIONS: We confirmed the presence of a higher level of salivary pepsin in patients with NERD than in patients with FH. Salivary pepsin concentrations correlated with severity of mucosal integrity impairment in the NERD group. We suggest that in patients with NERD, low levels of salivary pepsin can help identify patients with FH, in addition the higher the pepsin concentration, the more likely the severity of dilated IS.

Reflujo faringolaríngeo: revisión de los nuevos métodos diagnósticos / Laryngopharyngeal reflux: a review of new diagnostic methods

El reflujo faringo laríngeo (RFL), es una causa común de morbilidad del tracto aerodigestivo superior. A pesar de su alta prevalencia, aún existe controversia respecto de la precisión diagnóstica de esta enfermedad, así como de su fisiopatología y manejo. Los test diagnósticos actuales aún presentan limitaciones significativas, de ahí que surja el interés por encontrar métodos rápidos y eficientes que mejoren su pesquisa. El presente trabajo tiene por objeto la revisión de la literatura actual en cuanto a los métodos disponibles para su diagnóstico.

The laryngopharyngeal reflux is a common cause of morbidity of the upper aerodigestive tract. Despite its high prevalence, there is still controversy regarding the diagnostic accuracy of this disease and its pathophysiology and management. The current diagnostic test still have significant limitations, hence the interest arises to find fast and efficient methods to improve their research. This paper aims to review the current literature regarding available methods for diagnosis.