Hypopharyngeal pepsin and Sep70 as diagnostic markers of laryngopharyngeal reflux: preliminary study

Abstract

Depletion of Sep70 with the presence of pepsin in the hypopharynx may indicate cellular injury in laryngopharynx due to constant proximal reflux. However, the normative data for these markers have to be validated.

Pepsin in saliva as a biomarker for oropharyngeal reflux compared with 24‐hour esophageal impedance/pH monitoring in pediatric patients

“…Gastro‐esophageal reflux is common in infants and children and can be assessed using diagnostic tests such as esophageal pH monitoring and MII/pH . Salivary pepsin has been studied as a potential noninvasive diagnostic method for gastric reflux in adults and children . Because pepsin is normally produced only by gastric chief cells in the stomach and is absent from the oropharynx, the presence of pepsin in the saliva is evidence that a gastro‐esophageal reflux event has reached the oropharynx.…”

“…3,4,24,[32][33][34][35][36][37][38][39] Salivary pepsin has been studied as a potential noninvasive diagnostic method for gastric reflux in adults and children. 5,6,[8][9][10][11][12][13][14][15][16][17][18] Because pepsin is normally produced only by gastric chief cells in the stomach and is absent from the oropharynx, the presence of pepsin in the saliva is evidence that a gastro-esophageal reflux event has reached the oropharynx. Pepsin has been measured by direct measurement of pepsin enzymatic activity, Western blotting, and ELISA as reviewed.…”

“…Measurement of gastric pepsin 3b (pepsin A‐4) in the oropharynx has been studied as a noninvasive method to detect oropharyngeal reflux in both adults and children . Because pepsin A is normally found only in gastric juice, it has been hypothesized that GER events positively correlate with the presence of oropharyngeal pepsin .…”

“…Measurement of gastric pepsin 3b (pepsin A-4) in the oropharynx has been studied as a noninvasive method to detect oropharyngeal reflux in both adults and children. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] Because pepsin A is normally found only in gastric juice, it has been hypothesized that GER events positively correlate with the presence of oropharyngeal pepsin. 8 To test this hypothesis, we analyzed individual saliva samples collected at varying time periods following impedance-detected GER episodes for the presence of gastric pepsin Additionally, we used validated GERD questionnaires 19,20 to objectively assess clinical symptoms in all subjects.…”

The importance of voice analysis in evaluating the effectiveness of reflux treatment

“…[5,24] Although recent studies have showed some promising methods for diagnosis of LPR such as laryngeal sensory testing and control of blood pepsin levels, [25] the diagnosis of LPR is made clinically. For instance omeprazole test means empirical treatment in patients with potential LPR has a sensitivity and specificity of 89% [26] and preferred by many clinicians as a diagnostic test.…”