Untitled

Potluri, S; Friedenberg, Frank K.; Parkman, Henry P.; Chang, Alan; MacNeal, Robert; Manus, Christopher; Bromer, Matthew Q.; Malik, Aslam; Fisher, Robert S.; Nugent, Thomas F.; Thangada, Vinod K.; Kueppers, Friedrich; Miller, Larry S.

doi:10.1023/a:1025467600662

Cited by 98 publications

(24 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In keeping with our findings, pepsin detection in throat sputum has been suggested to be a sensitive and non-invasive diagnostic method for laryngopharyngeal reflux [20]. Our study supports previous studies on the identification of pepsin in airway secretions for the diagnosis of laryngopharyngeal reflux [26,27,28,29]. Pepsin was detected mainly in the samples collected at the time of symptoms (n = 18).…”

Section: Discussionsupporting

confidence: 91%

Pepsin Detection in the Sputum/Saliva for the Diagnosis of Gastroesophageal Reflux Disease in Patients with Clinically Suspected Atypical Gastroesophageal Reflux Disease Symptoms

Kim¹,

Lee²,

Yeo³

et al. 2008

Digestion

View full text Add to dashboard Cite

Background/Aims: Atypical manifestations of gastroesophageal reflux disease (GERD) are diverse. We aimed to determine whether pepsin detection in the sputum/saliva could be useful for diagnosing GERD in patients with clinically suspected atypical GERD symptoms. Methods: Patients with clinically suspected atypical GERD symptoms provided sputum/saliva collected before bedtime, at the time of those symptoms, and after awakening for pepsin measurement by Western blot analysis. All subjects received 24-hour esophageal pH monitoring, and then 40 mg of esomeprazole was given twice a day for 2 weeks. Results: The pepsin test was positive in 20 out of 40 patients, with pepsin detected mainly in the samples collected at the time of symptoms (45%). Samples collected from healthy volunteers (n = 8) were all negative for pepsin. 24-hour pH-metry was positive in 9 patients (23%). Based on 24-hour pH-metry data, the sensitivity and negative predictive value of the pepsin test were excellent in most of typical and atypical symptom groups, whereas its specificity and positive predictive value were relatively low, particularly in atypical symptom groups. Conclusions: Pepsin measurement in the sputum/saliva collected at the time of symptoms provides a sensitive, non-invasive method for diagnosing GERD in patients with clinically suspected atypical GERD symptoms.

show abstract

Section: Discussionsupporting

confidence: 91%

Pepsin Detection in the Sputum/Saliva for the Diagnosis of Gastroesophageal Reflux Disease in Patients with Clinically Suspected Atypical Gastroesophageal Reflux Disease Symptoms

Kim¹,

Lee²,

Yeo³

et al. 2008

Digestion

View full text Add to dashboard Cite

show abstract

“…Using esophagitis as the gold standard, they found that the sensitivity of pepsin was 83% 6 . In another study of sputum samples in adults with GER symptoms undergoing pH monitoring, Potluri et al report that the sensitivity of pepsin in sputum at any given time, using a pH drop to <4 as the gold standard reflux test, was 75% and specificity 91% for proximal acid reflux while it had a sensitivity of 63% and a specificity of 92% for distal acid reflux 7 .…”

Section: Discussionmentioning

confidence: 99%

“…In limited previous studies, pepsin, which is produced in the stomach, has been found in the lungs of children and adults with respiratory disease suggesting the presence of microaspiration of gastric contents, but there has been an inconsistent relationship with lung pepsin and reflux monitoring 2–7 . In a single adult study in which pH measurements were used, the sensitivity of salivary pepsin in predicting proximal esophageal reflux was 75% and the specificity was 91% 7 . In a single pediatric study of children with reflux symptoms and respiratory disease, the authors found 84% of patients with respiratory disease and reflux symptoms were pepsin positive.…”

Section: Introductionmentioning

confidence: 99%

The presence of pepsin in the lung and its relationship to pathologic gastro‐esophageal reflux

Rosen

Johnston

Hart

et al. 2011

Neurogastroenterology Motil

View full text Add to dashboard Cite

Background Pepsin has been proposed as a biomarker of reflux related lung disease. It is the goal of this study to determine 1) if there is a higher reflux burden as measured by pH-MII in patients that are pepsin positive in the lung and 2) the sensitivity of pepsin in predicting pathologic reflux by pH, MII and EGD. Methods We recruited children between the ages of 1–21 with chronic cough or asthma undergoing bronchoscopy, esophagogastroduodenoscopy (EGD), and multichannel intraluminal impedance (pH-MII) probe placement. The reflux profiles were compared between those patients that were pepsin positive and negative; proportions were compared using Chi square analyses and means were compared using t testing. Key Results Only the mean number of non-acid reflux events was associated with pepsin positivity (0.04). The sensitivity and specificity of pepsin in predicting pathologic reflux by pH-MII or EGD was 57% and 65% respectively. The positive predictive value of pepsin in predicting pathologic reflux by pH, MII or EGD was 50% (11/22) and the negative predictive value was 71% (20/28). There was a significantly higher mean LLMI in patients that were pepsin positive compared to pepsin negative patients (81±54 vs. 47±26, p=0.001). Conclusions and Inferences Lung pepsin cannot predict pathologic reflux in the esophagus but its correlation with lung inflammation suggests that pepsin may be a important biomarker for reflux-related lung disease.

show abstract

“…Bronchoscopy is an invasive diagnostic procedure, therefore alternative methods to measure pepsin are sought. Salivary pepsin seems an attractive option because of ease of sampling, but no pediatric studies have been performed so far with comparison with pH-MII 13–16 . The objective of this study is to test the sensitivity of salivary pepsin for diagnosing reflux-related lung disease, compared against combined pH-MII testing, endoscopy, and GERD symptom scores.…”

mentioning

confidence: 99%

Salivary Pepsin Lacks Sensitivity as a Diagnostic Tool to Evaluate Extraesophageal Reflux Disease

Amirault

Mitchell

et al. 2016

The Journal of Pediatrics

View full text Add to dashboard Cite

Objectives To determine the sensitivity of salivary pepsin compared with multichannel intraluminal impedance with pH testing (pH-MII), endoscopy, and gastroesophageal reflux disease (GERD) questionnaires. Study design We prospectively recruited 50 children from Boston Children’s Hospital, who were undergoing pH-MII to evaluate for GERD. Patients completed 24 hour pH-MII testing, symptom and quality of life questionnaires, and provided a saliva specimen which was analyzed using the PepTest® lateral flow test. A subset of patients also underwent bronchoscopy and esophagogastroduodenoscopy. ROC analyses were performed to determine the sensitivity of salivary pepsin compared with each reference standard. Results 21 patients (42%) were salivary pepsin positive, with median concentration of pepsin in the saliva 10 ng/mL (IQR 10 – 55). There was no significant difference in the distributions of acid, nonacid, total reflux episodes, full column reflux or any other reflux variable in patients that were pepsin positive compared with pepsin negative (p>0.5). There was no significant correlation between the number of reflux episodes and pepsin concentrations (p>0.1). There was no positive relationship between salivary pepsin positivity, any extraesophageal symptoms or quality of life scores, or inflammation on bronchoscopy or esophagogastroduodenoscopy (p>0.3). Conclusions Salivary pepsin measurement has a low sensitivity for predicting pathologic gastroesophageal reflux in children.

show abstract

Untitled

Cited by 98 publications

References 13 publications

Pepsin Detection in the Sputum/Saliva for the Diagnosis of Gastroesophageal Reflux Disease in Patients with Clinically Suspected Atypical Gastroesophageal Reflux Disease Symptoms

Pepsin Detection in the Sputum/Saliva for the Diagnosis of Gastroesophageal Reflux Disease in Patients with Clinically Suspected Atypical Gastroesophageal Reflux Disease Symptoms

The presence of pepsin in the lung and its relationship to pathologic gastro‐esophageal reflux

Salivary Pepsin Lacks Sensitivity as a Diagnostic Tool to Evaluate Extraesophageal Reflux Disease

Contact Info

Product

Resources

About