Clinical-Diagnostic Correlations in Laryngopharyngeal Reflux (LPR). The Role of Peptesttm

Abstract

LaryngoPharyngeal Reflux (LPR) is a term recently described, classified among the "extra-esophageal disorders", caused by another pathology called "Gastro-Esophageal Disease" (GED). Pepsin has been recognized as the true marker and the responsible factor of mucosal damage.The clinical-instrumental diagnosis of LPR is mainly based upon video laryngoscopy exam, pH-measuring, pH-impedance measuring, using "score" questionnaires, designed to establish the presence of specific symptoms (Reflux Symptom Index -RSI) and endoscopic signs (Reflux Finding Score -RFS). The evidence of the role of pepsin associated to the LPR helped to develop new technologies, able to detect the presence of that enzyme within the saliva; this device is called Peptest TMThe aim of the present study was to correlate the qualitativequantitative values of salivary pepsin (using Peptest TM ) with symptoms and signs obtained from RSI and RFS. The final goal is to validate this enzyme immunoassay method using LPR diagnostic tools.Seventy-five patients were recruited (41 females, 34 males) aged between 12 and 71 years old, (average age 45 years). All patients performed anamnesis, including food habits analysis, RSI evaluation, rhinofibrolaryngoscopy exam with RFS calculation and Peptest TM.Highly comparable results were obtained in all of the 75 patients undergoing double detection of Peptest TM , with LFD measure (T band intensity) and pepsin concentration (ng/ml).Statistically significant correlation concerning symptoms and saliva pepsin concentration was demonstrated as well as the relationship between objective signs and saliva pepsin concentration. The PeptestTM could become the "Gold standard" in all cases LPR pathology suspicion and may allow revealing the symptoms of that pathology at its early onset, avoiding dealing with more invasive methods and helping to adopt the correct therapeutic follow-up as soon as possible.