2021
DOI: 10.21053/ceo.2020.00465
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Pepsin and Laryngeal and Hypopharyngeal Carcinomas

Abstract: Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, which are both exhibiting increasing incidences. Laryngopharyngeal reflux is the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. There remains controversy regarding whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria … Show more

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Cited by 13 publications
(17 citation statements)
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References 122 publications
(184 reference statements)
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“…Therefore, chronic pepsin exposure could trigger laryngeal epithelial carcinogenesis [26]. Cells take up pepsin via receptor-mediated endocytosis; pepsin is stored in vesicles and transported to organelles such as the Golgi apparatus [2]. Pepsin absorbed into the laryngeal epithelium is inactive but stable because the mean pH of the laryngopharynx is 6.8.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Therefore, chronic pepsin exposure could trigger laryngeal epithelial carcinogenesis [26]. Cells take up pepsin via receptor-mediated endocytosis; pepsin is stored in vesicles and transported to organelles such as the Golgi apparatus [2]. Pepsin absorbed into the laryngeal epithelium is inactive but stable because the mean pH of the laryngopharynx is 6.8.…”
Section: Discussionmentioning
confidence: 99%
“…Laryngopharyngeal reflux (LPR) refers to the reflux of gastric contents above the upper esophageal sphincter, causing various symptoms and signs [1]. The gastric contents include gastric acid and non-acids such as pepsin, cholate, bacteria, and trypsin [2,3]. Tissue damage caused by nonacidic components cannot be alleviated by proton pump inhibitors (PPIs) alone [3].…”
Section: Introductionmentioning
confidence: 99%
“…Pepsin under these conditions is stable but inactivated or dormant. Pepsin is reactivated by the reduction in the pH of the laryngeal microenvironment [4,[7][8][9][10]. Tissue damage caused by pepsin activity may be mediated by the epithelial-mesenchymal transition (EMT), cellular mitochondria [11][12][13], oxidative DNA damage [14], and laryngeal mucosal protective proteins [15].…”
Section: Introductionmentioning
confidence: 99%
“…The mechanism of laryngopharyngeal mucosal injury caused by pepsin mainly includes the following. (1) Pepsin can downregulate E-cadherin and reduce cell adhesion, leading to the release and accumulation of β-catenin from the cell membrane to the cytoplasm, thereby increasing the possibility of tumor cell infiltration and metastasis [25,26]. Pepsin can also combine with CXC chemokine receptor 2 (CXCR 2) by inducing the secretion of interleukin (IL)-8 and ultimately altering the levels of E-cadherin/βcatenin [27].…”
Section: Pepsinmentioning
confidence: 99%