Salivary biomarkers and esophageal disorders

Abstract

Summary Saliva is a complex physiologic fluid that contains an abundance of biological analytes, or biomarkers. Recent research has shown that these biomarkers may be able to convey the physiologic health of a person. Work has been done linking derangements in these salivary biomarkers to a wide variety of pathologic disorders ranging from oncologic diseases to atopic conditions. The specific area of interest for this review paper is esophageal disorders. Particularly because the diagnosis and management of esophageal disorders often includes invasive testing such as esophagogastroduodenoscopy, prolonged pH monitoring, and biopsy. The aim of this review will be to explore salivary biomarkers (pepsin, bile, epidermal growth factor, and micro-RNA) that are being studied as they relate specifically to esophageal disorders. Finally, it will explore the benefits of salivary testing and identify areas of possible future research.

Review article: Diagnosis and management of laryngopharyngeal reflux

“…Though saliva is predominately composed of water, there is a growing body of literature into the complex and rich microenvironment that exists, which can help with diagnosis of a variety of disease processes, such as GERD and LPR. 66 These testing strategies hold great intrigue due to the fact that they are non-invasive, can be collected in an office-based setting, relatively affordable and more accessible than other testing modalities. In the evaluation of GERD and LPR, a few salivary biomarkers have been investigated: pepsin, bile acids and the microbiome.…”

“…69 More recently, pepsin has been measured using a lateral flow device, which uses monoclonal antibodies against pepsin to quickly ascertain the pepsin concentration in a given sample. 66 One such device is the Peptest (RDBiomed, United Kingdom). The diagnostic utility of salivary pepsin as a biomarker for GERD has yielded varying sensitivities and specificities, which is likely based on time of collection, method of collection and diet.…”

“…Pepsin has historically been measured through enzyme‐linked immunosorbent assay, 67 via its ability to digest fibrinogen, 68 and through western blot 69 . More recently, pepsin has been measured using a lateral flow device, which uses monoclonal antibodies against pepsin to quickly ascertain the pepsin concentration in a given sample 66 . One such device is the Peptest (RDBiomed, United Kingdom).…”

“…Pepsinogen is an endopeptidase that is secreted by gastric chief cells and activated to pepsin through the acidic environment of the stomach and has been studied as a biomarker in GERD and LPR. 66 Pepsin has historically been measured through enzyme-linked immunosorbent assay, 67 via its ability to digest fibrinogen, 68 and through western blot. 69 More recently, pepsin has been measured using a lateral flow device, which uses monoclonal antibodies against pepsin to quickly ascertain the pepsin concentration in a given sample.…”

Screening for Esophageal Squamous Cell Carcinoma: A Review

“…Human papilloma viruses have been shown to play an important role in pathogenesis of other squamous cell cancers, however in esophagus, the evidence is inconclusive. 27 Most of the studies done on screening are from high incidence areas, where the entire adult population between the age group of 40 and 69 years have been screened. [28][29][30][31][32][33][34][35][36] In an ongoing RCT in China, 33 considering the risk factors for ESCC, in non-endemic areas-heavy smokers (>10 pack years), those with a family history of ESCC in first degree relatives, heavy alcohol consumers (>28 g/day for 10 years), history of esophagitis and reflux disease, eating salted food/pickled food at least once a week were used as inclusion criteria to select patients for screening.…”