Stimulated saliva secretion is reduced in proton pump inhibitor-resistant severe reflux esophagitis patients

Tanabe, Tomohide; Koeda, Mai; Kitasako, Yuichi; Momma, Eri; Hoshikawa, Yoshimasa; Hoshino, Shintaro; Kawami, Noriyuki; Kaise, Mitsuru; Iwakiri, Katsuhiko

doi:10.1007/s10388-021-00825-1

Cited by 13 publications

(21 citation statements)

References 39 publications

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“…In addition, considering that proton pump inhibitors are currently recommended as the preferred treatment for GERD, the use of proton pump inhibitors (PPI) is thought to affect the secretion and properties of saliva. In GERD patients taking PPIs, their salivary flow rate was significantly lower than controls, and their acid buffering capacity decreased ( Tanabe et al, 2021 ). Therefore, drug use accompanying GERD may also be a causative factor for oral lesions.…”

Section: Discussionmentioning

confidence: 99%

Exploring the causal relationship between gastroesophageal reflux and oral lesions: A mendelian randomization study

Shu

2022

Front. Genet.

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Background: Clinical observations and retrospective studies have observed that patients with gastroesophageal reflux disease (GERD) have an increased probability of dental erosion, periodontitis and oral mucosal lesions and other common oral lesions. However, whether there is a genetic causal relationship between GERD and the occurrence of oral lesions has not been reported.Methods: In this study, we extracted instrumental variables from the largest published summary statistics of the oral lesion phenotype GWAS in UK Biobank (UKBB) and GERD GWAS. Then, we performed a causal inference analysis between GERD and common oral lesions by mendelian randomization (MR) analysis with the R package “TwoSampleMR”.Results: We observed a significant causal relationship between GERD and several common oral lesion phenotypes (painful gums, loose teeth, toothache, and mouth ulcers). GERD showed a positive correlation with the occurrence of these oral lesions. After removing outlier SNPs via the MR-PRESSO package, our conclusions were still robust.Conclusion: Our findings provide the first evidence for a genetic causal effect of GERD on oral lesion pathogenesis. For patients with confirmed GERD, attention should be paid to taking interventions to prevent the occurrence of oral lesions.

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Section: Discussionmentioning

confidence: 99%

Exploring the causal relationship between gastroesophageal reflux and oral lesions: A mendelian randomization study

Shu

2022

Front. Genet.

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“…Collaboration between physicians and dentists is strongly advocated to prevent or ameliorate possible adverse oral effects from both endogenous and exogenous acids, and to promote adequate saliva production in patients with GERD [ 41 ]. Numerous researches present the correlation between the values of salivary pH, the disturbances in salivary quantity, and the GERD symptoms [ 33 , 34 , 35 , 42 , 43 ]. Oral cavity diseases may be developed as a result of changes in the oral fluid characteristics, including pH, which can modify the properties of dental materials [ 1 , 44 , 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…These results are consistent with current data from the literature. Tanabe et al (2021) [34] analyzed stimulated saliva by chewing sugar-free gums for 3 min in 22 patients with GERD resistant to proton pump inhibitor (PPI) treatment, and 22 patients responding to treatment, and the amount of saliva accumulated was significantly lower in the PPI-resistant group than in the PPI-responding group, with medians of 3.7 (2.2-6.8) and 4.9 (4.0-7.8) mL, respectively (p = 0.029). The same protocol for stimulated saliva collection was used by Koeda et al [35] in their 2021 study, this time on 31 patients diagnosed with non-erosive reflux disease (NERD), and 31 healthy subjects from the control group.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Salivary pH, Buffer Capacity, and Flow in Patients with and without Gastroesophageal Reflux Disease

Bechir

Cuc

Tohati

et al. 2021

IJERPH

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The oral cavity has specific and individualized characteristics, with pH, saliva flow, buffer capacity, temperature, and microorganisms content influencing oral health. Currently, the prevalence of gastroesophageal reflux disease (GERD) is constantly increasing. The objective of this study was to evaluate and compare the saliva quantity at 5 min, salivary pH, and salivary buffer capacity in patients with and without GERD, necessary for establishing the correct dental treatment plan. A Saliva-Check Buffer (GC) kit was used for the determination of salivary variables. The total number of 80 patients included in the study were divided into a study group and a control group, each containing 40 patients. Saliva quantity at 5 min was lower in patients suffering from GERD. The salivary pH of these patients turned to acid values compared to the salivary pH of controls, where the values were within the normal range. In patients with GERD, the determined salivary buffer capacity was low or very low. The use of the Saliva-Check Buffer (GC) kit is a simple, easy, non-invasive and patient-accepted method, which can also be used in the dentist’s office to assess the saliva buffer capacity and pH, variables that are important for establishing a correct dental treatment plan.

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“…The secretion of saliva is triggered by acid reflux into the esophagus via the esophagosalivary reflex [3]. We previously reported that the volume of saliva secreted in patients with GERD was reduced [4][5][6]. A relationship has been suggested between refractoriness to proton pump inhibitors (PPI) and the volume of saliva secreted [4,7].…”

Section: Introductionmentioning

confidence: 99%

“…We previously reported that the volume of saliva secreted in patients with GERD was reduced [4][5][6]. A relationship has been suggested between refractoriness to proton pump inhibitors (PPI) and the volume of saliva secreted [4,7]. However, the effects of PPI on the volume of saliva secreted in the same subjects have rarely been reported [8].…”

Section: Introductionmentioning

confidence: 99%

Proton Pump Inhibitor Treatment Has Little Effects on Secretion of Saliva in Patients with Proton Pump Inhibitor-Responsive Mild Reflux Esophagitis and Non-Erosive Reflux Disease

et al. 2022

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Introduction: The secretion of saliva, which is triggered by acid reflux into the esophagus via the esophagosalivary reflex, plays a crucial role in the defensive mechanisms of the esophagus. The volume of saliva secreted in patients with gastroesophageal reflux disease (GERD) is reduced. However, the effects of proton pump inhibitors (PPI) on the secretion of saliva have rarely been reported. Therefore, the present study investigated changes in the volume and pH of saliva after the cessation of PPI. Materials and Methods: We retrospectively reviewed the records of consecutive patients previously diagnosed with mild reflux esophagitis (RE) or non-erosive reflux disease (NERD) controlled with PPI (including vonoprazan) who performed the salivary secretion test before and after a 2-week cessation of PPI. The volume, pH, and pH after acid loading (buffering capacity) of saliva were compared before and after the cessation of PPI. Results: Thirty-two patients (25 NERD, 7 mild RE) were included. The second saliva test was performed a median interval of 14 months [12.0–15.3] after the first test. No significant differences were observed in the volume of saliva secreted before and after the cessation of PPI (before 4.0 mL [2.7–6.0] vs. after 4.0 mL [2.3–5.9], p = 0.894). No significant differences were noted in pH or changes in pH after acid loading before and after the cessation of PPI (pH: before 7.1 ± 0.24 vs. after 7.0 ± 0.24, p = 0.1. Delta pH after acid loading: before 1.0 [0.8–1.2] vs. after 1.0 [0.8–1.2], p = 0.844). Conclusion: The cessation of PPI did not appear to affect the volume, pH, or buffering capacity of saliva in patients with PPI-responsive mild RE and NERD.

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Stimulated saliva secretion is reduced in proton pump inhibitor-resistant severe reflux esophagitis patients

Cited by 13 publications

References 39 publications

Exploring the causal relationship between gastroesophageal reflux and oral lesions: A mendelian randomization study

Exploring the causal relationship between gastroesophageal reflux and oral lesions: A mendelian randomization study

Comparative Study of Salivary pH, Buffer Capacity, and Flow in Patients with and without Gastroesophageal Reflux Disease

Proton Pump Inhibitor Treatment Has Little Effects on Secretion of Saliva in Patients with Proton Pump Inhibitor-Responsive Mild Reflux Esophagitis and Non-Erosive Reflux Disease

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