1. Correlation of salivary and nasal lavage pepsin with MII-pH testing.
- Author
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Klimara MJ, Johnston N, Samuels TL, Visotcky AM, Poetker DM, Loehrl TA, Blumin JH, and Bock JM
- Subjects
- Adult, Biomarkers metabolism, Case-Control Studies, Electric Impedance, Enzyme-Linked Immunosorbent Assay, Esophageal pH Monitoring methods, Esophagus physiopathology, Female, Follow-Up Studies, Humans, Hydrogen-Ion Concentration, Laryngopharyngeal Reflux metabolism, Laryngopharyngeal Reflux physiopathology, Male, Middle Aged, Nasal Lavage, Prospective Studies, Esophagus metabolism, Laryngopharyngeal Reflux diagnosis, Nasal Mucosa metabolism, Pepsin A metabolism, Saliva metabolism
- Abstract
Objectives: Laryngopharyngeal reflux (LPR) is a common upper airway disease. Salivary pepsin is a proposed marker for LPR; however, the optimal time for collection of specimens for pepsin detection and pepsin's presence in the oral and nasal secretions relative to concurrent multichannel intraluminal impedance-pH (MII-pH) monitoring are unknown., Study Design: Prospective case-control study with an experimental design., Methods: Patients undergoing MII-pH testing for evaluation of LPR and asymptomatic control subjects were selected. Nasal lavage and saliva samples were collected in the clinic prior to MII-pH probe placement. Additional saliva samples were obtained an hour after each meal and upon waking the following morning. Nasal lavage and salivary pepsin were measured by ELISA., Results: Twenty-six patients undergoing MII-pH testing and 13 reflux-free control patients were enrolled. Salivary pepsin was detected in 11 of 26 patients with suspected LPR and 0 of 13 controls. Pepsin was most frequently detected in the specimen provided upon waking at an average concentration of 186.9 ng/mL. A significant correlation was observed between salivary pepsin in waking samples to MII-pH measurements, including reflux bolus duration, and proximal and distal recumbent reflux episodes (P < 0.05). A significant correlation was also observed between salivary pepsin upon waking or sinus lavage and reflux symptom index (P < 0.05)., Conclusion: Pepsin in salivary and nasal lavage samples demonstrated an association with MII-pH-documented LPR. Pepsin detection was most frequent in morning samples, supporting use of morning salivary pepsin levels as a potential noninvasive technique for LPR diagnosis., Level of Evidence: 2 Laryngoscope, 130:961-966, 2020., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)
- Published
- 2020
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