Pepsin assay: a marker for reflux in pediatric glue ear.
OBJECTIVE
To evaluate if analysis of pepsin/pepsinogen in middle ear effusions can be considered a diagnostic marker for laryngopharyngeal reflux (LPR) in children with otitis media with effusion (OME).


METHODS
Ambulatory 24-hour dual-probe pH monitoring was carried out on 31 children with OME. Middle ear effusions were collected from 17 children during myringotomy. Total pepsin/pepsinogen concentrations in effusions were measured by ELISA using antipepsin antibody.


RESULTS
Dual-probe pH monitoring showed that 22/31 (71%) of the studied children had significant LPR. The concentrations of pepsin/pepsinogen in middle ear effusions, ranged from 0.085 to 5.02 microg/ml, were found to be up to 4.5 to 231.44 times higher than the serum levels. There was a significant positive correlation between the level of pepsin/pepsinogen assayed in the effusions of the 17 children and the number of pharyngeal reflux episodes measured by pH monitoring.


CONCLUSIONS
Control of LPR may be an essential component in the successful management of OME in pediatric patients. Pepsin/pepsinogen analysis in effusions of children, using ELISA, can be considered a reliable marker for assessment of reflux in children with OME.
Abd El-Fattah
Ahmed M
AM
Department of Otolaryngology, Mansoura University, Mansoura, Egypt.
Abdul Maksoud
Gamal A
GA
Ramadan
Ahmed S
AS
Abdalla
Ahmed F
AF
Abdel Aziz
Mohamed M
MM
D000233:Adenoidectomy; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D050782:Esophageal pH Monitoring; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007013:Hypopharynx / Q000503:physiopathology*; D007223:Infant; D008876:Middle Ear Ventilation; D018670:Monitoring, Ambulatory / Q000379:methods; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000503:physiopathology; D010434:Pepsin A / Q000032:analysis* / Q000097:blood; D020116:Pepsinogen A / Q000032:analysis* / Q000097:blood; D011446:Prospective Studies; D014068:Tonsillectomy
D015415:Biomarkers; D020116:Pepsinogen A; D010434:Pepsin A