Dilated intercellular space in chronic laryngitis and gastro-oesophageal reflux disease: at baseline and post-lansoprazole therapy.
BACKGROUND
Dilation of intercellular spaces is reported to be an early morphological marker in gastro-oesophageal reflux. It remains unknown if this marker is useful in diagnosing reflux-related chronic laryngitis.


OBJECTIVE
To determine histopathology and electron microscopic changes in oesophageal and laryngeal epithelium in chronic laryngitis.


METHODS
In this prospective blinded study, we enrolled 53 participants: 15 controls, 20 patients with GERD and 18 patients with chronic laryngitis. The latter two groups were subsequently treated with lansoprazole 30 mg bid for 12-weeks. Baseline and postacid suppressive therapy biopsies were obtained from distal oesophagus and laryngeal postcricoid areas. Biopsy specimens were evaluated for histopathology and dilated intercellular space changes.


RESULTS
There was no significant increase in oesophageal or laryngeal epithelium intercellular spaces among GERD or laryngitis patients compared with controls at baseline or postacid suppressive therapy. Only patients with GERD had significantly (P = 0.03) higher proportion of moderate-to-severe oesophageal spongiosis and basal cell hyperplasia, which normalized postacid suppressive therapy.


CONCLUSIONS
There was no increase in the width of intercellular spaces in the oesophagus or larynx in GERD or chronic laryngitis at baseline or postacid suppressive therapy. Our findings question the uniform presence of dilated intercellular space in patients with GERD.
Vaezi
M F
MF
Vanderbilt University Medical Center, Nashville, TN 37232-5280, USA. michael.vaezi@vanderbilt.edu
Slaughter
J C
JC
Smith
B S
BS
Washington
M K
MK
Jerome
W G
WG
Garrett
C G
CG
Hagaman
D
D
Goutte
M
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001706:Biopsy; D002908:Chronic Disease; D004108:Dilatation, Pathologic; D005110:Extracellular Space / Q000187:drug effects*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007365:Intercellular Junctions / Q000187:drug effects*; D064747:Lansoprazole; D007827:Laryngitis / Q000188:drug therapy / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D064747:Lansoprazole