Correlation of pepsin-measured laryngopharyngeal reflux disease with symptoms and signs.
OBJECTIVE
Pepsin detection in throat sputum has been posited as a reliable biological marker of laryngopharyngeal reflux disease (LPRD). This study was designed to further correlate pepsin concentration with symptoms and signs of LPRD.


METHODS
Cross-sectional study.


METHODS
Nanfang Hospital of Southern Medical University.


METHODS
Fifty-six laryngitis patients were divided into a reflux laryngitis group and a chronic laryngitis group based on the reflux symptom index (RSI), reflux finding score (RFS), and proton pump inhibitor treatment for two weeks. Oral and hypopharyngeal secretions from the study patients and from 15 healthy subjects were collected. Thirty-six obstructive sleep apnea (OSA) patients were divided into a mild-moderate group and a severe group by the apnea-hypopnea index (AHI). Bedtime and first-morning oral secretions were collected. Enzyme-linked immunosorbent assay was used to measure the pepsin concentration.


RESULTS
In laryngitis patients, the total score of RSI and RFS (P < 0.05), and the symptoms, including clearing throat often, coughing, and sensing a lump in the throat (P < 0.006), were more severe in the pepsin-positive group. No significant differences were found between the oral and hypopharyngeal secretions. In OSA, pepsin levels in the first-morning oral secretions were correlated with AHI, mean SaO(2), and mini SaO(2) (P < 0.01). However, RSIs were not significantly correlated with these indicators.


CONCLUSIONS
Higher levels of pepsin in sputum were associated with higher RSI and RFS in cases of laryngitis. There was no relationship between pepsin levels and RSI in cases of OSA. There were no differences of pepsin concentration in sputum collection methods or in collection timing.
Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China.
Lu
L
Wang
Xiong
X
Liu
You-li
YL
Liu
Fang-fang
FF
Zeng
Ting
T
Wu
Chun-li
CL
Yang
Hai-yan
HY
Shen
Xiang-ping
XP
Li
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007827:Laryngitis / Q000175:diagnosis* / Q000209:etiology; D057045:Laryngopharyngeal Reflux / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010434:Pepsin A / Q000032:analysis*; D010614:Pharynx; D013183:Sputum / Q000737:chemistry*
D015415:Biomarkers; D010434:Pepsin A