title: Pepsinogen identification in the middle ear fluid of children with otitis media with effusion.
abstract: OBJECTIVE
  This study aims to investigate the presence and concentration of pepsin/pepsinogen in middle ear fluid and to discuss the potential mechanisms involved in the pathogenesis of this condition.
  
  
  METHODS
  A total of 33 children (21 boys, 12 girls; mean age 5.7±2.4 years; range 3 to 13 years) diagnosed with otitis media with effusion and scheduled for operation were enrolled into the study. Fluids aspirated from the middle ear were assessed for the presence of pepsinogen and albumin and blood samples were drawn simultaneously for comparison.
  
  
  RESULTS
  Mean pepsinogen concentration was statistically significantly higher in middle ear fluids compared with serum samples (262.4 ng/mL [range: 211.7 ng/mL - 301.1 ng/mL] versus 102.6 ng/mL [range: 80.7 ng/mL - 134.5 ng/mL], respectively) (p<0.001). On the other hand, mean albumin concentration was significantly lower (1.1 g/dL [range: 0.01 g/dL - 9.5 g/dL] versus 5.8 g/dL [range: 0.9 - 9.5 g/dL], respectively) (p<0.001). The highest pepsinogen concentration was detected in patients with purulent effusion (275.3 ng/mL).
  
  
  CONCLUSIONS
  Our findings support the theory of gastro-esophageal reflux related pepsinogen transition to the middle ear and indicate that pepsinogen may a reliable biochemical marker for the assessment of gastro-esophageal reflux.
authors.affiliation: Department of Otolaryngology, Afyon State Hospital, 03030 Afyon, Turkey.
authors.forename: Aytuğ
authors.initials: A
authors.lastname: Buyruk
authors.forename: Üstün
authors.initials: Ü
authors.lastname: Osma
authors.forename: Mustafa Deniz
authors.initials: MD
authors.lastname: Yılmaz
authors.forename: Hülya
authors.initials: H
authors.lastname: Eyigör
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods; D000293:Adolescent; D000418:Albumins / Q000032:analysis; D001301:Audiometry, Pure-Tone / Q000379:methods; D015415:Biomarkers / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004432:Ear, Middle / Q000201:enzymology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000201:enzymology; D006801:Humans; D008297:Male; D010034:Otitis Media with Effusion / Q000097:blood / Q000201:enzymology*; D010035:Otitis Media, Suppurative / Q000201:enzymology; D038781:Otoscopy / Q000379:methods; D010434:Pepsin A / Q000032:analysis / Q000097:blood; D020116:Pepsinogen A / Q000032:analysis* / Q000097:blood; D012709:Serum Albumin / Q000032:analysis
chemical_list: D000418:Albumins; D015415:Biomarkers; D012709:Serum Albumin; D020116:Pepsinogen A; D010434:Pepsin A