bile; biomarker; cholesterol; elastase; enzyme; gastroesophageal reflux; laryngopharyngeal reflux; lipase; pepsin; saliva; Bile Acids and Salts; Biomarkers; Cholesterol; Adult; Female; Humans; Male; Middle Aged; Bile Acids and Salts/metabolism; Bile Acids and Salts/analysis; Case-Control Studies; Cholesterol/metabolism; Cholesterol/analysis; Esophageal pH Monitoring; Hydrogen-Ion Concentration; Prospective Studies; Aged; Biomarkers/analysis; Biomarkers/metabolism; Laryngopharyngeal Reflux/metabolism; Laryngopharyngeal Reflux/diagnosis; Saliva/chemistry; Saliva/metabolism; Surgery; Otorhinolaryngology
Abstract :
[en] [en] OBJECTIVE: To investigate the digestive enzymes and biomarkers in the saliva of patients with laryngopharyngeal reflux (LPR) and asymptomatic individuals.
STUDY DESIGN: Prospective controlled study.
SETTING: Multicenter study.
METHODS: Patients with LPR at the hypopharyngeal-esophageal impedance-pH monitoring (HEMII-pH) and asymptomatic individuals were consecutively recruited from January 2020 to April 2023 from 2 University Hospitals. The saliva of patients (off PPIs) and asymptomatic individuals was collected to measure pH, elastase, bile salts, cholesterol, gastric, and pancreatic lipases. Anxiety, symptoms, and findings were studied through perceived stress scale (PSS), reflux symptom score (RSS), and reflux sign assessment (RSA).
RESULTS: Sixty-seven LPR patients and 57 asymptomatic individuals completed the evaluations. LPR patients reported higher PSS, RSS, and RSA than asymptomatic individuals. The mean saliva pH was more alkaline in LPR patients (7.23: 95% confidence interval [CI]: 7.08, 7.38) compared to controls (6.13; 95% CI: 5.95, 6.31; P = .001). The mean concentration of elastase was higher in patients (51.65 µg/mL; 95% CI: 44.47, 58.83 µg/mL) versus asymptomatic individuals (25.18 µg/mL; 95% CI: 21.64, 28.72 µg/mL; P = .001). The saliva cholesterol reported higher concentration in healthy individuals (3.43 mg/dL; 95% CI: 3.21, 3.65 mg/dL) compared to patients (1.16 mg/dL; 95% CI: 1.05, 1.27 mg/dL; P = .001). The saliva pH, and elastase concentration were significantly associated with the baseline RSS, while saliva cholesterol was negatively associated with the severity of RSS and RSA.
CONCLUSION: Cholesterol, bile salts, and elastase are biomarkers of LPR and should be considered to develop future non-invasive saliva device for the detection of LPR.
Disciplines :
Otolaryngology
Author, co-author :
Lechien, Jerome R; Division of Laryngology and Broncho-esophagology, Department of Otolaryngology-Head Neck Surgery, EpiCURA Hospital, Baudour, Belgium ; Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium ; Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Phonetics and Phonology Laboratory, (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France ; Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium ; Polyclinique Elsan de Poitiers, Poitiers, France
De Marrez, Lisa G; Department of Otorhinolaryngology-Head and Neck Surgery, CHU Brugmann, Brussels, Belgium
Hans, Stephane; Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Phonetics and Phonology Laboratory, (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France
Muls, Vinciane; Department of Gastroenterology, CHU Saint-Pierre, Brussels, Belgium
Spinato, Linda; Department of Otorhinolaryngology-Head and Neck Surgery, CHU Brugmann, Brussels, Belgium
Briganti, Giovanni ; Université de Mons - UMONS > Faculté de Médecine et de Pharmacie > Service de Médecine computationnelle et Neuropsychiatrie ; Department of Psychiatry, CHU Brugmann, Brussels, Belgium
Saussez, Sven ; Université de Mons - UMONS > Faculté de Médecine et de Pharmacie > Service d'Anatomie humaine et Oncologie expérimentale ; Division of Laryngology and Broncho-esophagology, Department of Otolaryngology-Head Neck Surgery, EpiCURA Hospital, Baudour, Belgium ; Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Phonetics and Phonology Laboratory, (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France
De Vos, Nathalie; Department of Clinical Chemistry, LHUB-ULB, Brussels, Belgium
Language :
English
Title :
Digestive Biomarkers of Laryngopharyngeal Reflux: A Preliminary Prospective Controlled Study.
Publication date :
May 2024
Journal title :
Otolaryngology - Head and Neck Surgery
ISSN :
0194-5998
eISSN :
1097-6817
Publisher :
John Wiley and Sons Inc, England
Volume :
170
Issue :
5
Pages :
1364 - 1371
Peer reviewed :
Peer Reviewed verified by ORBi
Research unit :
M121 - Service de Médecine computationnelle et Neuropsychiatrie
Research institute :
Santé
Funding text :
Vesale Grant & IRIS‐Recherche Grant (Foundation Roi Baudouin). The study is funded by the Groupement de Coopération Sanitaire ELSAN, 58 bis rue de la Boétie, 75008 Paris, France. Pr. Giovanni Briganti for the sample size analyzes. B. Johnson for the proofread.
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