Usefulness of Matrix Metalloproteinase-7 in Saliva as a Diagnostic Biomarker for Laryngopharyngeal Reflux Disease.

Author(s):  
Nu-Ri Im ◽  
Byoungjae Kim ◽  
Kwang-Yoon Jung ◽  
Seung-Kuk Baek

Abstract Introduction Several diagnostic methods are currently being used to diagnose LPRD (laryngopharyngeal reflux disease), but have the disadvantage of being invasive, subjective, or expensive. Objectives Our purpose in this study was to investigate the correlation between pepsin and MMP-7 (Matrix Metalloproteinase-7) in pharyngeal secretions of subjects according to RSI (Reflux Symptom Index) score to find out the diagnostic value of MMP-7. Method We recruited 173 subjects aged between 19 and 85 years who completed the RSI scale. All samples were taken after waking up, and the amount of the pepsin and MMP-7 in saliva were measured by means of an enzyme activity assay. Results There was a significant increase of pepsin and MMP-7 activity in the study group with an RSI score of 13 or higher. The sensitivity and specificity of MMP-7 for predicting the possibility of an RSI of 13 or more was higher than that of pepsin. When MMP-7 and pepsin were combined, this sensitivity and specificity increased. Conclusion An enzyme assay of MMP-7 in saliva may be a noninvasive and easy technique for diagnosing LPRD.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nu-Ri Im ◽  
Byoungjae Kim ◽  
Kwang-Yoon Jung ◽  
Seung-Kuk Baek

AbstractSeveral diagnostic methods are currently being used to diagnose LPRD (laryngopharyngeal reflux disease), but have the disadvantage of being invasive, subjective, or expensive. Our purpose in this study was to investigate the correlation between pepsin and MMP-7 (Matrix Metalloproteinase-7) in pharyngeal secretions of subjects according to RSI (Reflux Symptom Index) score to find out the diagnostic value of MMP-7. We recruited 173 subjects aged between 19 and 85 years who completed the RSI scale. All samples were taken after waking up, and the amount of the pepsin and MMP-7 in saliva were measured by means of an enzyme activity assay. There was a significant increase of pepsin and MMP-7 activity in the study group with an RSI score of 13 or higher. The sensitivity and specificity of MMP-7 for predicting the possibility of an RSI of 13 or more was higher than that of pepsin. When MMP-7 and pepsin were combined, this sensitivity and specificity increased. An enzyme assay of MMP-7 in saliva may be a noninvasive and easy technique for diagnosing LPRD.


Author(s):  
Feng Pei ◽  
Wei Jia Hu ◽  
Yi Nan Mao ◽  
Yu Liang Zhao

Background:To explore whether combined with TCM based on classical proton pumpinhibitors PPIs therapy can achieve better efficacy for patients withlaryngopharyngeal reflux disease. Methods: There were 150 laryngopharyngeal refluxpatients enrolled and divided into three groups randomly, with 50 cases in each group.Patients in group A were treated with the proton pump inhibitor (PPI) lansoprazole.Patients in group B were treated with lansoprazole combined with Banxia Houpudecoction, and patients in group C were treated with acupuncture treatments and acombination of Chinese and Western medicine. The reflux symptom index (RSI), refluxfinding score (RFS), and quality of life (36 item short form health survey questionnaire)were assessed before and 4 and 8 weeks after treatment. Results: The RSI and RFSscores of the three groups were significantly reduced after treatment (P < 0.001). Ingroup B and C, they were lower than in group A at 8 weeks (P < 0.01). The SF 36 scoreof 3 groups increased after treatment. At both 4 and 8 weeks (P < 0.001), and patientsin groups B and C scored higher than patients in group A (P < 0.001). The total effectiverate of group B and group C was higher than that of group A (P < 0.05). Conclusion:All three treatments have therapeutic effects on the disease, but the efficacy of a PPIalone is not as good as the combined treatments’ efficacies. Moreover, PPI combinedwith Banxia Houpu decoction and/or acupuncture treatment substantially affects lifeimprovement.


Author(s):  
Adhira Gobind

<p class="abstract"><strong>Background:</strong> Laryngopharyngeal reflux disease (LPRD) is one of the most prevalent upper gastrointestinal disorder encountered in clinical practice and its optimal treatment is not standardized. The role of magnesium in the human body functions is often underestimated. Since magnesium (Mg) plays a major role in the regulation of smooth muscle contractionby relaxing the pyloric sphincter and enhancing gastric emptying, thereby decreasing the pressure on the LES, it was hypothesized that adding magnesium supplements along with the regular treatment for LPRD, can improve LPRD symptoms. Magnesium has a neutralizing action on the gastric acid and therefore, it may be pertinent to achieve optimal Mg intakes in patients with LPRD.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done over a period of 1 year conducted in a tertiary care hospital in central India in patients presenting with LPRD of the age group 18-65 years.  </p><p class="abstract"><strong>Results:</strong> The study patients were divided into two groups-one treated with esmoprazole 40 mg capsules and alginate syrup and the other with esmoprazole capsules, alginate syrup and magnesium glycinate (250 mg) supplement. Both the groups showed appreciable improvement in their mean reflux symptom index (RSI) and reflux finding score (RFS) at 1 month and 3 months follow-up. Females showed a higher preponderance than males in the disease, symptoms and the mean RSI and RFS score.</p><p class="abstract"><strong>Conclusions:</strong> Addition of magnesium supplements along with the regular treatment for LPRD, can improve LPRD symptoms and should be considered in the treatment protocol of LPRD.</p>


Author(s):  
Manoj Kumar L. ◽  
Anand K. H. ◽  
Raadhika Shree N.

<p class="abstract"><strong>Background:</strong> Laryngopharyngeal reflux disease is an under diagnosed condition due to unavailability of the diagnostic tool that is dual probe pH monitoring and is on the rise in adult population according to El Serag by 4% every year since 1976.</p><p class="abstract"><strong>Methods:</strong> Adult patients coming to the outpatient department between April 2017 to April 2018 were evaluated using reflux symptom index score (RSI). Score greater than 13 were suggestive of laryngopharyngeal reflux and patients underwent 24 hours ambulatory dual probe pH monitoring. 7 or more reflux events in study period were diagnostic of laryngopharygeal reflux.  </p><p class="abstract"><strong>Results:</strong> 3000 adult patients were screened for RSI and 1756 (58.3%) had scored greater than 13. Among these patients 893 patients had 7 or more reflux events in pH monitoring. We found a prevalence of 29.76% in our study population.</p><p class="abstract"><strong>Conclusions:</strong> Prevalence laryngopharyngeal reflux disease needs to assess periodically at regular intervals to create more awareness of the disease and patient education thus preventing from causing chronic illnesses.</p><p class="abstract"> </p>


2021 ◽  
Vol 8 (27) ◽  
pp. 2467-2471
Author(s):  
Binu Raju George ◽  
Ajayan P.V ◽  
Saify Samad

BACKGROUND Laryngopharyngeal reflux is a common clinical condition encountered in Otolaryngology practice. It is one of the major causes of laryngeal inflammation. It presents with a constellation of symptoms making the diagnosis difficult. Reflux Symptom Index and Reflux Finding Score are two tools which aid in diagnosis of Laryngopharyngeal reflux. The main objective of this study was to study the agent, host and environment factors of epidemiology of patients with laryngopharyngeal reflux disease using Reflux Symptom Index and Reflux Finding Score. METHODS A descriptive study was conducted on 100 patients attending the Department of Otorhinolaryngology, Government Medical College and Hospital, Thrissur, Kerala. The study period was for one year from December 2017 to December 2018. Demographic data of the patients was recorded, and patients were evaluated for Laryngopharyngeal reflux disease using Reflux Symptom Index and Reflux Finding Score using 70 degree / flexible nasopharyngolaryngoscopy. The clinical data collected was then tabulated and analysed. RESULTS From the study conducted in 100 patients, 59 % were females and 41 % males. Most common symptom noted was frequent clearing of throat which was present in 88 % cases. Least frequent symptom was choking episode (in 5 %). CONCLUSIONS The prevalence of Laryngopharyngeal Reflux Disease was commonest in the 31 to 40 years age group with mean age was 37.8 ± 2.35 years. The male to female ratio were 1:1.43. The disease was common in labourers and housewives. Risk factors were consumption of tea/coffee, inadequate sleep of less than 6 hrs. Lower socioeconomic group populations were more vulnerable than higher income group. The RSI score was between 13 and 15 in 53 % of the patients. KEYWORDS Laryngopharyngeal Reflux, Reflux Symptom Index, Reflux Finding Score


2015 ◽  
Vol 44 (2) ◽  
pp. 131
Author(s):  
Chrisma Pramana ◽  
Muyassaroh Muyassaroh ◽  
Dwi Antono

Latar Belakang: Laryngopharyngeal Reflux Disease (LPRD) menyebabkan kerusakan mukosa laring dan faring.  Zinc adalah kelompok zat gizi mikro yang berperan dalam inhibisi terhadap sekresi asam lambung, pembentukan carbonic anhidrase, dan reepitelisasi. Tujuan: Mengetahui pengaruh suplementasi zinc pada perbaikan klinis penderita LPRD. Metode: Penelitian eksperimental dengan pre-post test randomized control trial pada penderita LPRD di klinik THT-KL RSUP Dr. Kariadi yang memenuhi kriteria penelitian. Kelompok kontrol diberikan omeprazol dan plasebo, sedangkankelompok perlakuan diberikan omeprazol dan zinc. Pemberian terapi dilakukan selama 4 minggu kemudian dianalisis skoring Reflux Symptom Index (RSI) dan Reflux Finding Score (RFS) sebelum terapi dan sesudah terapi pada kedua kelompok. Analisis data dengan uji Wilcoxon dan independent t test. Hasil: Sampel sebanyak 27 penderita, kelompok kontrol 13 orang, dan kelompok perlakuan 14 orang. Skor RSI sebelum terapi pada kelompok kontrol 22,92±6,982, sedangkan pada kelompok perlakuan19,57±6,136 (p=0,223). Skor RFS sebelum terapi pada kelompok kontrol 10,46±2,367, sedangkan pada kelompok perlakuan 10,86±2,983 (p=0,767). Skor RSI sesudah terapi pada kelompok kontrol 15,92±8,893, sedangkan pada kelompok perlakuan 9,07±6,294 (p=0,034). Skor RFS sesudah terapi pada kelompok kontrol 6,54±1,808, sedangkan pada kelompok perlakuan 4,54±2,240 (p=0,024). Kesimpulan: Suplementasi zinc berpengaruh pada perbaikan klinis penderita LPRD. Perbaikan klinis penderita LPRD yang diberikan suplementasi zinc lebih baik dibanding tanpa suplementasi zinc. Kata kunci: Reflux Symptom Index, Reflux Finding Score, zinc ABSTRACTBackground: Laryngopharyngeal Reflux Disease (LPRD) could cause mucosal damage on larynx and pharynx. Zinc is microsubstance which has a role as inhibiting factor to gastric acid, carbonic anhidrase establishment, and reepitelization. Objective: The study aimed to know the effect of zinc onLPRD patient’s clinical improvement. Methods: Experimental study with pre-post test randomized control trial on LPRD patients in ENT center RSUP Dr. Kariadi. Control group was prescribed omeprazole and placebo,while interventioned group was prescribed omeprazole and zinc. The treatment was conducted for 4 weeks, and Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were analyzed before and after treatment for both groups. Data were analyzed with Wilcoxon’s test and independent t-test. Result: The sample was 27 patients, consisted of 13 patients in control group and 14 patients in interventioned group. RSI score before theraphy on control group was 22,92±6,982, on interventioned group 19,57±6,136(p=0,223). RFS score on control group 10,46±2,367, on interventioned group 10,86±2,983 (p=0,767). RSI after theraphy on control group 15,92±8,89,3 while on interventioned group 9,07±6,294 (p=0,034). RFS score after theraphy on control group 6,54±1,808, while on interventioned group 4,54±2,240 (p=0,024). Conclusion: This study found that zinc supplementation had an effect on clinical improvement on patients with LPRD. Clinical improvement on LPRD patients who got zinc supplementation was found better than without zinc supplementation.Keywords: Reflux Symptom Index, Reflux Finding Score, Zinc


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Abdul-Latif Hamdan ◽  
Jad Jabbour ◽  
Zaid Al Zaghal ◽  
Sami T. Azar

The purpose of this study is to look at the prevalence of laryngopharyngeal reflux disease in patients with goiter in a group of 52 patients with goiter. All participants were asked to respond to the 9 questions on the Reflux Symptom Index (RSI). A diagnosis of LPRD based on symptoms was made for any RSI score above 10. The average score of every question was computed for all patients with goiter and compared to the corresponding average score of the controls. A value of less than 0.05 was considered statistically significant. The total prevalence of LPRD in patients with goiter as indicated by an RSI score greater than 10 was 15.4% versus 9.1% in controls. The difference was not statistically significant ( value 0.525). Looking at the average score of the individual symptoms as listed in the RSI questionnaire, the average score of all the symptoms was higher in patients with goiter versus controls. There was no correlation between LPRD and any of the demographic variables except for nodules ( value 0.035). The presence of laryngopharyngeal symptoms in patients with goiter should alert the treating physician to the presence of laryngopharyngeal reflux disease.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ameer Kakaje ◽  
Mohammad Marwan Alhalabi ◽  
Ayham Alyousbashi ◽  
Ayham Ghareeb

AbstractAllergic rhinitis (AR) is a common medical condition worldwide. It is an inflammation in the nasal mucosa due to allergen exposure throughout the year. Laryngopharyngeal reflux (LPR) is another medical condition that can overlap with AR. LPR can be considered an extra oesophageal manifestation of gastro-oesophageal reflux disease (GORD) or a different entity. Its diagnosis imposes a real challenge as it has a wide range of unspecific symptoms. Although AR and LPR are not life-threatening, they can severely affect the quality of life for years and cause substantial distress. Moreover, having AR is associated with having asthma which is also in turn associated with GORD. This is a cross-sectional study which used surveys distributed online on Social Media and targeted people across Syria. All participants who responded to the key questions were included. Reflux symptom index (RSI) was used for LPR, and score for allergic rhinitis (SFAR) was used for AR. Demographic questions and whether the participant had asthma were also included in the survey. We found that there was an association between the symptoms of LPR and AR p < 0.0001 (OR, 2.592; 95% CI 1.846–3.639), and their scores were significantly correlated (r = 0.334). Having asthma was associated with LPR symptoms p = 0.0002 (OR 3.096; 95% CI 1.665–5.759) and AR p < 0.0001 (OR 6.772; 95% CI 2.823–16.248). We concluded that there was a significant association between having LPR, AR, and asthma. We need more studies to distinguish between their common symptoms and aetiologies.


Author(s):  
Ameer Kakaje ◽  
Mohammad Marwan Alhalabi ◽  
Ayham Alyousbashi ◽  
Aya Hamid ◽  
Yousef Mahmoud

Abstract Backgrounds: Syria has entered its ninth year of conflict and as its medical sector facing major hurdles, laryngopharyngeal reflux (LPR) is often overlooked although it has an association with worsening quality of life and affecting many aspects as it is chronic and left untreated although it can lead to many complications such as dysphonia. This study is to evaluate LPR prevalence and its association with different aspects such as cigarette, and shisha smoking, and the effect of war on LPR.Methods: Cross-sectional study by using online questionnaires that included demographics, smoking, war related questions and reflux symptom index (RSI) were used online in many cities around Syria.Findings: This research included 734 responders with 75.5% being female and the mean age being 23.97 years. 31.9% of subjects had symptoms suggestive of LPR. Participants were Syrians and we included every responder who agreed and did not neglect any question. We only found that being distressed from war noises was associated with positive LPR symptoms [P=0.009 (OR, 1.562; 95% CI 1.117-2.183)], but losing someone or changing place of living due to war were not associated with LPR. LPR was associated with cigarette smoking (P<0.05). Finally, having asthma, and male gender in the younger population were associated with LPR (P<0.05). No clear association with age, or shisha and no significant associations were found with consanguinity, marital status, educational level and SES.Interpretations: About one third had LPR symptoms. War distress from war noise, cigarette smoking, asthma, and allergic were significantly correlated with LPR.


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