Sensitive pepsin immunoassay for detection of laryngopharyngeal reflux.

Academic Article


  • OBJECTIVES/HYPOTHESIS: To determine whether measurement of pepsin in throat sputum by immunoassay could be used as a sensitive and reliable method for detecting laryngopharyngeal reflux (LPR) compared with 24-hour double-probe (esophageal and pharyngeal) pH monitoring. STUDY DESIGN: Patients with clinical LPR undergoing pH monitoring provided throat sputum samples during the reflux-testing period for pepsin measurement using enzyme-linked immunoadsorbent assay. RESULTS: Pepsin assay results from 63 throat sputum samples obtained from 23 study subjects were compared with their pH monitoring data. Twenty-two percent (14/63) of the sputum samples correlated the presence of pepsin with LPR (pH < or = 4 at the pharyngeal probe), of which the median concentration of pepsin was 0.18 microg/mL (range 0.003-22 microg/mL). Seventy-eight percent (49/63) of the samples unassociated with (pharyngeal) reflux contained no detectible pepsin. Mean pH values for pepsin-positive samples were significantly lower than negative samples at both esophageal probe (pH 2.2 vs. pH 5.0) (P < .01) and the pharyngeal probe (pH 4.4 vs. pH 5.8) (P < .01). When the pepsin assay results were compared with the pharyngeal pH data for detecting reflux (events pH < or = 4), the pepsin immunoassay was 100% sensitive and 89% specific for LPR. CONCLUSIONS: Detection of pepsin in throat sputum by immunoassay appears to provide a sensitive, noninvasive method to detect LPR.
  • Authors

    Published In

  • Laryngoscope  Journal
  • Keywords

  • Acid-Base Equilibrium, Adult, Aged, Analysis of Variance, Cohort Studies, Enzyme-Linked Immunosorbent Assay, Female, Gastric Acidity Determination, Gastric Juice, Gastroesophageal Reflux, Humans, Hydrogen-Ion Concentration, Laryngitis, Male, Middle Aged, Monitoring, Physiologic, Pepsin A, Probability, Prospective Studies, Radioimmunoassay, Sensitivity and Specificity, Severity of Illness Index
  • Digital Object Identifier (doi)

    Author List

  • Knight J; Lively MO; Johnston N; Dettmar PW; Koufman JA
  • Start Page

  • 1473
  • End Page

  • 1478
  • Volume

  • 115
  • Issue

  • 8