Eckley Claudia A, Sardinha Luis Roberto, Rizzo Luiz Vicente
Department of Otolaryngology, Santa Casa School of Medicine and Hospitals of São Paulo, São Paulo, Brazil.
Ann Otol Rhinol Laryngol. 2013 Jul;122(7):440-4. doi: 10.1177/000348941312200705.
The diagnosis of laryngopharyngeal reflux (LPR) is controversial. There is no correlation between the number of reflux episodes and the severity of the inflammatory response at the esophagus or the laryngopharyngeal segment. Some authors have suggested that decreased salivary epidermal growth factor (EGF) concentrations in patients with gastroesophageal reflux disease and LPR point to a breakdown in the local defenses. Our objective was to establish whether treatment of the disease influences low salivary EGF concentrations.
The spontaneous whole saliva of 20 adults with LPR was sampled at a tertiary teaching hospital before and after a 16-week course of full-dose proton pump inhibitor and compared to that of 12 healthy controls. Salivary EGF concentrations were established with a commercially available enzyme-linked immunosorbent assay kit.
Although the mean salivary EGF concentrations were higher before treatment than after treatment and control of the disease (25,083 versus 19,359 pg/mL), this difference was not statistically significant (p = 0.065). The mean salivary EGF concentration of healthy control subjects was significantly higher (54,509 pg/mL; p < 0.0001).
Both before and after treatment, patients with reflux laryngitis present lower salivary EGF concentrations than healthy control subjects, suggesting a primary deficit in their protective mechanisms.
喉咽反流(LPR)的诊断存在争议。反流发作次数与食管或喉咽段炎症反应的严重程度之间没有相关性。一些作者认为,胃食管反流病和LPR患者唾液表皮生长因子(EGF)浓度降低表明局部防御功能受损。我们的目的是确定该疾病的治疗是否会影响唾液EGF浓度降低。
在一家三级教学医院,对20名患有LPR的成年人在接受为期16周的全剂量质子泵抑制剂治疗前后采集自发全唾液样本,并与12名健康对照者的样本进行比较。使用市售的酶联免疫吸附测定试剂盒测定唾液EGF浓度。
尽管治疗前唾液EGF平均浓度高于治疗后且疾病得到控制(分别为25,083 pg/mL和19,359 pg/mL),但这种差异无统计学意义(p = 0.065)。健康对照者的唾液EGF平均浓度显著更高(54,509 pg/mL;p < 0.0001)。
无论治疗前后,反流性喉炎患者的唾液EGF浓度均低于健康对照者,提示其保护机制存在原发性缺陷。