epidermal-growth-factor and Laryngitis

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.

Topics: Adult; Aged; Anti-Ulcer Agents; Biomarkers; Case-Control Studies; Epidermal Growth Factor; Female; Humans; Laryngitis; Laryngopharyngeal Reflux; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Proton Pump Inhibitors; Saliva; Sensitivity and Specificity; Severity of Illness Index; Treatment Outcome

Topics: Adult; Endosonography; Epidermal Growth Factor; Esophagoscopy; Follow-Up Studies; Gastroesophageal Reflux; Humans; Laryngitis; Laryngoscopy; Magnetic Resonance Imaging; Male; Proton Pump Inhibitors; Proton Pumps; Risk Assessment; Severity of Illness Index; Treatment Outcome; Zollinger-Ellison Syndrome

The mechanisms involved in the mucosal alterations of laryngopharyngeal reflux (LPR) have not been well established. Reports indicate a decrease in the salivary epidermal growth factor (EGF) of patients with reflux esophagitis, but there are no reports of its behavior in LPR. Our objective was to determine the salivary concentration of EGF in adults with LPR.. Salivary EGF concentration of 26 patients with LPR and 20 healthy controls was determined using a commercially available ELISA kit. Patients with LPR were graded according to endoscopic and laryngoscopic criteria.. Salivary EGF concentration was significantly lower in the LPR group when compared with controls (P = 0.002). No correlation between the severity of laryngeal findings or esophagitis and salivary EGF concentration could be determined.. The decreased salivary concentration of EGF in adults with LPR suggests that a deficiency in this polypeptide could be associated to the disease.

Topics: Adult; Aged; Enzyme-Linked Immunosorbent Assay; Epidermal Growth Factor; Female; Gastroesophageal Reflux; Humans; Laryngitis; Male; Middle Aged; Saliva