Chronic pharyngitis and the association with pepsin detection and reflux disease

Peter W. Dettmar, Qiuping Wang, Rachel M. Hodgson, Xiu Wang, Yifei Li, Manjie Jiang, Li Xu, Yu Lan, Andrew D. Woodcock

Abstract

Background: Pepsin is a biomarker for reflux disease and a major etiological factor in laryngopharyngeal reflux (LPR). Do chronic pharyngitis patients have significant concentrations of pepsin present in saliva samples indicating the presence of reflux disease?
Methods: Thirty-two patients with chronic pharyngitis symptoms and laryngoscopy findings from the reflux finding score (RFS), indicating chronic pharyngitis, were recruited from an Ear, Nose and Throat (ENT) department. A total of 96 patient saliva samples were analysed for the presence of pepsin. Reflux questionnaires assessed the symptoms of reflux [reflux symptom index (RSI), RFS, and reflux disease questionnaire (RDQ)] and, the non-invasive reflux diagnostic device PeptestTM was used to determine the concentration of pepsin present in the patient’s saliva samples. PeptestTM uses lateral flow technology and contains two unique human anti-pepsin monoclonal antibodies fully validated and sensitive for the detection of pepsin in saliva.
Results: In total, 78% of chronic pharyngitis patients had medium to high concentrations of pepsin (>75 ng/mL) in their saliva samples. In chronic pharyngitis patients 81% were found to have a positive pepsin concentration in post-prandial samples, compared to the control, where 32% were found to have a positive pepsin concentration.
Conclusions: A correlation was shown between the presence of pepsin and the presence of chronic pharyngitis. 78% of chronic pharyngitis patients were shown to have medium to high concentrations of pepsin in their saliva samples and 81% had a positive pepsin concentration in post-prandial samples. PeptestTM demonstrated good diagnostic potential and as a non-invasive, rapid and easy to use test, it will play an important role as a first line reflux diagnostic.