Effects of acids, pepsin, bile acids, and trypsin on laryngopharyngeal reflux diseases: physiopathology and therapeutic targets

Li, Yading; Xu, Gaofan; Zhou, Baosen; Tang, Yi-Shuang; Liu, Xiaowen; Wu, Yue; Wang, Yi; Kong, Jinliang; Xu, Tingting; He, Cong; Shi, Zhu; Wang, Xiaosu; Zhang, Jianning

doi:10.1007/s00405-021-07201-w

Cited by 34 publications

(32 citation statements)

References 94 publications

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“… 2 However, the pathogenesis of LPRD remains unclear, as it is a disease with multiple etiological factors. 3 …”

Section: Introductionmentioning

confidence: 99%

Correlation Between Refractory Laryngopharyngeal Reflux Disease and Symptoms of Anxiety and Depression

Huang¹,

Liao²,

Gan³

et al. 2022

NDT

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Background and Study Aims The occurrence, development, and prognosis of refractory laryngopharyngeal reflux disease (LPRD) may be related to anxiety and depression. Our study aims to investigate anxiety and depressive symptoms in LPRD and clarify the correlations among them. Patients and Methods Twenty-eight patients were diagnosed with LPRD and subsequently referred to the Department of Mental Health for treatment. The patients were divided into the Self-rating Anxiety Scale (SAS)/Self-rating Depression Scale (SDS) positive group (+) and the SAS/SDS negative group (−). All patients were treated (oral administration) with a standard dose of proton pump inhibitor (PPI, omeprazole 20 mg bid) plus one tablet of Deanxit (flupentixol-melitracen) after breakfast. Treatment efficacy was evaluated after one month of drug treatment. The therapeutic effect of PPI treatment alone was compared with that treated with PPI + Deanxit. Results Among 28 patients with refractory LPRD, the main reflux symptoms and signs were specific. There were differences in gender distribution and age distribution among the 28 patients with refractory LPRD, and there were 17 patients (60.7%) in the SAS/SDS (+) group and 11 patients in the SAS/SDS (−) group (39.3%). Regarding efficacy evaluation after one month of PPI + Deanxit treatment, the differences in indices before and after treatment were statistically significant (all p <0.05). Conclusion Anxiety and depressive symptoms influence the occurrence, development, and treatment efficacy of refractory LPRD. Attention to and targeted treatment of anxiety and depressive symptoms can help improve the treatment outcomes of patients with refractory LPRD.

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“… 2 However, the pathogenesis of LPRD remains unclear, as it is a disease with multiple etiological factors. 3 …”

Section: Introductionmentioning

confidence: 99%

Correlation Between Refractory Laryngopharyngeal Reflux Disease and Symptoms of Anxiety and Depression

Huang¹,

Liao²,

Gan³

et al. 2022

NDT

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“…One study has shown gastric reflux that reaches into the upper airway causing cellular damage in the epithelial lining and introducing chronic inflammation resulting in laryngopharyngeal malignant transformation [13]. Another study demonstrated reflux material such as hydrochloric acid, pepsin, bile, bile acids and trypsin inducing cellular proliferation, apoptosis and DNA damage all promoting carcinogenesis of the larynx and pharynx [14]. These pathogeneses may occur in the lower respiratory tract resulting in chronic inflammation thus contributing to the development of NSCLC.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Gastroesophageal Reflux Disease and Non-Small Cell Lung Cancer: A Retrospective Case-Control Study

et al. 2022

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Background: Lung cancer is a leading cause of mortality in the USA. Non-small cell lung cancer (NSCLC) contributes to 85% of all lung cancers. It is the most prevalent subtype amongst non-smokers, and its incidence has risen in the last 20 years. In addition, gastroesophageal reflux disease (GERD) has been associated with several lung pathologies, namely idiopathic pulmonary fibrosis and asthma. We aimed to investigate the association between GERD and NSCLC by performing a retrospective, multicenter, case-control study. This is the first study of this nature to be carried out in the USA.Methods: Data were retrieved from 17 Northwell health care facilities in the New York area between the years 2010 and 2018. Inclusion criteria were patients > 18 years of age with NSCLC (large cell, adenocarcinoma, and squamous cell). They were appropriately matched with controls based on age, gender, weight, comorbidities, and medication use. Our exposure group had a diagnosis of GERD based on the International Classification of Diseases, Ninth/10th Revision (ICD 9/10) codes and endoscopic, in addition to histological evidence if present. We excluded patients with secondary lung cancers, esophageal adenocarcinoma, other primary malignancies, Barrett's esophagus, and smokers. Logistic regression was conducted to determine the adjusted odds ratio (OR) and corresponding 95% confidence interval (CI) for the association between NSCLC and GERD.Results: A total of 1,083 subjects were included in our study: 543 (50%) patients were diagnosed with NSCLC. In this population, GERD was twice as prevalent compared to controls (20.4% vs. 11.6%, P < 0.001). Multivariate analysis demonstrated that GERD was associated with a higher risk of NSCLC compared to matched controls (OR = 1.86, 95% CI = 1.26 -2.73). In addition, GERD patients treated with either antihistamines or proton pump inhibitors did not demonstrate an overall reduced risk of NSCLC (OR = 1.01, 95% CI = 0.48 -2.12). Conclusions:Our study demonstrates that GERD is associated with a higher risk of NSCLC, irrespective of GERD treatment. We postulate that GERD patients suffer from chronic micro-aspirations leading to a prolonged inflammatory state within the lung parenchyma, triggering specific proliferative signaling pathways that may lead to malignant transformation.

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“…Acid and bile reflux play a critical role-hydrochloric acid is a major cause of esophageal irritation and reflux symptoms causing injury to mucosal epithelial cells and inflammation. The abnormal secretion and activation of pepsin can also cause proteolysis and cell damage [13]. Pathohistological changes in the esophageal mucosa can be divided into three categories: nonerosive reflux disease, reflux oesophagitis, and Barett's esophagus [14].…”

Section: Etiology and Pathophysiology Of Gerdmentioning

confidence: 99%

The Differences between Gastroesophageal and Laryngopharyngeal Reflux

Širić¹,

Rosso²,

Včev³

2023

Gastroesophageal Reflux Disease - A Growing Concern

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Gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) have different pathophysiological mechanisms of occurrence and are characterized by different clinical pictures and symptomatology. In clinical practice, it often happens that LPR remains unrecognized or is defined as atypical gastroesophageal reflux, thus, it is necessary to distinguish between these two clinical entities. Laryngopharyngeal reflux refers to the return of gastric contents from the stomach through the esophagus to the larynx, pharynx, paranasal cavities, middle ear, and lower respiratory tract, and it is part of the wider extraesophageal reflux syndrome (EER). Extraesophageal symptoms are common in GERD, and studies show an increasing prevalence of LPR in patients with GERD, as well as an association of reflux disease with cough and dysphonia symptoms. The aim of the chapter is to describe differences between GER and LPR in order to facilitate the recognition and differentiation of manifest and latent symptoms, diagnosis, and choice of therapeutic approach.

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Effects of acids, pepsin, bile acids, and trypsin on laryngopharyngeal reflux diseases: physiopathology and therapeutic targets

Cited by 34 publications

References 94 publications

Correlation Between Refractory Laryngopharyngeal Reflux Disease and Symptoms of Anxiety and Depression

Correlation Between Refractory Laryngopharyngeal Reflux Disease and Symptoms of Anxiety and Depression

The Association Between Gastroesophageal Reflux Disease and Non-Small Cell Lung Cancer: A Retrospective Case-Control Study

The Differences between Gastroesophageal and Laryngopharyngeal Reflux

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