Estudo comparativo da concentração salivar do fator de crescimento epidérmico em indivíduos com laringite crônica por doença do refluxo gastroesofágica antes e após o tratamento: resultados preliminares

Abstract

The Laryngopharyngeal Reflux (LPR) physiopathology is still unknown. The Epidermal Growth Factor (EGF) is a biologically active salivary protein that aids in the rapid regeneration of the oropharyngeal and upper digestive tract mucosas. Salivary deficiency of this protein in patients with LPR has been demonstrated in previous studies. Aim: To compare salivary EGF concentration in patients with LPR before and after treatment. Materials and Methods: In this prospective study twelve patients with GERD and moderate LPR were studied. Whole saliva samples were collected before and after treatment and salivary EGF concentration was determined using a commercially available ELISA kit (Quantikine ®). Results: There were eleven females and one male among the patients, the mean age was 49 years. The mean pre-treatment salivary EGF concentration was 2,867.6 pg/mL and the mean post treatment EGF concentration was 1,588.5 pg/mL. This difference was statistically significant (p=0.015). Discussion and Conclusions: Although salivary EGF concentrations are higher before LPR treatment, the concentration is still much lower than the mean salivary EGF concentration in normal individuals without LPR, which suggests a primary disorder of this defense factor in individuals with LPR.

pH salivary analysis of subjects suffering from Sjögren's Syndrome and laryngopharyngeal reflux

“…The patient was instructed not to brush his/her teeth or use mouthwash in the morning of saliva collection. The method of collection was the one previously described by Eckley et al 18 , 19 , 20 …”

“…For individuals with xerostomia, Eckley & Costa 18 noticed significant drops in the pH and in the salivary volume of patients with LPR, when compared to normal individuals. Moreover, these changes seem to be a response to reflux, and not a primary deficiency, because after controlling the disease, pH and salivary volume go back to normal 19 . However, in SS individuals, it is not known how saliva could interfere in the balance of the laryngeal and esophageal coating epithelium.…”

Contemporary approach to the etiology, diagnosis and therapy of laryngopharyngeal reflux – literature review

“…25 Neka istraživanja pokazala su da su količina sline i pH sline značajno niži u bolesnika s LPRom nego u zdravih kontrolnih ispitanika te da je to prvenstveno posljedi ca, a ne uzrok refluksa, jer su se oba parametra nor malizirala nakon primjene antirefluksne terapije. 26,27 Slina također sadrži i epidermalni faktor rasta koji pomaže obnovi epitela ždrijela i jednjaka, a koji je u slini bolesnika s LPRom značajno snižen. 28 Osim što slina ispire i neutralizira kiselinu, i sluznica jednjaka ima sposobnost neutralizacije kiseline sekrecijom bi karbonatnih iona.…”

Refluxo laringofaríngeo e bulimia nervosa: alterações vocais e larínegas

“…A DRGE também pode apresentar sintomatologia exclusivamente extra-esofágica, laringofaríngea e/ou traqueo-brônquica, caracterizando, assim, o RLF 25 que pode atingir a laringe e as pregas vocais, com consequências sobre a voz. Os pacientes do sexo masculino apresentam maior incidência de alterações laríngeas que os do sexo feminino 9 , apesar de a DRGE predominar no sexo feminino 35 .…”

“…A primeira associação entre doença laríngea e RLF foi relatada por Coffin em 1903 37 , demonstrando que a "eructação de gases do estômago" e a hiperacidez eram responsáveis por sintomas em muitos de seus pacientes com "catarro pós-nasal". Estudos subsequentes afirmam que a mucosa da laringe é bastante sensível a substâncias químicas e que mesmo RLF intermitentes podem causar graves lesões inflamatórias 11,27,35,38 , pois, ao contrário do esôfago, pouco se conhece a respeito dos fatores mecânicos e químicos que atuam na sua proteção 35 .…”