Pepsin assay: A marker for reflux in pediatric glue ear

Abstract

Control of LPR may be an essential component in the successful management of OME in pediatric patients. Pepsin/pepsinogen analysis in effusions of children, using ELISA, can be considered a reliable marker for assessment of reflux in children with OME.

Laryngopharyngeal reflux: diagnosis and treatment of a controversial disease

“…In adults, high pepsinogen levels of up to 95 times higher than that in serum were reported by Sone et al [14 ]. Abd El-Fattah et al [15 ] reported LPR in 71% of children with OME. They detected high levels of pepsinogen in middle ear effusions up to 231 times higher than serum levels, with a significant positive correlation between pepsinogen levels in the effusion and the number of LPR events.…”

Diagnosing GORD in Respiratory Medicine

“…In patients with GORD, elevated levels of pepsin have recently been described in the respiratory epithelial lining fluid using EBC (Krishnan et al, 2007), using bronchoalveolar lavage (BAL; Farrell et al, 2006), and via the sampling of middle ear effusions of children with pharyngeal reflux (Abd El-Fattah et al, 2007; see Table 1). The advantage of analyzing pepsin is that it is not normally found in the lung and therefore should be specific for reflux.…”

Gastric pepsin in middle ear fluid of children with otitis media: Clinical implications

“…However, the middle ear pepsin concentrations far exceeded serum pepsin concentrations, indicating that the pepsin had not been concentrated in the middle ear cleft from serum [30]. Several other studies have duplicated this fi nding using a comparison of pepsin, albumin, and fi brinogen levels of ear samples with serum [33,39]. Lieu et al [34] found the gene encoding for pepsinogen I/A in two samples of gastric mucosa via reverse transcriptase polymerase chain reaction but not in separate discarded specimens from mastoid mucosa [34].…”

“…El-Fattah et al [39] reported on 31 children with otitis media who had undergone 24-hour dual-probe pH testing, and pepsin was tested using direct ELISA in 17 children (mean age, 6.2 years) who underwent myringotomy with tube placement. Twenty-two children showed a positive pH probe study, indicating high prevalence of laryngopharyngeal refl ux in otitis media.…”