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The Role of Pepsin in LPR: Will It Change Our Diagnostic and Therapeutic Approach to the Disease?

  • Laryngopharyngeal Reflux (T. Carroll, Section Editor)
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Abstract

Laryngopharyngeal reflux (LPR) is the back flow of gastric contents into the laryngopharynx. It is estimated that this disease affects 20−40 % of the United States population and is commonly encountered by otolaryngologists. Patients with LPR present with symptoms due to chronic laryngeal irritation such as hoarseness and cough. Pepsin, a gastric enzyme, has been shown to be a specific and sensitive biomarker for LPR. Measurement of pepsin in patients with LPR symptoms holds promise as a reliable diagnostic test. Studies have shown that pepsin induces cell damage, inflammation, and neoplastic changes independently of gastric acid in an endocytosis-dependent manner. Thus, pepsin has been proposed as a novel therapeutic target, especially for patients experiencing refractory symptoms on currently available anti-reflux medications. Further research is needed to elucidate the exact role that pepsin plays in inflammatory and neoplastic diseases of the laryngopharynx and to develop pharmacologic agents targeting pepsin.

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Authors and Affiliations

  1. Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA

    Kendra E. Luebke, Tina L. Samuels & Nikki Johnston

  2. Department of Microbiology and Molecular Genetics, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA

    Tina L. Samuels & Nikki Johnston

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  1. Kendra E. Luebke
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  2. Tina L. Samuels
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Correspondence to Nikki Johnston.

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Luebke, K.E., Samuels, T.L. & Johnston, N. The Role of Pepsin in LPR: Will It Change Our Diagnostic and Therapeutic Approach to the Disease?. Curr Otorhinolaryngol Rep 4, 55–62 (2016). https://doi.org/10.1007/s40136-016-0106-4

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