Evidence map›Paper›PMID 29264754›Full record

ArticleSurgical endoscopy2018

Sep70/Pepsin expression in hypopharynx combined with hypopharyngeal multichannel intraluminal impedance increases diagnostic sensitivity of laryngopharyngeal reflux.

Toshitaka Hoppo, Ali H Zaidi, Daisuke Matsui, Samantha A Martin, Yoshihiro Komatsu, Emily J Lloyd, Juliann E Kosovec, Albert A Civitarese, Natalie H Boyd, Amit Shetty and 3 more

Abstract read
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Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
  2. Review
  3. Effects of acids, pepsin, bile acids, and trypsin on laryngopharyngeal reflux diseases: physiopathology and therapeutic targets.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022
    Review
  4. [Effect of proton pump inhibitort on salivary pepsin concentration in patients with laryngopharyngeal reflux].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2021
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Toshitaka HoppoEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Ali H ZaidiEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Daisuke MatsuiEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Samantha A MartinEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Yoshihiro KomatsuEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Emily J LloydEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Juliann E KosovecEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Albert A CivitareseEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Natalie H BoydEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Amit ShettyEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Ashten N OmsteadEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Emily SmithEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Blair A JobeEsophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA. blair.jobe@ahn.org.ORCID 0000-0002-5463-2252
Allegheny Health Network · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImproved methods of diagnosis of laryngopharyngeal reflux (LPR) would enable surgeons to better identify patients who may benefit from antireflux surgery (ARS). The objective of the present study was to assess if hypopharyngeal Pepsin and Sep70 expression combined with hypopharyngeal multichannel intraluminal impedance (HMII) has the potential to increase diagnostic sensitivity of LPR.

methodsThis study was performed on patients who underwent unsedated transnasal endoscopy with hypopharyngeal biopsy and 24-h HMII to determine abnormal proximal exposure (APE) and DeMeester score (DMS) from 2013 to 2016. Pepsin and Sep70 protein expression was assessed by Western blots of biopsy specimens. The outcomes of ARS were assessed using reflux symptom index (RSI). HMII APE classification, Sep 70, and Pepsin protein levels were compared in normative and symptomatic LPR patients and further analyzed alongside quality of life changes following ARS.

resultsOf 30 subjects enrolled, 23 were excluded for abnormal HMII results or endoscopic evidence of esophagitis. Seven subjects and 105 patients were included in the normative and symptomatic groups, respectively. Compared to the normative group, only Pepsin expression was significantly higher in the symptomatic group [APE+/LPR+ (p = 0.000), APE+/LPR- (p = 0.001), and APE- (p = 0.047)]. Further, the ratio of Sep70/Pepsin was significantly lower in the symptomatic group [APE+/LPR+ (p = 0.008), APE+/LPR- (p = 0.000), and APE- (p = 0.050)], and a cutoff ratio for a diagnosis of LPR was established as < 158. Of 105 symptomatic patients, 48 patients underwent ARS. Of these, 17 patients had complete pre- and post-RSI questionnaires. LPR symptoms improved in 15 (88%), of whom 2 were APE- but met criteria for a diagnosis of LPR based on the Sep70/Pepsin cutoff.

conclusionsThe identified Sep70/Pepsin ratio may serve as a reliable biomarker for the diagnosis of LPR. As a result, this may help identify additional patients who have a false-negative HMII result due to the 24-h testing window.

Indexed as

Electric ImpedanceAdultAgedAged, 80 and overBiomarkersCase-Control StudiesFemaleHSP70 Heat-Shock ProteinsHumansHypopharynxLaryngopharyngeal RefluxMaleMiddle AgedPepsin ARetrospective StudiesYoung AdultBiomarkersHSP70 Heat-Shock ProteinsPepsin ASEP70 protein, humanHypopharyngeal multichannel intraluminal impedanceLaryngopharyngeal refluxPepsinSep70

Identifiers

PMID29264754
OpenAlexW2777732682

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.