Becker V, Drabner R, Schmid RM, et al. Gastroenterology. 2013;144(5):S-865).
OBJECTIVES: The aim of this study was to correlate H+K+-ATPase expression in human laryngeal epithelium with pharyngeal pH monitoring and combined pH/ impedance measurement (pH/MII) in patients with suspected laryngopharyngeal reflux.
RESULTS: In total 15 patients suspected for LPR were analyzed. 12 of 15 patients had pathological results in DxpH; 5 of 15 patients had pathological results in pH/MII. Four patients had pathological results in both functional tests. In one patient, laryngeal H+K+-ATPase was verified by immunohistochemical staining. Both, DxpH and pH/MII showed pathological results. In another patient, real-time RT-PCR for each of the both H+K+-ATPase subunits were positive. Pathological results were assessed by DxpH, regular results in pH/MII measurements.
CONCLUSION: Our preliminary clinical data support these new pathophysiological mechanisms in patients with LPR for the first time. We detected relevant acid pH levels in patients with laryngeal H+K+-ATPase expression and excluded gastroesophageal reflux. We assume evidence of laryngeal H+K+-ATPase expression in a higher number of patients, which might be missed due to sampling error. Pharyngeal pH measurement has the potential to detect these patients.