Clara Mota Randal Pompeu, Thiago Meneses Araújo Leite Sales, Lucas Antonio Duarte Nicolau, Anna Caroline Rodrigues de Souza Matos, Aline Almeida Figueiredo Borsaro, Tanila Aguiar Andrade Coutinho, Larissa Freire Alves Nogueira, Fábio Rocha Fernandes Távora, Miguel Ângelo Nobre E Souza, Daniel Siffrim, Marcellus Henrique Loiola Ponte de Souza
{"title":"喉咽反流患者喉部和下咽粘膜完整性及对质子泵抑制剂的反应","authors":"Clara Mota Randal Pompeu, Thiago Meneses Araújo Leite Sales, Lucas Antonio Duarte Nicolau, Anna Caroline Rodrigues de Souza Matos, Aline Almeida Figueiredo Borsaro, Tanila Aguiar Andrade Coutinho, Larissa Freire Alves Nogueira, Fábio Rocha Fernandes Távora, Miguel Ângelo Nobre E Souza, Daniel Siffrim, Marcellus Henrique Loiola Ponte de Souza","doi":"10.1007/s00405-025-09214-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether impairment of integrity of laryngeal and hypopharyngeal mucosa in laryngopharyngeal reflux (LPR) could be related to response to proton pump inhibitors (PPIs).</p><p><strong>Methods: </strong>Chronic hoarseness with Reflux Finding Score (RFS) > = 7 was evaluated using the Reflux Disease Questionnaire (RDQ) and Reflux Symptoms Index (RSI). Upper endoscopy was performed and samples of the laryngeal posterior commissure were collected to evaluate ex vivo laryngeal mucosal integrity by transepithelial resistance (TER) using Ussing chamber. In vivo, hypopharyngeal integrity was measured using intraluminal impedance. Clinical responders scored < 13 and had a drop of at least 50% in the initial RSI after 8 weeks of pantoprazole.</p><p><strong>Results: </strong>Eighteen patients completed the protocol, Esophagitis was detected in 28% of the patients, and one patient presented acid exposure above 6%. After treatment, 66.67% responded to PPI. Laryngeal basal TER and TER drops after the weakly acidid challenge showed no difference between PPI responders and non-responders. Hypopharyngeal basal impedance was similar between the groups. After acid exposure test, there was a lower impedance in non-responders.</p><p><strong>Conclusion: </strong>In laryngopharyngeal reflux, hypopharyngeal mucosal integrity was lower in PPI non-responders. These preliminary results suggest that the weaker laryngopharyngeal mucosa in refractory LPR may require new therapies aimed at improving barrier function.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2159-2164"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mucosal integrity of the larynx and hypopharynx and the response to proton pump inhibitors in patients with laryngopharyngeal reflux.\",\"authors\":\"Clara Mota Randal Pompeu, Thiago Meneses Araújo Leite Sales, Lucas Antonio Duarte Nicolau, Anna Caroline Rodrigues de Souza Matos, Aline Almeida Figueiredo Borsaro, Tanila Aguiar Andrade Coutinho, Larissa Freire Alves Nogueira, Fábio Rocha Fernandes Távora, Miguel Ângelo Nobre E Souza, Daniel Siffrim, Marcellus Henrique Loiola Ponte de Souza\",\"doi\":\"10.1007/s00405-025-09214-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate whether impairment of integrity of laryngeal and hypopharyngeal mucosa in laryngopharyngeal reflux (LPR) could be related to response to proton pump inhibitors (PPIs).</p><p><strong>Methods: </strong>Chronic hoarseness with Reflux Finding Score (RFS) > = 7 was evaluated using the Reflux Disease Questionnaire (RDQ) and Reflux Symptoms Index (RSI). Upper endoscopy was performed and samples of the laryngeal posterior commissure were collected to evaluate ex vivo laryngeal mucosal integrity by transepithelial resistance (TER) using Ussing chamber. In vivo, hypopharyngeal integrity was measured using intraluminal impedance. Clinical responders scored < 13 and had a drop of at least 50% in the initial RSI after 8 weeks of pantoprazole.</p><p><strong>Results: </strong>Eighteen patients completed the protocol, Esophagitis was detected in 28% of the patients, and one patient presented acid exposure above 6%. After treatment, 66.67% responded to PPI. Laryngeal basal TER and TER drops after the weakly acidid challenge showed no difference between PPI responders and non-responders. Hypopharyngeal basal impedance was similar between the groups. After acid exposure test, there was a lower impedance in non-responders.</p><p><strong>Conclusion: </strong>In laryngopharyngeal reflux, hypopharyngeal mucosal integrity was lower in PPI non-responders. 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Mucosal integrity of the larynx and hypopharynx and the response to proton pump inhibitors in patients with laryngopharyngeal reflux.
Purpose: To evaluate whether impairment of integrity of laryngeal and hypopharyngeal mucosa in laryngopharyngeal reflux (LPR) could be related to response to proton pump inhibitors (PPIs).
Methods: Chronic hoarseness with Reflux Finding Score (RFS) > = 7 was evaluated using the Reflux Disease Questionnaire (RDQ) and Reflux Symptoms Index (RSI). Upper endoscopy was performed and samples of the laryngeal posterior commissure were collected to evaluate ex vivo laryngeal mucosal integrity by transepithelial resistance (TER) using Ussing chamber. In vivo, hypopharyngeal integrity was measured using intraluminal impedance. Clinical responders scored < 13 and had a drop of at least 50% in the initial RSI after 8 weeks of pantoprazole.
Results: Eighteen patients completed the protocol, Esophagitis was detected in 28% of the patients, and one patient presented acid exposure above 6%. After treatment, 66.67% responded to PPI. Laryngeal basal TER and TER drops after the weakly acidid challenge showed no difference between PPI responders and non-responders. Hypopharyngeal basal impedance was similar between the groups. After acid exposure test, there was a lower impedance in non-responders.
Conclusion: In laryngopharyngeal reflux, hypopharyngeal mucosal integrity was lower in PPI non-responders. These preliminary results suggest that the weaker laryngopharyngeal mucosa in refractory LPR may require new therapies aimed at improving barrier function.
期刊介绍：
Official Journal of
European Union of Medical Specialists – ORL Section and Board
Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery
"European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level.
European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.
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