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Pepsin as a causal agent of inflammation during nonacidic reflux. Otolaryngol Head Neck Surg 2009 Nov;141(5):559-63

Date

10/29/2009

Pubmed ID

19861190

DOI

10.1016/j.otohns.2009.08.022

Scopus ID

2-s2.0-70350501815 (requires institutional sign-in at Scopus site)   124 Citations

Abstract

OBJECTIVE: To investigate the contribution of pepsin to inflammation attributed to nonacidic gastric reflux via analysis of inflammatory cytokine and cytokine receptor gene expression in pepsin-treated human hypopharyngeal epithelial cells in vitro.

STUDY DESIGN: Translational research.

SETTING: This study was performed in an academic research laboratory.

SUBJECTS AND METHODS: Human hypopharyngeal epithelial cells were incubated with or without pepsin (0.1 mg/mL) at pH 7.4, 37 degrees C, overnight. Expression of 84 inflammatory cytokines and cytokine receptors was analyzed via RT(2) qPCR array.

RESULTS: Expression of a number of inflammatory cytokines and receptors was altered in human hypopharyngeal epithelial cells following overnight treatment with pepsin at neutral pH. Greater than 1.5-fold change in gene expression was detected for CCL20, CCL26, IL8, IL1F10, IL1A, IL5, BCL6, CCR6, and CXCL14 (P < 0.05).

CONCLUSION: Exposure of hypopharyngeal cells to pepsin in a nonacidic environment induces the expression of several pro-inflammatory cytokines and receptors, including those known to be involved in inflammation of esophageal epithelium in response to reflux and which contribute to the pathophysiology of reflux esophagitis. These data indicate that refluxed pepsin may contribute to laryngeal inflammation associated with nonacidic gastric reflux, including that experienced by patients despite maximal acid suppression therapy.

Author List

Samuels TL, Johnston N

Author

Nikki Johnston PhD Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cytokines
Epithelial Cells
Esophagitis, Peptic
Humans
Hypopharynx
In Vitro Techniques
Inflammation
Pepsin A
Receptors, Cytokine