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Reproducibility of Salivary Pepsin: Clinic versus Home. Otolaryngol Head Neck Surg 2012 Aug;147(2 suppl):P195



Pubmed ID



Objective: Pepsin immunoassay of saliva samples is a potential objective test for reflux and extra-esophageal reflux (EER). This study aims to assess the reproducibility of pepsin samples in a clinical cohort study. Method: Saliva samples were obtained following a standardized protocol on 3 occasions. Subjects expectorated pharyngeal secretions in an upright position in clinic, and on 2 mornings following recumbence and sleep. All samples were frozen for storage and Western blot immunoassay for pepsin was performed. Results: From 70 subjects, 59 first samples completed showed the prevalence of pepsin (+) was 26%. Of 34 subjects who returned the home collected sample, only 6% of the 2nd samples were positive and none of the 3rd samples were positive. 46.3% of the subjects had elevated Reflux Symptom Index (RSI) but the correlation with pepsin (+) was not significant. Conclusion: Our study was unable to produce consistent results of pepsin assays in a nonlaryngology clinical setting. Salivary pepsin assay is a conceptually promising non-invasive test for EER; however the timing and logistics of sample collection in order to be a feasible clinical test may need further studies and adjustments.

Author List

Laohasiriwong S, Johnston N, Woodson BT


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

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