Abstract
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.
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