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AIM:To determine the laryngeal H+K+-ATPase and pharyngeal p H in patients with laryngopharyngeal reflux(LPR)-symptoms as well as to assess the symptom scores during PPI therapy.METHODS:Endoscopy was performed to exclude neoplasia and to collect biopsies from the posterior cricoid area(immunohistochemistry and PCR analysis).Immunohistochemical staining was performed with monoclonal mouse antibodies against human H+K+-ATPase.Quantitative real-time RT-PCR for each of the H+K+-ATPase subunits was performed.The p H values were assessed in the aerosolized environment of the oropharynx(Dxp H Catheter) and compared to a subsequently applied combined p H/MII measurement.RESULTS:Twenty patients with LPR symptoms were included.In only one patient,the laryngeal H+K+-ATPase was verified by immunohistochemical staining.In another patient,real-time RT-PCR for each H+K+-ATPase subunit was positive.Fourteen out of twenty patients had pathological results in Dxp H,and 6/20 patients had pathological results in p H/MII.Four patients had pathological results in both functional tests.Nine out of twenty patients responded to PPIs.CONCLUSION:The laryngeal H+K+-ATPase can only be sporadically detected in patients with LPR symptoms and is unlikely to cause the LPR symptoms.Alternative hypotheses for the pathomechanism are needed.The role of pharyngeal p H-metry remains unclearand its use can only be recommended for patients in a research study setting.
AIM: To determine the laryngeal H + K + -ATPase and pharyngeal p H in patients with laryngopharyngeal reflux (LPR) -symptoms as well as to assess the symptom scores during PPI therapy. METHODS: Endoscopy was performed to exclude neoplasia and to collect biopsies from the posterior cricoid area (immunohistochemistry and PCR analysis). Immunohistochemical staining was performed with monoclonal mouse antibodies against human H + K + -ATPase. Quantitative real-time RT-PCR for each of the H + K + -ATPase subunits was performed. pH values were assessed in the aerosolized environment of the oropharynx (Dxp H Catheter) and compared to a subsequently applied combined p H / MII measurement. RESULTS: Twenty patients with LPR symptoms were included.In only one patient, the laryngeal H + K + -ATPase was verified by immunohistochemical staining. Another patient, real-time RT-PCR for each H + K + -ATPase subunit was positive. Fourteen out of twenty patients had pathological results in Dxp H, and 6/20 patients had pathological resu lts in p H / MII. Four patients with pathological results in both functional tests. Neine out of twenty patients responded to PPIs. CONCLUSION: The laryngeal H + K + -ATPase can only be sporadically detected in patients with LPR symptoms and is unlikely to cause the LPR symptoms. Alternative hypotheses for the pathomechanism are needed. The role of pharyngeal p H-metry remains unclearand its use can only be recommended for patients in a research study setting.