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Biomarkers and laryngopharyngeal reflux

Published online by Cambridge University Press:  14 September 2011

J M Wood*
Affiliation:
ENT Unit, Department of Surgery, Flinders University and Flinders Medical Centre, Bedford Park, South Australia, Australia
D J Hussey
Affiliation:
ENT Unit, Department of Surgery, Flinders University and Flinders Medical Centre, Bedford Park, South Australia, Australia
C M Woods
Affiliation:
ENT Unit, Department of Surgery, Flinders University and Flinders Medical Centre, Bedford Park, South Australia, Australia
D I Watson
Affiliation:
ENT Unit, Department of Surgery, Flinders University and Flinders Medical Centre, Bedford Park, South Australia, Australia
A S Carney
Affiliation:
ENT Unit, Department of Surgery, Flinders University and Flinders Medical Centre, Bedford Park, South Australia, Australia
*
Address for correspondence: Prof A.S. Carney, Flinders ENT, Department of Surgery, Room 3D204, Flinders Medical Centre, Bedford Park, South Australia 5042, Australia Fax: +61 8 8204 3987 E-mail: scarney@ent-surgery.com

Abstract

Laryngopharyngeal reflux is a controversial but increasingly made diagnosis used in patients with a collection of often non-specific laryngeal symptoms. It is a clinical diagnosis, and its pathophysiology is currently poorly understood.

Previous reflux research has focused on injurious agents, acid, pepsin and biomarker expression. Failure of intrinsic defences in the larynx may cause changes in laryngeal epithelia, particularly alterations in carbonic anhydrases and E-cadherin. Carbonic anhydrase III levels vary in the larynx in response to laryngopharyngeal reflux, depending on location. Expression of E-cadherin, a known tumour suppressor, is reduced in the presence of reflux. Mucin expression also varies according to the severity of reflux.

Further research is required to define the clinical entity of laryngopharyngeal reflux, and to identify a definitive mechanism for mucosal injury. Understanding this mechanism should allow the development of a comprehensive model, which would enable future diagnostic and therapeutic interventions to be developed.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited 2011

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