| Bile acids in laryngopharyngeal refluxate: Will they enhance or attenuate the action of pepsin? | |
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MedLine Citation:
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PMID: 23070961 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES/HYPOTHESIS: To assess if, as previously reported in the literature, bile acids inhibit pepsin activity, resulting in pepsin having a less important role in laryngopharyngeal damage in reflux disease. STUDY DESIGN: Prospective translational research study. METHODS: A total of 78 patient's fasting gastric juice samples were obtained from routine endoscopy. The total bile acid (TBA) content and pepsin activity were measured using a 3α-hydroxysteroid dehydrogenase-based kit for bile acids; and pepsin activity was measured using succinyl albumin/dimethylhaemoglobin as a substrate and the development of new N-terminals. The ability of bile acids to effect pepsin activity was assessed with three primary bile acids, two unconjugated and one taurine conjugated, using the above N-terminal assay. RESULTS: Gastric juice contained median TBA of 40 (range 10-10010) μM and pepsin activity of 408 (range 27-3892)ug/ml. We used this data to inform the relative levels of pepsin and bile acids that might occur in a reflux event, and we used concentrations of bile acids between 10-100μM. Pepsin activity was pH dependent, but 28% of the activity was retained at pH 5.5. None of the bile acids showed any significant effect on pepsin activity across the pH range 2.0-6.0. CONCLUSIONS: At the levels and pH that pepsin and bile acids might occur in an LPR event, bile acids do not attenuate pepsin activity. Pepsin could be considered a damaging factor even at high pH, and it will aggravate further any damaging effects of bile acids in the refluxate. Laryngoscope, 2012. |
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Authors:
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Mahmoud S Ali; Shruti Parikh; Peter Chater; Jeffrey P Pearson |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-15 |
Journal Detail:
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Title: The Laryngoscope Volume: - ISSN: 1531-4995 ISO Abbreviation: Laryngoscope Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc. |
Affiliation:
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Department of Otolaryngology, Mansoura University Hospital, Mansoura University, Egypt. msamomar@yahoo.co.uk. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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