| Simulated reflux decreases vocal fold epithelial barrier resistance. | |
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MedLine Citation:
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PMID: 20564752 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES/HYPOTHESIS: The vocal fold epithelium provides a barrier to the entry of inhaled and systemic challenges. However, the location of the epithelium makes it vulnerable to damage. Past research suggests, but does not directly demonstrate, that exposure to gastric reflux adversely affects the function of the epithelial barrier. Understanding the nature of reflux-induced epithelial barrier dysfunction is necessary to better recognize the mechanisms for vocal fold susceptibility to this disease. Therefore, we examined the effects of physiologically relevant reflux challenges on vocal fold transepithelial resistance and gross epithelial and subepithelial appearance. STUDY DESIGN: Ex vivo, mixed design with between-group and repeated-measures analyses. METHODS: Healthy, native porcine vocal folds (N = 52) were exposed to physiologically relevant acidic pepsin, acid-only, or pepsin-only challenges and examined with electrophysiology and light microscopy. For all challenges, vocal folds exposed to a neutral pH served as control. RESULTS: Acidic pepsin and acid-only challenges, but not pepsin-only or control challenges significantly reduced transepithelial resistance within 30 minutes. Reductions in transepithelial resistance were irreversible. Challenge exposure produced minimal gross changes in vocal fold epithelial or subepithelial appearance as evidenced by light microscopy. CONCLUSIONS: These findings demonstrate that acidic environments characteristic of gastric reflux compromise epithelial barrier function without gross structural changes. In healthy, native vocal folds, reductions in transepithelial resistance could reflect reflux-related epithelial disruption. These results might guide the development of pharmacologic and therapeutic recommendations for patients with reflux, such as continued acid-suppression therapy and patient antireflux behavioral education. |
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Authors:
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Elizabeth Erickson; Mahalakshmi Sivasankar |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: The Laryngoscope Volume: 120 ISSN: 1531-4995 ISO Abbreviation: Laryngoscope Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-28 Completed Date: 2010-08-16 Revised Date: 2010-09-02 |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 1569-75 Citation Subset: IM |
Affiliation:
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Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Disease Models, Animal Electric Impedance Gastroesophageal Reflux / physiopathology* Gastrointestinal Agents / pharmacology* Hydrochloric Acid / pharmacology* Laryngeal Mucosa / drug effects, physiopathology* Pepsin A / pharmacology* Regurgitation, Gastric / physiopathology Swine Vocal Cords / drug effects, physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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R03 DC008690-02/DC/NIDCD NIH HHS; R03 DC008690-03/DC/NIDCD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Gastrointestinal Agents; 7647-01-0/Hydrochloric Acid; EC 3.4.23.1/Pepsin A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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