New aspects in the pathomechanism and diagnosis of the XXXX -clinical impact of laryngeal proton pumps and pharyngeal pH metry in extraesophageal gastroesophageal reflux disease.

@entity1 @entity8823 @entity3529 @entity5
AIM: To determine the laryngeal H+ @entity3529 -ATPase and pharyngeal pH in @entity1 with @entity8823 ( @entity8823 )-symptoms as well as to assess the symptom scores during PPI therapy. METHODS: Endoscopy was performed to exclude @entity5 and to collect biopsies from the posterior cricoid area (immunohistochemistry and PCR analysis). Immunohistochemical staining was performed with monoclonal mouse antibodies against @entity1 H+ @entity3529 -ATPase. Quantitative real-time RT-PCR for each of the H+ @entity3529 -ATPase subunits was performed. The pH values were assessed in the aerosolized environment of the oropharynx (DxpH Catheter) and compared to a subsequently applied combined pH/MII measurement. RESULTS: Twenty @entity1 with @entity8823 symptoms were included. In only one @entity1 , the laryngeal H+ @entity3529 -ATPase was verified by immunohistochemical staining. In another @entity1 , real-time RT-PCR for each H+ @entity3529 -ATPase subunit was positive. Fourteen out of twenty @entity1 had pathological results in DxpH, and 6/20 @entity1 had pathological results in pH/MII. Four @entity1 had pathological results in both functional tests. Nine out of twenty @entity1 responded to PPIs. CONCLUSION: The laryngeal H+ @entity3529 -ATPase can only be sporadically detected in @entity1 with @entity8823 symptoms and is unlikely to cause the @entity8823 symptoms. Alternative hypotheses for the pathomechanism are needed. The role of pharyngeal pH-metry remains unclear and its use can only be recommended for @entity1 in a research study setting.
