Laryngeal Mucosa: Its Susceptibility to Damage by Acid and Pepsin
Laryngeal Mucosa: Its Susceptibility to Damage by Acid and Pepsin
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DOI：
10.1002/lary.20665
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发表时间：
2010-04-01
期刊：
影响因子：
2.6
通讯作者：
Pearson, Jeffrey P.
中科院分区：
文献类型：
--
作者：
Bulmer, David M.;Ali, Mahmoud S.;Pearson, Jeffrey P.
目标/假设。猪喉粘膜暴露于胃蛋白酶和酸将根据解剖部位产生不同的损伤效应，反映了在人类喉中观察到的咽喉反流（LPR）效应。本研究的目的是定量酸单独和酸和胃蛋白酶对喉组织造成的损伤，并确定这种损伤的程度是否取决于组织部位。前瞻性转化研究方法。在一个小的Ussing室中的切除的猪喉损伤模型被用来测量胃蛋白酶和酸对五个位点的影响（心室、声带、后连合、声门上和声门下粘膜）将组织样品在内腔侧用pH 2和4HCl，pH 2加1mg/mL胃蛋白酶，和pH4 + 1mg/mL胃蛋白酶通过在光密度（OD）260 nm和OD 280 nm处浴溶液的吸光度的变化以及通过测量与在pH7.4缓冲液中浴的组织相比释放的DNA来评估损伤。根据组织学，除声门下粘膜外，所有组织均耐受pH 4.0。pH2.0加胃蛋白酶处理后，仅后连合未见明显损伤，其吸光度变化和DNA释放均呈相似模式。声门下粘膜最易受损伤，后连合最少。喉组织在pH 4.0时基本上对损伤有抵抗力，但当胃蛋白酶存在时会受到损伤。这表明在LPR中，pH 4.0或更高的回流液只有在含有胃蛋白酶时才会受到损伤。
Objectives/Hypothesis. Exposure of pig laryngeal mucosa to pepsin and acid will have a differential damaging effect depending on the anatomical site, mirroring the effects seen in the human larynx in laryngopharyngeal reflux (LPR). This study aims to quantitate damage caused to laryngeal tissue by acid alone, and acid and pepsin, and also to determine if the extent of this damage depends on the tissue site.Study Design. Prospective translational research studyMethods. An excised porcine laryngeal damage model in a small Ussing chamber was used to measure the effect of pepsin and acid on five sites (ventricles, vocal folds, posterior commissure, supraglottic, and subglottic mucosa) The tissue samples were incubated on the lumenal side for 1 hour with pH 2 and 4 HCl, pH 2 plus 1 mg/mL pepsin, and pH 4 plus 1 mg/mL pepsin Damage was assessed by changes in absorbance of the bathing solution at optical density (OD) 260 nm and OD 280 nm and by measurement of released DNA compared to tissues bathed in pH 7.4 buffer Damage was also assessed histologicallyResults. Based on histology, all the tissues were resistant to pH 4.0 except the subglottic mucosa. Only the posterior commissure was not damaged by pH 2.0 plus pepsin Similar patterns were observed with absorbance changes and DNA release.Conclusions. The subglottic mucosa was the most susceptible to damage and the posterior commissure the least. Laryngeal tissues are essentially resistant to damage at pH 4.0, but are damaged when pepsin is present This suggests that in LPR, pH 4.0 or above refluxate would only be damaging if it contains pepsin