Simulated reflux decreases vocal fold epithelial barrier resistance.
Simulated reflux decreases vocal fold epithelial barrier resistance.
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DOI：
10.1002/lary.20983
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发表时间：
2010-08
期刊：
影响因子：
2.6
通讯作者：
Sivasankar, Mahalakshmi
中科院分区：
文献类型：
--
作者：
Erickson, Elizabeth;Sivasankar, Mahalakshmi
声带上皮为吸入性和全身性挑战的进入提供了屏障。然而，上皮的位置使其容易受到损伤。过去的研究表明，但没有直接证明，暴露于胃反流不利地影响上皮屏障的功能。了解反流引起的上皮屏障功能障碍的性质是必要的，以更好地认识声带对这种疾病的易感性的机制。因此，我们研究了生理相关的反流挑战对声带跨上皮阻力和总上皮和上皮下外观的影响。离体、混合设计，组间和重复测量分析。将健康的天然猪声带（N = 52）暴露于生理学相关的酸性胃蛋白酶、仅酸或仅胃蛋白酶激发，并采用电生理学和光学显微镜进行检查。对于所有挑战，暴露于中性pH的声带作为对照。酸性胃蛋白酶和仅酸激发，但非仅胃蛋白酶或对照激发在30分钟内显著降低跨上皮阻力。跨上皮阻力的降低是不可逆的。通过光学显微镜检查证明，激发暴露在声带上皮或上皮下外观中产生最小的大体变化。这些发现表明，胃反流的酸性环境特征损害上皮屏障功能，而没有总体结构变化。在健康的天然声带中，跨上皮阻力的降低可能反映了反流相关的上皮破坏。这些结果可能指导反流患者的药理学和治疗建议的发展，如持续的抑酸治疗和患者抗反流行为教育。
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. Ex vivo, mixed design with between-group and repeated-measures analyses. 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. 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. 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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