{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:43:58Z","timestamp":1790649838193,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T00:00:00Z","timestamp":1537747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["Project No. NSC101\u20102314\u2010B\u2010075A\u2010004\u2010MY3"],"award-info":[{"award-number":["Project No. NSC101\u20102314\u2010B\u2010075A\u2010004\u2010MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate the prediction value of saliva pepsin detection for an 8\u2010week proton pump inhibitor (PPI) response in patients with a Reflux Symptoms Index (RSI) score \u226513, which indicates possible laryngopharyngeal reflux.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective individual single\u2010cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were recruited who had experienced chronic laryngopharyngeal symptoms (RSI score \u226513) for more than 3 months after excluding other etiologies. The patients received PPI (40 mg of esomeprazole once daily) treatment for 8 weeks. Prior to treatment, the patients submitted saliva\/sputum samples that were collected during the time symptoms were observed. The samples were taken for pepsin detection, and performed using the commercially available Peptest lateral flow device. The association of the Peptest results and PPI response were statistically analyzed with the \u03c7<jats:sup>2<\/jats:sup> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010four patients completed the study, and upon completion of PPI treatment, the mean RSI score was significantly reduced from 19.22 \u00b1 5.18 to 8.99 \u00b1 5.69. Forty\u2010four (59.5%) patients exhibited a good response as defined by an RSI score reduction \u226550%. The results of the Peptest were semiquantitatively graded as 0, 1, 2, 3 (negative, weak positive, moderate positive and strong positive, respectively) based upon the visual intensity of the test sample line as compared to the control line. Twenty\u2010four patients (32.4%) exhibited grade 3 strong positive results. The Peptest strong positive results (<jats:italic>P<\/jats:italic> &lt; .05) were significantly associated with a good PPI response, with the positive predictive value being 79.2%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Analysis of strong positive results for pepsin detection in saliva\/sputum samples may be a useful, noninvasive method for predicting better PPI response in patients with suspected reflux induced chronic laryngopharyngeal symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2 <jats:italic>Laryngoscope<\/jats:italic>, 129:709\u2013714, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27502","type":"journal-article","created":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T13:15:31Z","timestamp":1537794931000},"page":"709-714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Saliva Pepsin Detection and Proton Pump Inhibitor Response in Suspected Laryngopharyngeal Reflux"],"prefix":"10.1002","volume":"129","author":[{"given":"Ching\u2010Ping","family":"Wang","sequence":"first","affiliation":[{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Department of Speech Language Pathology and Audiology Chung Shan Medical University  Taichung Taiwan"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5934-724X","authenticated-orcid":false,"given":"Chen\u2010Chi","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Department of Speech Language Pathology and Audiology Chung Shan Medical University  Taichung Taiwan"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han\u2010Chung","family":"Lien","sequence":"additional","affiliation":[{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Division of Gastroenterology Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Jiun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang\u2010Heng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai\u2010Li","family":"Liang","sequence":"additional","affiliation":[{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"College of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010An","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taichung Veterans General Hospital  Taichung 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