{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:53:25Z","timestamp":1791939205996,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the presence and clinical value of salivary elastase, pepsin, trypsin, cholesterol, and bile salts in the development of laryngopharyngeal reflux disease\u2010related chronic cough (LPRD\u2010CC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective controlled study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>University hospital study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with LPRD at the 24\u2010hour hypopharyngeal\u2010esophageal multichannel intraluminal impedance\u2010pH monitoring were recruited from two European hospitals. Symptoms and findings were evaluated with the reflux symptom score (RSS), quality\u2010of\u2010life RSS (QoL\u2010RSS), and the reflux sign assessment (RSA) at baseline and following 3 months of treatment. Pepsin, trypsin, elastase, cholesterol, and bile acids were measured in the saliva of patients. Clinical presentation and enzyme patterns were compared between patients with LPRD\u2010CC versus patients without chronic cough. Predictive values of digestive enzymes on clinical patterns were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 104 recruited patients, 54 had LPRD\u2010CC and 50 did not. Patients with chronic cough demonstrated significantly lower pharyngeal upright reflux events but higher RSS compared to those without chronic cough. The CC group demonstrated significant reduction of RSS (164.4\u2009\u00b1\u2009104.5 vs 105.1\u2009\u00b1\u2009103.2) and RSA (27.7\u2009\u00b1\u20096.6 vs 21.6\u2009\u00b1\u20098.1) following treatment. RSS (78.4\u2009\u00b1\u200951.3 vs 50.2\u2009\u00b1\u200949.7) and RSA (24.8\u2009\u00b1\u20097.9 vs 21.5\u2009\u00b1\u200910.3) were similarly reduced in the non\u2010CC group. The chronic cough group maintained significantly higher scores in otolaryngological RSS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.033), respiratory RSS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.036), overall RSS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.035), and RSS quality of life (RSS\u2010QoL) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.007). Salivary elastase demonstrated moderate correlation with both chronic cough presence (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.325) and RSS (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.353), while salivary bile salts correlated strongly with RSS\u2010QoL (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.564). In patients with chronic cough, esophageal acid exposure time showed a significant negative correlation with salivary pH (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u2009\u22120.443).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LPRD patients with chronic cough demonstrated higher symptom severity than those without, with salivary elastase and bile salts as potential predictors of clinical findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.1283","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T08:11:41Z","timestamp":1746173501000},"page":"453-460","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Predictive Value of Digestive Enzymes in Patients With Reflux\u2010Induced Chronic Cough"],"prefix":"10.1002","volume":"173","author":[{"given":"Jerome R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Department of Surgery, UMONS Research Institute for Health Sciences and Technology, Faculty of Medicine University of Mons (UMons) Mons Belgium"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, School of Medicine, Foch Hospital University Paris Saclay Paris France"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery CHU Saint\u2010Pierre Brussels Belgium"},{"name":"Department of Otolaryngology Elsan Hospital Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"De Vos","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Libre de Bruxelles (ULB) Brussels Belgium"},{"name":"Department of Clinical Chemistry Laboratoire Hospitalier Universitaire Bruxelles \u2013 Universitair Laboratorium Brussel (LHUB\u2010ULB) Brussels Belgium"},{"name":"Department of Laboratory Medicine Centre Hospitalier Universitaire (CHU) Saint\u2010Pierre Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Saussez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery CHU Saint\u2010Pierre Brussels Belgium"},{"name":"Department of Anatomy and Experimental Oncology, UMONS Research, Institute for Health Sciences and Technology University of Mons (UMons) Mons Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31134"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816664330"},{"key":"e_1_2_9_4_1","article-title":"Clinical relevance and therapeutic findings of chronic cough related to laryngopharyngeal reflux disease","volume":"29","author":"Lechien JR","year":"2025","journal-title":"J Voice"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.69"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-024-08881-w"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1348985"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-024-09181-z"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2022.12.008"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314722"},{"key":"e_1_2_9_11_1","unstructured":"LechienJR.Last advancement in laryngopharyngeal reflux disease. 2025; HNOL."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28017"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419888947"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30322"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.09.162"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13707"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-2980.2011.00519.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2005.05.011"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/17534666241305952"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813482103"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.2270"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819827488"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940010901103"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20985"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940511400302"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200206000-00016"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.1283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:47:14Z","timestamp":1760971634000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.1283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,2]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/ohn.1283"],"URL":"https:\/\/doi.org\/10.1002\/ohn.1283","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,2]]},"assertion":[{"value":"2025-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}