{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:11:52Z","timestamp":1788304312035,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"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":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the digestive enzymes and biomarkers in the saliva of patients with laryngopharyngeal reflux (LPR) and asymptomatic individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective controlled study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multicenter study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with LPR at the hypopharyngeal\u2010esophageal impedance\u2010pH monitoring (HEMII\u2010pH) and asymptomatic individuals were consecutively recruited from January 2020 to April 2023 from 2 University Hospitals. The saliva of patients (off PPIs) and asymptomatic individuals was collected to measure pH, elastase, bile salts, cholesterol, gastric, and pancreatic lipases. Anxiety, symptoms, and findings were studied through perceived stress scale (PSS), reflux symptom score (RSS), and reflux sign assessment (RSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010seven LPR patients and 57 asymptomatic individuals completed the evaluations. LPR patients reported higher PSS, RSS, and RSA than asymptomatic individuals. The mean saliva pH was more alkaline in LPR patients (7.23: 95% confidence interval [CI]: 7.08, 7.38) compared to controls (6.13; 95% CI: 5.95, 6.31; <jats:italic>P<\/jats:italic>\u2009=\u2009.001). The mean concentration of elastase was higher in patients (51.65\u2009\u00b5g\/mL; 95% CI: 44.47, 58.83\u2009\u00b5g\/mL) versus asymptomatic individuals (25.18\u2009\u00b5g\/mL; 95%\u00a0CI: 21.64, 28.72\u2009\u00b5g\/mL; <jats:italic>P<\/jats:italic>\u2009=\u2009.001). The saliva cholesterol reported higher concentration in healthy individuals (3.43\u2009mg\/dL; 95% CI: 3.21, 3.65\u2009mg\/dL) compared to patients (1.16\u2009mg\/dL; 95% CI: 1.05, 1.27\u2009mg\/dL; <jats:italic>P<\/jats:italic>\u2009=\u2009.001). The saliva pH, and elastase concentration were significantly associated with the baseline RSS, while saliva cholesterol was negatively associated with the severity of RSS and RSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cholesterol, bile salts, and elastase are biomarkers of LPR and should be considered to develop future non\u2010invasive saliva device for the detection of LPR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.674","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T07:39:10Z","timestamp":1707896350000},"page":"1364-1371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Digestive Biomarkers of Laryngopharyngeal Reflux: A Preliminary Prospective Controlled Study"],"prefix":"10.1002","volume":"170","author":[{"given":"Jerome R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Division of Laryngology and Broncho\u2010esophagology, Department of Otolaryngology\u2010Head Neck Surgery EpiCURA Hospital Baudour Belgium"},{"name":"Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology University of Mons (UMons) Mons Belgium"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Foch Hospital, School of Medicine Paris Saclay University, Phonetics and Phonology Laboratory (UMR 7018 CNRS, Universit\u00e9 Sorbonne Nouvelle\/Paris 3) Paris France"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery CHU Saint\u2010Pierre Brussels Belgium"},{"name":"Polyclinique Elsan de Poitiers Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa G.","family":"De Marrez","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery CHU Brugmann Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Hans","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Foch Hospital, School of Medicine Paris Saclay University, Phonetics and Phonology Laboratory (UMR 7018 CNRS, Universit\u00e9 Sorbonne Nouvelle\/Paris 3) Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinciane","family":"Muls","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology CHU Saint\u2010Pierre Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Spinato","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery CHU Brugmann Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Briganti","sequence":"additional","affiliation":[{"name":"Department of Psychiatry CHU Brugmann Brussels 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