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Published on: December 2, 2011
Simulated reflux decreases vocal fold epithelial barrier resistance
Elizabeth Erickson1, Mahalakshmi Sivasankar
1Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana, USA.
The Laryngoscope
|June 22, 2010
Summary
Gastric reflux, particularly acidic components, damages vocal fold barrier function by reducing transepithelial resistance. This disruption occurs without visible structural changes, highlighting a key mechanism in vocal fold susceptibility to reflux disease.
Area of Science:
- Otolaryngology
- Gastroenterology
- Cell Biology
Background:
- The vocal fold epithelium acts as a crucial barrier against inhaled and systemic threats.
- Its exposed location makes it susceptible to damage, with gastric reflux being a suspected, yet unproven, contributor to epithelial barrier dysfunction.
- Understanding how reflux impacts vocal fold barrier function is vital for addressing vocal fold susceptibility to disease.
Purpose of the Study:
- To investigate the effects of physiologically relevant gastric reflux challenges on vocal fold epithelial barrier function.
- To assess changes in transepithelial resistance and gross epithelial/subepithelial appearance following reflux exposure.
Main Methods:
- Utilized an ex vivo model with healthy porcine vocal folds (N=52).
- Exposed vocal folds to controlled challenges: acidic pepsin, acid-only, pepsin-only, and neutral pH (control).
- Assessed barrier function using electrophysiology (transepithelial resistance) and light microscopy.
Main Results:
- Acidic pepsin and acid-only challenges significantly reduced transepithelial resistance within 30 minutes.
- The observed reductions in transepithelial resistance were irreversible.
- Light microscopy revealed minimal gross structural changes in the vocal fold epithelium or subepithelium.
Conclusions:
- Acidic conditions, characteristic of gastric reflux, impair vocal fold epithelial barrier function.
- Reduced transepithelial resistance in healthy vocal folds may indicate reflux-related epithelial disruption.
- Findings support continued acid-suppression therapy and patient education for managing reflux-related vocal fold issues.
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