Laryngeal and Esophageal EGF-r Expression in Patients With Reflux Laryngitis
Condition: Gastroesophageal Reflux Disease; Chronic Laryngitis
MeSH terms: Laryngitis; Gastroesophageal Reflux; Croup
Study type: Interventional

Summary: 
      -  Saliva plays an important role in the homeostasis of the digestive tract mucosa.

        -  Salivary organic components, such as the Epidermal Growth Factor(EGF) have been found in
           defficient concentrations in patients with gastroesophageal reflux disease (GERD) and
           reflux related laryngitis (LPR).

        -  The epidermal growth factor receptor (EGFR) signaling pathway is one of the most
           important pathways that regulate growth, survival, proliferation, and differentiation in
           mammalian cells

        -  Eperdermal growth factor receptor (EGFR) overexpression has been linked to
           hyperproliferative diseases.

        -  It is unknown if the inflammatory process in GERD is realated to difficiencies in EGFR
           expression.

        -  The objective of the current study was to try to establish a correlation between the
           expression of EGFR in the laryngeal and esophageal mucosa and the severity of laryngitis
           in adults with GERD and LPR
    

Detailed description: 
      Objectives: The expression of the Epidermal Growth Factor receptor (EGFR) has been studied in
      a number of neoplastic and chronic diseases, but there are no reports in literature regarding
      its expression in chronic laryngitis associated to Gastroesophageal Reflux isease (GERD),
      also known as Laryngopharyngeal Reflux (LPR). The current study compared the expression of
      EGFR in the esophageal and laryngeal mucosa of adults with GERD and LPR. Study Design:
      Prospective based on imunohistochemical analysis of parafine embedded biopsy specimens and
      clinical data. Methods: From August, 2004 to February 2007 a total of 24 adults with
      confirmed diagnosis of LPR and no other clinical conditions or habits known to cause chronic
      laryngitis were studied at a University Hospital. Biopsies of the distal esophagus and the
      retrocrycoid laryngeal mucosa were obtained during upper digestive endoscopy. Data were
      analyzed statistically comparing samples in each individual and between individuals using the
      severity of histological signs of inflammation on hematoxacillin and eosinophillin (HE)
      stains to immunohistochemical analysis of the expression of EGFR. Other independent variables
      were severity of symptoms and signs, gender and age. Fishers´s exact test and multivariance
      ANOVA tests were used with significance level established at 95%.
    

Intervention name(s): Biopsy of the retrocrycoid laryngeal mucosa; Biopsy of the distal esophageal mucosa
Intervention type(s): Procedure; Procedure
Intervention description(s): Biopsies of the retrocrycoid laryngeal mucosa were performeed under sedation using a forceps introduced by the working channel of the endoscope; Biopsies were performeed under sedation using a forceps introduced by the working channel of the endoscope during upper digestive endoscopy
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: Gastroesophageal Reflux Disease (GERD); Chronic Laryngitis; Epidermal Growth factor receptor