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. 2021 Oct;18(4):900-907.
doi: 10.1007/s10388-021-00845-x. Epub 2021 Apr 22.

Saliva secretion is reduced in proton pump inhibitor-responsive non-erosive reflux disease patients

Mai Koeda  1 , Tomohide Tanabe  1 , Yuichi Kitasako  2   3 , Eri Momma  1 , Yoshimasa Hoshikawa  1 , Shintaro Hoshino  1 , Noriyuki Kawami  1 , Mitsuru Kaise  1 , Katsuhiko Iwakiri  4
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Saliva secretion is reduced in proton pump inhibitor-responsive non-erosive reflux disease patients

Mai Koeda et al. Esophagus. 2021 Oct.

Abstract

Background: There is no consensus on the relationship between saliva secretion and non-erosive reflux disease (NERD). In this study, saliva secretion and salivary epidermal growth factor (EGF) in patients with NERD were examined.

Methods: Thirty-one PPI-responsive NERD patients and 31 control subjects were recruited for this case-control study. Saliva secretion testing was performed. Saliva secretion was assessed as follows: each patient chewed sugar-free gum for 3 min prior to endoscopy, and the amount and pH of saliva before and after acid loading as an index of the acid-buffering capacity were measured. The salivary EGF concentration was assessed by ELISA.

Results: The amount of saliva secreted was significantly lower in the NERD group than in the control group, with medians (25th-75th percentile) of 4.0 mL/3 min (2.0-6.0) and 6.0 (3.9-8.0), respectively (p = 0.0131). Salivary pH was significantly lower in the NERD group (7.0 [6.8-7.2]) than in the control group (7.2 [7.0-7.3], p = 0.0100). Salivary pH after acid loading was significantly lower in the NERD group (5.8 [5.4-6.2]) than in the control group (6.3 [6.1-6.5], p = 0.0002). The difference in pH of stimulated saliva after acid loading (1.2 [0.9-1.5], p = 0.0021) was significantly higher in the NERD group than in the control group (0.8 [0.7-1.1]). The salivary EGF concentration was significantly higher in the NERD group (2513.0 pg/mL [1497.5-5005.0] than in the PPI-responsive group (1641.0 [1139.8-2092.0], p = 0.0032).

Conclusion: Stimulated saliva secretion was reduced in PPI-responsive NERD patients.

Keywords: Non-erosive reflux disease; Saliva secretion; Salivary epidermal growth factor.

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