Dilated intercellular space in chronic laryngitis and gastro‐oesophageal reflux disease: at baseline and post‐lansoprazole therapy

• Published in: Alimentary pharmacology & therapeutics Vol. 32; no. 7; pp. 916 - 924
• Main Authors: Vaezi, M. F., Slaughter, J. C., Smith, B. S., Washington, M. K., Jerome, W. G., Garrett, C. G., Hagaman, D., Goutte, M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2010; Blackwell
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adult; Anti-Infective Agents - therapeutic use; Basal cells; Biological and medical sciences; Biopsy; Chronic Disease; Digestive system; Dilatation, Pathologic; Epithelium; Esophagus; Extracellular Space - drug effects; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - pathology; Humans; Hyperplasia; Intercellular Junctions - drug effects; Lansoprazole; Laryngitis; Laryngitis - drug therapy; Laryngitis - pathology; Larynx; Longitudinal Studies; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Otorhinolaryngology. Stomatology; Pharmacology. Drug treatments; Prospective Studies; Statistics as Topic; Surveys and Questionnaires; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Gastroesophageal reflux; Intercellular space; Enzyme; Respiratory disease; Esophageal disease; H; Enzyme inhibitor; K; Proton pump inhibitor; Laryngitis; Chronic; Treatment; Benzimidazole derivatives; Antisecretory agent; exchanging ATPase; Hydrolases; ENT disease; Digestive diseases; Larynx disease; Lansoprazole
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2010.04420.x

Aliment Pharmacol Ther 2010; 32: 916–924 Summary Background  Dilation of intercellular spaces is reported to be an early morphological marker in gastro‐oesophageal reflux. It remains unknown if this marker is useful in diagnosing reflux‐related chronic laryngitis. Aim  To determine histopathology and electron microscopic changes in oesophageal and laryngeal epithelium in chronic laryngitis. Methods  In this prospective blinded study, we enrolled 53 participants: 15 controls, 20 patients with GERD and 18 patients with chronic laryngitis. The latter two groups were subsequently treated with lansoprazole 30 mg bid for 12‐weeks. Baseline and postacid suppressive therapy biopsies were obtained from distal oesophagus and laryngeal postcricoid areas. Biopsy specimens were evaluated for histopathology and dilated intercellular space changes. Results  There was no significant increase in oesophageal or laryngeal epithelium intercellular spaces among GERD or laryngitis patients compared with controls at baseline or postacid suppressive therapy. Only patients with GERD had significantly (P = 0.03) higher proportion of moderate‐to‐severe oesophageal spongiosis and basal cell hyperplasia, which normalized postacid suppressive therapy. Conclusions  There was no increase in the width of intercellular spaces in the oesophagus or larynx in GERD or chronic laryngitis at baseline or postacid suppressive therapy. Our findings question the uniform presence of dilated intercellular space in patients with GERD.