Laryngopharyngeal Reflux And Epithelial Barrier Function In Vocal Fold Polyps

ObjectiveTo investigate asociation between laryngopharyngeal reflux(LPR)and vocal fold polyps(VFPs),and further measure the level of bile acids in saliva and the exprssions of CLDN1,CLDN4 in epithelium in VFPs.We planned to analyse the correlation between bile acids and the exprssions of CLDN1,CLDN4,so as to explore whether the bile acids affect the epithelial barrier function in VFPs.MethodsCase control survey was designed.Subjects who came to the otolaryngology department of the first affiliated hospital of chongqing medical university including 152 cases with VFPs and 176 cases with normal vocal fold were selected.All the subjects filled in a questionnaire and were assessed by the reflux symptom index(RSI)and the reflux finding score(RFS).RSI > 13 and(or)RFS > 7 were classified as LPR.Chi-square test,univariate and multivariate unconditional logistic regression models were used for statistical analysis.70 patients with VFPs and 30 patients with laryngeal squamous cellcarcinoma(LSCC)were included.Adjacent normal tissues obtained from patients with LSCC were as control.64 saliva samples were collected from the patients with VFPs upon waking.The epithelium structure was detected by hematoxylin and eosin staining.The expressions of CLDN1 and CLDN4 were measured by real-time quantitative polymerase chain reaction and immunohistochemistry.ResultsMultivariate unconditional logistic regression analysis showed that LPR was an independent risk factor for VFPs.Total bile acids were found in all saliva samples from the patients with VFPs.Discernible dilatation of intercellular spaces in epithelium was observed in VFPs.The expression of CLDN4 was decreased in polyp tissues compared with normal tissues.The expression of CLDN1 between polyp tissues and normal tissues was no significant difference.Salivary total bile acids levels were not correlated with the level of CLDN4 m RNA expression in polyps.ConclusionLPR was an independent risk factor for VFPs.Epithelial barrier in VFPs was impaired and associated with the discernible dilatation of intercellular spaces and decrease of CLDN4.Salivary total bile acids levels were not correlated with the expression of CLDN4 and whether bile acids would damage the epithelial barrier function in VFPs remained unclear.