Research Status Of Pepsin In Reflux Related Diseases

Background: GERD(Gastroesophageal reflux disease)is a common reflux-related disease,which causes a series of clinical symptoms and complications due to abnormal reflux.Pepsin is a kind of digestive protease that is mainly secreted and produced by gastric chief cells of the stomach.In recent years,more and more studies have shown that as one of the contents of the stomach,pepsin plays an important role in the development of GERD as well as gastric acid,and it may play a more important role in the injury of extraesophageal tissue.Some studies suggest that pepsin may have a special mechanism of reflux and injury different from gastric acid,and it could be used as a target to optimize the treatment.At the same time,the detection of pepsin outside the gastroesophageal provides direct evidence for the occurrence of reflux.Therefore,some scholars suggest that pepsin in saliva could be used as a marker for the diagnosis of GERD and reflux-related diseases.Objective: Combined with the characteristics of pepsin and the existing researches,exploring the research status of pepsin on different tissue injuries in reflux-related diseases and the relationship between pepsin and acid reflux.Furthermore,evaluating the diagnostic value of salivary pepsin test in refluxrelated diseases by related research.Conclusion: In reflux-related diseases,Pepsin can damage tissue through proteolysis.Besides,it can cause DIS of cells,resulting in esophageal damage.In the extraesophageal organization,pepsin could cause tissue damage through abnormal reflux,without the acidic environment caused by reflux.And it can reduce the defense and aggravate the injury of throat tissue.In pulmonary diseases,Pepsin may be involved in the development of gastroesophageal reflux cough.And it can aggravate the process of pulmonary fibrosis,and it is closely related to COPD,bronchiectasis,asthma,and idiopathic pulmonary fibrosis.At the same time,because pepsin could cause tissue damage,without the acidic environment caused by reflux,some studies think that it can be used as a target,using alginate to optimize the existing treatment of reflux-related diseases.Furthermore,the detection of salivary pepsin with great value in diagnosing reflux-related diseases,but it needs to be further studies in sampling timing,frequency,and detection method.