Is laryngopharyngeal reflux associated with changes in laryngeal mucosal flora?

• Published in: Clinical otolaryngology 2008-06, Vol.33 (3), p.303-303
• Main Authors: Birchenall, K.A., Cogan, T.A., Birchall, M.A., Rees, L.E.N.
• Format: Article
• Language: English
• Subjects: Eubacteria
• ISSN: 1749-4478; 1749-4486
• DOI: 10.1111/j.1749-4486.2008.01747_16.x

Objectives.  To determine whether laryngeal reflux (LPR) affects the population size and distribution of laryngeal mucosal flora in humans; and whether LPR alters the integrity of the laryngeal mucosa. Further, to specifically assess whether Helicobacter pylori (H. pylori) is present in the laryngeal mucosa and if LPR is associated with this. Methods.  Laryngeal mucosal biopsies were taken from patients diagnosed LPR‐positive or LPR‐negative, none of whom had laryngeal disease. Presence of bacteria and epithelial integrity were determined by: fluorescent in situ hybridisation using oligonucleotide probes specific to all Eubacteria and H. pylori; real‐time PCR specific for H. Pylori and all bacteria; and immunofluorecence using an antibody to occludin. Results.  Helicobacter pylori was discovered in all the biopsies tested – both in those taken from patients who did not have LPR and those that did – with no significant difference in its distribution between the two groups. Helicobacter pylori was found in both the epithelium and lamina propria of the laryngeal mucosa. Further, an increase in the number of total Eubacteria present in the laryngeal mucosa was found to be significantly associated with LPR (LPR mean 58.2 se 19.0 bacteria/field of view, non‐LPR mean 17.3 se 4.7; P = 0.02). Conclusions.  The association between LPR and an increase in total Eubacteria in the laryngeal mucosa presents a possible aetiology for pathological symptoms associated with LPR. The fact that H. pylori was present in all of the laryngeal mucosal biopsies has significant implications for upper airway research.