Expert review of clinical immunology · 2025
Pepsin, trypsin, and MUC5B are independent risk factors for hearing impairment in patients with laryngopharyngeal reflux-related chronic secretory otitis media.
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Cao Ying, Qiu Jibing, Huai De, Song Hongmao
Аннотация
OBJECTIVE: This study evaluated the potential diagnostic utility of pepsin, trypsin, and mucin 5B (MUC5B) in hearing impairment in patients with laryngopharyngeal reflux (LPR)-related chronic secretory OM (CSOM).
METHODS: Patients with LPR-related CSOM were enrolled and assigned into the normal hearing (NH), and mild (Mi-HI) and moderate-to-severe hearing impairment (Mo-HI) groups. Pepsin, trypsin, and MUC5B contents were determined by ELISA, with their correlations with Eustachian tube dysfunction questionnaire-7 (ETDQ-7) score and inflammatory factors (interleukin [IL]-2, IL6, IL-8), and diagnostic performance in hearing impairment assessed by Pearson, Spearman, and ROC curves. Factors influencing hearing impairment were identified using logistic regression models.
RESULTS: Pepsin, trypsin, and MUC5B contents were upregulated in patients' middle ear effusion as hearing impairment worsened. The three indicators correlated to EDTQ-7 and inflammatory factors, and exhibited high diagnostic value for hearing impairment in LPR-related CSOM patients. Remarkably, their combination created significantly higher diagnostic value than a single indicator. Abundantly-increased pepsin, trypsin, and MUC5B amplified hearing impairment incidence.
CONCLUSION: Pepsin, trypsin, and MUC5B are independent risk factors for hearing impairment in LPR-related CSOM patients. Their combination assists hearing impairment diagnosis in patients, providing a tool in clinical practice to stratify patients and offering a theoretical basis for exploring therapeutic targets.
METHODS: Patients with LPR-related CSOM were enrolled and assigned into the normal hearing (NH), and mild (Mi-HI) and moderate-to-severe hearing impairment (Mo-HI) groups. Pepsin, trypsin, and MUC5B contents were determined by ELISA, with their correlations with Eustachian tube dysfunction questionnaire-7 (ETDQ-7) score and inflammatory factors (interleukin [IL]-2, IL6, IL-8), and diagnostic performance in hearing impairment assessed by Pearson, Spearman, and ROC curves. Factors influencing hearing impairment were identified using logistic regression models.
RESULTS: Pepsin, trypsin, and MUC5B contents were upregulated in patients' middle ear effusion as hearing impairment worsened. The three indicators correlated to EDTQ-7 and inflammatory factors, and exhibited high diagnostic value for hearing impairment in LPR-related CSOM patients. Remarkably, their combination created significantly higher diagnostic value than a single indicator. Abundantly-increased pepsin, trypsin, and MUC5B amplified hearing impairment incidence.
CONCLUSION: Pepsin, trypsin, and MUC5B are independent risk factors for hearing impairment in LPR-related CSOM patients. Their combination assists hearing impairment diagnosis in patients, providing a tool in clinical practice to stratify patients and offering a theoretical basis for exploring therapeutic targets.