A new therapeutic approach for the Dry Eye Syndrome in patients with laryngopharyngeal reflux: first data
Keywords:
laryngopharyngeal reflux, eye reflux, dry eye syndrome, magnesium alginate, hyaluronic acid, simethicone, Camelia sinensisAbstract
Laryngopharyngeal reflux (LPR) is a common disorder. Pepsin has been detected also at eye level, this was a starting point for newest theories about LPR impact on Dry Eye Syndrome. The current preliminary study compared two treatments in patients with Dry Eye Syndrome and LPR. Patients were treated with Gastroftal eye drops and Gastroftal tablets or hyaluronic acid eye drops for 3 months. The following parameters were evaluated: Ocular Surface Disease Index (OSDI), OSDI categories, Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Fluorescein Tear Breakup Time (B-TUT), and Schirmer test before and after treatment. On the whole, 21 patients were enrolled: 10 were treated with hyaluronic acid Atlantis (Group A) and 11 with Gastroftal eye drops and tablets (Group B). After treatment, in Group A only OSDI significantly diminished (p=0.029); in Group B there were significant reductions concerning OSDI (p=0.0277), OSDI categories (p=0.0211), RSI (p=0.0172), Schirmer test (p=0.0172), T-BUT (p=0.0265), and RFS (p=0.0205). The current preliminary demonstrated that the combined ocular and systemic therapy with hyaluronic acid, Magnesium alginate, Simethicone, and Camelia sinensis may be considered a promising treatment in patients with Dry Eye Syndrome due to LPR.
References
2. Gelardi M, Ciprandi G. Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR): new pragmatic insights in clinical practice. J BiolRegulHomeost Agents 2018;32(1 Suppl. 2):41-47
3. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-20
4. Vaezi MF, Hicks DM, Abelson TI, et al. Laryngeal signs and symptoms and gastroesophageal reflux disease (GERD): a critical assessment of cause and effect association. Clin Gastroenterol Hepatol 2003;1:333-4
5. Kahrilas PJ, Shaheen NJ, Vaezi MF. American Gastroenterological Association Institute Technical Review on the management of gastroesophageal reflux disease. Gastroenterol 2008;135:1392-413
6. Nehra AK, Alexander JA, Loftus CG, Nehra V. Proton Pump Inhibitors: Review of Emerging Concerns. Mayo Clin Proc 2018;93(2):240-246
7. Francis DO, Rymer JA, Slaughter JC, et al. High economic burden of caring for patients with suspected extraesophageal reflux. Am J Gastroenterol 2013;108:905-11
8. Bulmer DM, Ali MS, Brownlee IA, Dettmar PW. Laryngeal mucosa: its susceptibility to damage by acid and pepsin. Laryngoscope 2010;120:777-8
9. Adhami T, Goldblum JR, Richter JE, et al. Role of gastric and duodenal ingredients in laryngeal tissue injury: an experimental study in dogs. Am J Gastroenterol 2004;99:2098-2106
10. Loughlin CJ, Koufman JA, Averill DB, et al. Acid-induced laryngospasm in a canine model. Laryngoscope 1996;106:1506-9
11. Johnston N, Wells CW, Samuels TL, et al. Pepsin in non-acid refluxate can damage hypopharyngeal epithelial cells. Ann Otol Rhinol Laryngol 2009;118:677-85
12. Hamid S, Mostafa G. Extra-esophageal manifestations of gastroesophageal reflux disease: controversies between epidemiology and clinic. The Open Resp Med J 2012;6:121-6
13. Kung YM, Hsu WH, Wu MC, Wang JW. Recent advances in the pharmacological management of gastroesophageal reflux disease. Dig Dis Sci 2017;3:3298-316
14. Magliulo G, Plateroti R, Plateroti AM. Gastroesophageal reflux disease and the presence of pepsin in the tears. Med Hypothesis 2013;80:129-30
15. Iannella G, Di Nardo G, Plateroti R, Rossi P, Plateroti AM, Mariani P, Magliulo G. Investigation of pepsin in tears of children with laryngopharyngeal reflux disease. Int J Ped Otorhinolaryngol 2015;79:2312-5
16. Mazzacane D, Damiani V, Silvestri M, Ciprandi G, Marino P; G.O.A.L.-O.S.D. Study Group. Eye reflux: an ocular extraesophageal manifestation of gastric reflux. Int J Ophthalmol. 2018;11:1503-150
17. Gelardi M, Ciprandi G. Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR): new pragmatic insights in clinical practice. J BiolRegulHomeost Agents. 2018;32(Suppl. 2):41-47
18. Belafsky PC. Validity and reliability of the reflux symptom index (RSI). J Voice 2002; 16:274-7
19. Belafsky PC. Validity and reliability of the reflux finding score (RFS). Laryngoscope 2001; 111:1313-7
20. Walt JG, Rowe MM, Stern KL. Evaluating the functional impact of dry eye: the Ocular Surface Disease Index. Drug Int J 1997;31:1436
21. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol 2000;118:615-21
22. Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, Na KS, Schaumberg D, Uchino M, Vehof J, Viso E, Vitale S, Jones L. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15:334–365
23. Stevens S. Schirmer's test. Community Eye Health. 2011;24:45
24. Campagnolo AM, Priston J, Thoen RH, Medeiros T, Assuncao AR. Laryngopharyngeal reflux: diagnosis, treatment, and latest research. Arch Otorhinolaryngol 2014;18:184-91
25. Gelardi M, Taliente S, Fiorella ML, Quaranta N, Ciancio G, Russo C, et al. Ancillary therapy of intranasal T-LysYal for patients with allergic, non-allergic, and mixed rhinitis. J Biol Reg Homeost Ag 2016;30:99-106
26. Davies I, Burman-Roy S, Murphy MS: Guideline Development Group. Gastroesophageal reflux disease in children: NICE guidance. BMJ 2015; 350:g7703
27. Miraglia del Giudice M, Indolfi C, Ciprandi G, Decimo F, Campana G, Umano GR, Giannetti E, Maglione M. Magnesium Alginate in children with uncontrolledasthma.J Biol Reg 2019;33:593-9
28. Tong T, Liu YJ, Kang J, Zhang CM, Kang SG. Antioxidant Activity and Main Chemical Components of a Novel Fermented Tea. Molecules. 2019;24(16)
29. Ummarino D, Miele E, Martinelli M, Scarpato E, Crocetto F, Sciorio E, Staiano A. Effect of magnesium alginate plus simethicone on gastroesophageal reflux in infants. J Pediatr Gastroenterol Nutr. 2015;60:230-5
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