Expression Of Proton Pump H~+/K~+-ATPase ?,? Subunits In Laryngeal Tissues

Objective:At present,the etiological study of LPRD is mostly limited to the etiological study outside of pharynx and larynx.For example,it is believed that detection of pepsin in saliva can diagnose LPRD,but not all saliva pepsin test is positive.Some of the LPRD may be caused by the throat itself.Proton pump H+/K+-ATP enzymes have been found in submucosal glands of extragastric tissues,including submucosal glands of normal larynx,and then reported to express proton-pumped H+/K+-ATP enzymes in normal laryngeal tissues.These findings may explain the following phenomena:treatment of chronic laryngitis associated with LPRD without clinical symptoms of GERD is effective by proton pump inhibitor(PPI);this finding therefore questions the current understanding of GERD and LPRD.Therefore,it is necessary to expand the sample size to detect the expression of proton pump in laryngeal tissue.The goal of our study was to analysis of proton pump expression of mucous membrane in different parts of larynx which provides the basis for further study on the correlation between laryngopharyngeal reflux disease and laryngeal diseases.Methods:57 normal specimens of laryngeal mucosa were obtained from laryngectomy or total laryngectomy and/or hypopharyngeal carcinoma 3 cm away from the lesion.The epiglottic cartilage was obtained from a total laryngectomy specimen with no epiglottic involvement in glottic carcinoma,and the final pathological diagnosis was normal mucosa or epiglottic cartilage.The specimen was immediately fixed in 10%neutral formalin and embedded in paraffin.There were 186 specimens of laryngeal mucosa and 9 specimens of epiglottic cartilage.Expression of H+K+-ATPase a subunit detected by immunohistochemistry in 173 specimens of laryngeal mucosa and 8 specimens of epiglottic cartilage.Expression of H+/K+-ATPase ? subunit detected by immunohistochemistry in 195 specimens(14 specimens were too small to detect 2 subunits).Results:H+/K+-ATPase a and? subunits were expressed in hyaline nuclear membrane and cytolymph of laryngeal epithelial cells and cartilage.In 45 out of 181(24.9%)laryngeal tissue we have noticed a positive expression of the a subunit.43 of 195(22.1%)laryngeal tissues were positive for ? subunit.The positive expression of H+/K+-ATPase a and ? subunit is located seromucinous glands of submucosa.H+/K+-ATPase a and ? were mainly located in the supraglottic region,24.2%and 20.6%,respectively.Expression of a subunit in glottic region in 1 case,but no expression of ? subunit in glottic region.The positive expression of H+/K+-ATPase in the superior glottic area was higher than that in the glottic area,but there was no significant difference(Fisher accurate test,both of them p>0.05).The expression of H+/K+-ATPase a subunit was moderately positive in 5 out of 8 specimens(62.5%),negative expression in 3 specimens.The expression of ?subunit was moderately positive in 7 of 9 epiglottic cartilage specimen(77.8%)and negative in 2 specimen.Conclusion:H+/K+-ATPase a and ? subunits are mainly expressed in the supraglottic laryngeal mucosa and laryngopharyngeal reflux possible effects on the supraglottic mucosa,which causing various laryngeal diseases.