Pepsin: biomarker, mediator, and therapeutic target for reflux and aspiration

Nikki Johnston, Peter W. Dettmar, Frank G. Ondrey, Rahul Nanchal, Sang Hyuk Lee, Jonathan M. Bock

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Extra-esophageal reflux is suspected to cause a wide range of clinical symptoms in the upper airways. Diagnosis and treatment has focused on acid, but realization of the role of nonacid reflux has resulted in research investigating the use of pepsin as a biomarker for gastric reflux and aspiration. Pepsin analysis can complement the use of questionnaires and office-based diagnosis and lessen the dependency on invasive and expensive diagnostic tests. Furthermore, pepsin as a first-line diagnostic biomarker has been shown to improve the accuracy of reflux diagnosis. In addition to its use as a diagnostic biomarker, pepsin has been shown to cause inflammation independent of the pH of the refluxate and thus despite acid suppression therapy. Research is ongoing to develop new therapies for airway reflux that specifically target pepsin.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
JournalAnnals of the New York Academy of Sciences
Issue number1
StatePublished - Dec 2018

Bibliographical note

Publisher Copyright:
© 2018 New York Academy of Sciences.


  • airway
  • carcinogenesis
  • inflammation
  • pepsin
  • reflux
  • therapeutics


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