Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub- Types of GERD

Document Type : Original Article

Authors

1 Internal Medicine Department, Faculty of Medicine, Ain Shams University

2 depatment of internal medicine faculty of medecine ain shams university

3 clinical pathology, faculty of medicine, ain shams university, cairo , egypt

10.21608/asmj.2025.374334.1433

Abstract

Background: A stomach-based protease called pepsin has been linked to the etiology of GERD and may function as a
prospective biomarker for disease evaluation.
Aim: Our study's objective is to evaluate salivary pepsin's diagnostic accuracy as an intrinsic marker for GERD diagnosis, and
its utility to assess disease severity.
Methods: 90 Egyptian patients were enrolled in this study (45 patients with GERD and 45 healthy volunteers). Pepsin level
was estimated in saliva samples using ELISA kit. The disease severity was assessed according to the Los Angeles classification
and compared to the pepsin levels.
Results: Increased salivary Pepsin was shown to be highly statistically significant (p-value < 0.001) in Cases group (108.5 ±
46.6 ng/ml) when compared with Control group (24.4 ± 9.9 ng/ml). The present study revealed significant correlation between
salivary pepsin and Los Angeles classification of GERD severity. We observed statistically significant (p-value < 0.001)
increased salivary Pepsin in grade C cases (191.9 ± 27.4 ng/ml) when compared with grade B cases (98.2 ± 22.9 ng/ml) and
grade A cases (84.5± 25.5 ng/ml). It was demonstrated that salivary pepsin may be utilized to distinguish between the patients
and control groups using a roc curve at a cutoff level of > 46.5, with 95.6% sensitivity, 97.8% specificity, 97.8% PPV and
95.7% NPV.
Conclusion: Salivary pepsin can be used as cost-effective test to assess the severity of GERD and follow up of GERD patients
after therapy.

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