Peptest has been cited in a new book that focusses on the diagnosis and management of specific benign diseases of the foregut, including reflux disease.

The foregut comprises the mouth, oesophagus and the cardiac and pyloric regions of the stomach.

The SAGES Manual of Foregut SurgeryWritten by experts and released in May 2019, The SAGES Manual of Foregut Surgery book offers a comprehensive, state-of- the art review for clinicians and surgeons.

Chapter Nine of the new book – edited by Krzysztof Nowak, Saurabh Sharma, and Subhash Kini – focusses on Laryngopharyngeal Reflux (LPR).

Laryngopharyngeal reflux (LPR) is the influx of stomach contents into the upper airway, leading to symptoms such as hoarseness, non-productive throat clearing, sensation of having excess mucous in the throat, difficulties swallowing, dry cough, and difficulties breathing.

It describes how Pepsin, a proteolytic enzyme secreted in the stomach, is considered to be one of the primary causes of mucosal damage in LPR.

The authors write: “Detection of pepsin in the oropharynx is thus indicative of reflux. A recent systematic review reported that pepsin is a reliable marker for diagnosing LPR. Pepsin can be found in trace amounts in the upper aerodigestive tract in healthy asymptomatic individuals but at much lower levels when compared with LPR patients.”

“A few years ago, a new diagnostic tool, Peptest, emerged which has been available in the UK and Europe and has just been approved by the FDA in the USA in 2017. Peptest is an in vitro lateral flow device that uses monoclonal antibodies to detect pepsin in samples of coughed up saliva/respiratory secretions.”

“Peptest has been shown to be highly accurate and has validated performance measures in detection of GERD. Its sensitivity and specificity are reported to reach 87 per cent. It has a positive predictive value of 85 per cent and negative predictive value of 68 per cent in a blinded study where GERD was confirmed using pH measurement and EGD.”

You can download and read Chapter Nine of the book here.