Laryngopharyngeal reflux is a commonly described condition. There is strong evidence linking gastro-oesophageal reflux with oesophageal carcinomas. Gastric refluxate consists of gastric acid, pepsin and bile acids. The roles of pepsin and acidic conditions in the development of laryngopharyngeal carcinoma have been previously investigated. This in-vitro translational research study, looked to elucidate the effects of bile acids on a human hypopharyngeal squamous cell carcinoma cell line. Bile acid consists of four main constituent acids, and the study compared the effect of all four on epithelial-mesenchymal transition (EMT – a key process in the development of cancer invasion and metastasis). Up-regulation of TGF-β1 and MMP-9 (both have important roles in EMT) was noted to be different for different bile acids, thus opening up the possibility of targeted therapies. An important early in-vitro study, which reinforces the importance of barrier agents, such as alginates, in the treatment of laryngopharyngeal reflux.

Bile acids: a potential role in the pathogenesis of pharyngeal malignancy.
Shellman Z, Aldhahrani A, Verdon B, et al.
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Serge Latis

Liverpool Hospital, Sydney, NSW, Australia.

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