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European Journal of Hospital Pharmacy :... Mar 2023
The PEPSIN project: design and validation of a self-administered questionnaire for the assessment of equivalence between pens and prefilled syringes in patients on subcutaneous biological drugs.
Topics: Humans; Pepsin A; Syringes; Medication Errors
PubMed: 35273003
DOI: 10.1136/ejhpharm-2022-003273 -
BioMed Research International 2021Elderly patients receiving nasal feeding have weaker physiological function, and placement of a nasogastric tube weakens the natural barrier of the cardia-esophageal...
BACKGROUND
Elderly patients receiving nasal feeding have weaker physiological function, and placement of a nasogastric tube weakens the natural barrier of the cardia-esophageal sphincter; therefore, the risk of gastroesophageal reflux (GER) is higher. Many studies have shown that pepsin is extremely sensitive in predicting GERD, so this study intends to investigate the level of pepsin in saliva of elderly patients with nasal feeding and analyze its influencing factors.
METHODS
This was a cross-sectional study. Patients admitted to the Chinese PLA General Hospital from April 2018 to October 2018 who received nasal feeding were included. One ml of saliva was collected from each patient in while sitting during fasting in the morning and 1 hour after lunch for 3 consecutive days. Pepsin was quantified by enzyme-linked immunosorbent assay (ELISA). The patients were predivided into two groups (≥7.75g/ml or <7.75g/ml) based on the median pepsin. Baseline and clinical factors were compared.
RESULTS
The mean age of the patients was 91.09 ± 4.91 years. There were statistical differences in diabetes and feeding methods between the two groups. There was a positive correlation between the morning and postprandial pepsin levels ( = 0.442, < 0.001), and has no statistical difference ( = 0.175). Multivariate analysis showed that the risk factors for higher pepsin levels were diabetes (odds ratio (OR): 2.67; 95% CI: 1.225-5.819, = 0.013) and nasal feeding methods (OR: 2.475; 95% CI: 1.183-5.180, =0.016).
CONCLUSIONS
For patients undergoing nasal feeding who are older than 80 years, the fasting and 1-hour postprandial pepsin concentration were consistent. Diabetes and feeding methods are risk factors for high pepsin levels. For the elderly over 80 years old, age has no influence on pepsin concentration.
Topics: Administration, Intranasal; Aged; Aged, 80 and over; Eating; Electric Impedance; Esophageal pH Monitoring; Esophagus; Feeding Methods; Female; Gastroesophageal Reflux; Humans; Male; Pepsin A; Saliva
PubMed: 33564676
DOI: 10.1155/2021/4721812 -
American Journal of Physiology. Cell... Jan 2005Secretion of bicarbonate into the adherent layer of mucus gel creates a pH gradient with a near-neutral pH at the epithelial surfaces in stomach and duodenum, providing... (Review)
Review
Secretion of bicarbonate into the adherent layer of mucus gel creates a pH gradient with a near-neutral pH at the epithelial surfaces in stomach and duodenum, providing the first line of mucosal protection against luminal acid. The continuous adherent mucus layer is also a barrier to luminal pepsin, thereby protecting the underlying mucosa from proteolytic digestion. In this article we review the present state of the gastroduodenal mucus bicarbonate barrier two decades after the first supporting experimental evidence appeared. The primary function of the adherent mucus gel layer is a structural one to create a stable, unstirred layer to support surface neutralization of acid and act as a protective physical barrier against luminal pepsin. Therefore, the emphasis on mucus in this review is on the form and role of the adherent mucus gel layer. The primary function of the mucosal bicarbonate secretion is to neutralize acid diffusing into the mucus gel layer and to be quantitatively sufficient to maintain a near-neutral pH at the mucus-mucosal surface interface. The emphasis on mucosal bicarbonate in this review is on the mechanisms and control of its secretion and the establishment of a surface pH gradient. Evidence suggests that under normal physiological conditions, the mucus bicarbonate barrier is sufficient for protection of the gastric mucosa against acid and pepsin and is even more so for the duodenum.
Topics: Animals; Bicarbonates; Duodenum; Gastric Acid; Gastric Mucosa; Humans; Intestinal Mucosa; Pepsin A
PubMed: 15591243
DOI: 10.1152/ajpcell.00102.2004 -
Medical Science Monitor : International... Dec 2018BACKGROUND Gastroesophageal reflux disease (GERD) is very common. Salivary pepsin detection has previously been considered as a method for GERD diagnosis. We performed a... (Meta-Analysis)
Meta-Analysis
BACKGROUND Gastroesophageal reflux disease (GERD) is very common. Salivary pepsin detection has previously been considered as a method for GERD diagnosis. We performed a meta-analysis to investigate the utility of salivary pepsin assay as a diagnostic tool of GERD. MATERIAL AND METHODS PubMed, Web of Science, the Cochran Library, and EMBASE (from January 1980 to 23 October 2018) were searched for pepsin in saliva for GERD diagnosis. We summarized the retrieved specificity, sensitivity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves data in the meta-analysis. RESULTS In final analysis, a total of 5 studies were included. The summary sensitivity, specificity, NLR, and PLR were 0.60 (95% CI 0.41-0.76), 0.71 (95% CI 0.51-0.86), 0.56 (95% CI 0.34-0.93), and 2.1 (95% CI 1.1-4.1), respectively. The pooled DOR was 4 (95% CI 1.0-11.0) and area under the ROC was 0.70 (95% CI 0.66-0.74). CONCLUSIONS The meta-analysis showed that pepsin in saliva has moderate diagnostic value for GERD, and is not as helpful as previously thought.
Topics: Adult; Biomarkers; Gastroesophageal Reflux; Humans; Odds Ratio; Pepsin A; ROC Curve; Saliva; Sensitivity and Specificity
PubMed: 30596632
DOI: 10.12659/MSM.913978 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Feb 2023To analyze the consistency of pepsin assay kit, pepsin IHC, reflux symptom index(RSI) and reflux finding score(RFS) in the diagnosis of laryngopharyngeal reflux...
To analyze the consistency of pepsin assay kit, pepsin IHC, reflux symptom index(RSI) and reflux finding score(RFS) in the diagnosis of laryngopharyngeal reflux disease(LPRD). The clinical data of 61 inpatients with laryngeal diseases who were admitted to the Department of Otolaryngology, the First Affiliated Hospital of Kunming Medical University from May 2020 to December 2021 were retrospectively analyzed. The RSI and RFS scores, the Formwitz score of pepsin immunohistochemistry, and the results of pepsin detection kit were recorded. ICC group correlation coefficient and Kappa consistency analysis was used for three detection methods. Among 61 patients, 30 cases were positive and 31 cases were negative for the pepsin test kit, with a positive rate of 49.18%. The positive rate of pepsin immunohistochemistry was 45.90%(28/61), and the diagnostic agreement rate between the two was 70.49%. The consistency between them was high(=0.409). The positive rate of RSI and RFS in diagnosing LPRD was 62.30%(38/61), and the consistency rate was 73.77% with pepsin detection kit. The consistency between them was high(=0.486). Taking pepsin IHC as the reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of pepsin detection kit were 71.43%(20/28), 69.70%(23/33), 66.67%(20/30) and 74.19%(23/31), respectively. Using RSI and RFS scales as reference criteria, the sensitivity, specificity, positive predictive value and negative predictive value of pepsin detection kit were 89.29%(25/28), 60.61%(20/33), 65.79%(25/38) and 86.96%(20/23), respectively. Analysis of correlation coefficient within ICC group: ICC value was 0.628, 95% confidence interval(0.497-0.741), the three methods have good consistency. The RSI and RFS scale scores were in good agreement with the pepsin test kit, and the pepsin test kit was also in good agreement with pepsin immunohistochemistry. As a non-invasive diagnostic technique, the pepsin test kit can be widely used in the diagnosis of pharyngeal reflux in combination with pepsin immunohistochemistry and RSI and RFS scale.
Topics: Humans; Laryngopharyngeal Reflux; Pepsin A; Retrospective Studies; Immunohistochemistry; Pharynx
PubMed: 36756822
DOI: 10.13201/j.issn.2096-7993.2023.02.004 -
Alimentary Pharmacology & Therapeutics Apr 2011Gastro-oesophageal reflux disease (GERD) is one of the commonest diseases of Western populations, affecting 20 to 30% of adults. GERD is multifaceted and the classical... (Review)
Review
Review article: reflux and its consequences--the laryngeal, pulmonary and oesophageal manifestations. Conference held in conjunction with the 9th International Symposium on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21-23 April 2010.
BACKGROUND
Gastro-oesophageal reflux disease (GERD) is one of the commonest diseases of Western populations, affecting 20 to 30% of adults. GERD is multifaceted and the classical oesophageal symptoms such as heartburn and regurgitation often overlap with atypical symptoms that impact upon the respiratory system and airways. This is referred to as extra-oesophageal reflux disease (EERD), or laryngopharyngeal reflux (LPR), which manifests as chronic cough, laryngitis, hoarseness, voice disorders and asthma.
AIM
The 'Reflux and its consequences' conference was held in Hull in 2010 and brought together a multidisciplinary group of experts all with a common interest in the many manifestations of reflux disease to present recent research and clinical progress in GERD and EERD. In particular new techniques for diagnosing reflux were showcased at the conference.
METHODS
Both clinical and non-clinical key opinion leaders were invited to write a review on key areas presented at the `Reflux and its consequences' conference for inclusion in this supplement.
RESULTS AND CONCLUSION
Eleven chapters contained in this supplement reflected the sessions of the conference and included discussion of the nature of the refluxate (acid, pepsin, bile acids and non-acid reflux); mechanisms of tissue damage and protection in the oesophagus, laryngopharynx and airways. Clinical conditions with a reflux aetiology including asthma, chronic cough, airway disease, LPR, and paediatric EERD were reviewed. In addition methods for diagnosis of reflux disease and treatment strategies, especially with reference to non-acid reflux, were considered.
Topics: Adult; Asthma; Child; Cough; Gastroesophageal Reflux; Gastrointestinal Agents; Hoarseness; Humans; Laryngeal Diseases; Pepsin A
PubMed: 21366630
DOI: 10.1111/j.1365-2036.2011.04581.x -
Pneumologie (Stuttgart, Germany) May 2013Rennet is a mixture of the proteolytic enzymes pepsin and chymosin (rennin), which is usually obtained from the fourth stomach of young ruminants. While pepsin is also... (Review)
Review
Rennet is a mixture of the proteolytic enzymes pepsin and chymosin (rennin), which is usually obtained from the fourth stomach of young ruminants. While pepsin is also used in the pharmaceutical industry, both enzymes (pepsin and chymosin) are used for the coagulation of milk protein in the manufacture of cheese. Additionally, microbial rennet, which is naturally produced by certain microorganisms, has been used as a substitute for natural rennet in the cheese production for decades. Exposure to enzyme dusts has long been known to cause occupational immediate hypersensitivities. The present paper reviews the results of an evaluation of the literature data concerning occupational airway sensitisation due to natural and microbial rennet. Cases of specific airway sensitisation caused by rennet could be shown clearly by several studies. Positive skin prick and challenge tests as well as specific IgE antibodies have been described, thus suggesting an immunological mechanism.
Topics: Asthma, Occupational; Bacterial Proteins; Chymosin; Humans; Inhalation Exposure; Occupational Exposure; Pepsin A
PubMed: 23516165
DOI: 10.1055/s-0032-1326407 -
Molecules (Basel, Switzerland) Mar 2021As nutrition and a health tonic for both medicine and food, the protein content of is more than 40%, making it an ideal source to produce antioxidant peptides. This...
As nutrition and a health tonic for both medicine and food, the protein content of is more than 40%, making it an ideal source to produce antioxidant peptides. This work evaluated the effects of six different proteases (pepsin, trypsin, papain, flavourzyme, neutral protease and alcalase) on the antioxidant activity of protein, and analyzed the relationship between the hydrolysis time, the degree of hydrolysis (DH) and the antioxidant activity of the enzymatic hydrolysates. The results showed that the antioxidant activity of protein was significantly improved and the optimal hydrolysis time was maintained between 3-4 h under the action of different proteases. Among them, the protein hydrolysate which was hydrolyzed by pepsin for 180 min had the strongest comprehensive antioxidant activity and was most suitable for the production of antioxidant peptides. At this time, the DH, the DPPH radical scavenging activity, the absorbance value of reducing power determination and the hydroxyl radical scavenging activity corresponding to the enzymatic hydrolysate were 13.32 ± 0.24%, 70.63 ± 1.53%, 0.376 ± 0.009 and 31.96 ± 0.78%, respectively. Correlation analysis showed that there was a significant positive correlation between the hydrolysis time, the DH and the antioxidant activity of the enzymatic hydrolysates, further indicating that the hydrolysates of protein had great antioxidant potential. The traditional anti-aging efficacy of is closely related to the scavenging of reactive oxygen species, and its hydrolysates have better antioxidant capacity, which also provides support for further development of its traditional anti-aging efficacy.
Topics: Antioxidants; Free Radical Scavengers; Hydrolysis; Hydroxyl Radical; Materia Medica; Pepsin A; Peptide Hydrolases; Protein Hydrolysates; Reactive Oxygen Species
PubMed: 33804057
DOI: 10.3390/molecules26061625 -
PloS One 2020Pepsin plays an important role in laryngopharyngeal reflux (LPR), a risk factor for the development of hypopharyngeal squamous cell carcinomas (HPSCC). However, the role...
Pepsin plays an important role in laryngopharyngeal reflux (LPR), a risk factor for the development of hypopharyngeal squamous cell carcinomas (HPSCC). However, the role of pepsin in HPSCC is not clear. We show by immunohistochemistry that pepsin positivity occurs in a significant proportion of human primary HPSCC specimens, and in many cases matched adjacent uninvolved epithelia are negative for pepsin. Pepsin positivity is associated with nodal involvement, suggesting that pepsin may have a role in metastasis. Treatment of FaDu cancer cells with pepsin increased cell proliferation, possibly by inducing G1/S transition. We also observed significant changes in expression of genes involved in NF-kappaB, TRAIL and Notch signaling. Our data suggest that pepsin plays an important role in HPSCC and that targeting pepsin could have potential therapeutic benefits.
Topics: Aged; Carcinoma, Squamous Cell; Cell Line, Tumor; Female; G1 Phase; Gene Expression Regulation, Neoplastic; Humans; Laryngeal Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Proteins; Pepsin A; Pharyngeal Neoplasms; S Phase; Signal Transduction
PubMed: 31940393
DOI: 10.1371/journal.pone.0227408 -
Poultry Science Sep 2018Beta-keratin in poultry feathers is a structural protein that is resistant to degradation due to disulfide and hydrogen bonds. Feather meal can be a valuable feed...
Beta-keratin in poultry feathers is a structural protein that is resistant to degradation due to disulfide and hydrogen bonds. Feather meal can be a valuable feed compound if the digestibility can be increased. The objective of the present study was to analyze the effects of chemical, enzymatic, and pressure-thermic treatments for chicken feathers on solubility, in vitro protein digestibility (IVPD), and amino acid composition of solubilized and residual fractions. Two experiments were conducted. In experiment 1, models for solubility and IVPD were developed including the above factors applying a central composite face-centered design. Addition of sodium hydroxide (NaOH) and sodium sulfite (Na2SO3), and autoclaving time affected solubility and IVPD of the feather hydrolysates, but not addition of keratinolytic enzyme. In experiment 2, 7 combinations of the hydrolysis factors NaOH, Na2SO3, and autoclaving time with a predicted IVPD of 900 g/kg of DM, calculated for the sum of solubilized and residual feather fractions, were included to measure effects on IVPD and amino acid composition in each fraction. The IVPD values were higher for solubilized than residual fractions when treated with NaOH and autoclaving, but no differences were found when treated with Na2SO3 and autoclaving. Losses of cystine were substantial for all treatments, but lower for Na2SO3 than for NaOH. Furthermore, use of lower Na2SO3 concentration and longer autoclaving time reduced losses of cystine. Compared with NaOH treatments, Na2SO3 gave lower losses of threonine, arginine, serine, and tyrosine. With reference to the ideal protein profile for Atlantic salmon (Salmo salar L.), the treatments with 60 or 90 min autoclaving and 0.36 or 0.21% Na2SO3 had the highest chemical scores. The scores were generally higher for amino acids in residual than solubilized fractions, but with 90 min autoclaving and 0.21% Na2SO3 differences were small. In conclusion, hydrolysis of chicken feathers with low concentrations of Na2SO3 combined with autoclaving results in feather meal with high nutritional value for Atlantic salmon; separation of solubilized and residual fractions is not necessary.
Topics: Amino Acids; Animal Feed; Animals; Aquaculture; Avian Proteins; Chickens; Feathers; Pepsin A; Proteolysis; Salmo salar; Solubility
PubMed: 29796647
DOI: 10.3382/ps/pey175