What does this research mean for the field?

Pepsin plays a central mechanistic role in extraesophageal reflux injury, driving the need for pepsin-specific diagnostics and novel therapeutics such as direct pepsin inhibitors. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To summarize recent discoveries regarding the pathophysiology of pepsin in extraesophageal reflux and examine emerging diagnostic tools and targeted therapeutic approaches.

August 15, 2026Current Opinion in Otolaryngology & Head & Neck Surgery

Is pepsin in the foreground of extraesophageal reflux management yet?

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Authors

TSTina L. Samuels PEPelin Ergün NJNikki Johnston

Discussion

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Overview

Review demonstrates the pathogenic role of nonacid pepsin in extraesophageal reflux and highlights novel pepsin-targeted therapies, indicating a shift beyond conventional acid-suppression strategies.

Key Points

To summarize recent discoveries regarding the pathophysiology of pepsin in extraesophageal reflux and examine emerging diagnostic tools and targeted therapeutic approaches.
Narrative review synthesizing preclinical and clinical evidence on pepsin-mediated tissue injury in extraesophageal reflux (EER) and laryngopharyngeal reflux (LPR).
Evaluation of emerging diagnostic assays targeting pepsin activity and gastroduodenal biomarkers, alongside ongoing therapeutic trials involving direct pepsin inhibitors.
Weakly acidic and nonacid pepsin directly promote airway injury and endocytosis, showing an emerging pathogenic link to chronic pulmonary fibrotic diseases.
Preclinical evidence supports direct pepsin inhibition by HIV protease inhibitors, leading to active clinical trials investigating fosamprenavir for laryngopharyngeal reflux.
Advancing management requires targeted delivery systems like laryngopharyngeal inhalers, formal ICD-10-CM diagnostic codes, and validated clinical outcome tools for regulatory approval.

Cite This Study

Samuels et al. (2026) studied this question.

synapsesocial.com/papers/6a8019fe75c2e31742c8654a https://doi.org/10.1097/moo.0000000000001154

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August 15, 2026Current Opinion in Otolaryngology & Head & Neck Surgery

Is pepsin in the foreground of extraesophageal reflux management yet?

View Full Paper

Ask AI

Bookmark

Authors

TSTina L. Samuels PEPelin Ergün NJNikki Johnston

Discussion

Member takes

Overview

Review demonstrates the pathogenic role of nonacid pepsin in extraesophageal reflux and highlights novel pepsin-targeted therapies, indicating a shift beyond conventional acid-suppression strategies.

Key Points

To summarize recent discoveries regarding the pathophysiology of pepsin in extraesophageal reflux and examine emerging diagnostic tools and targeted therapeutic approaches.
Narrative review synthesizing preclinical and clinical evidence on pepsin-mediated tissue injury in extraesophageal reflux (EER) and laryngopharyngeal reflux (LPR).
Evaluation of emerging diagnostic assays targeting pepsin activity and gastroduodenal biomarkers, alongside ongoing therapeutic trials involving direct pepsin inhibitors.
Weakly acidic and nonacid pepsin directly promote airway injury and endocytosis, showing an emerging pathogenic link to chronic pulmonary fibrotic diseases.
Preclinical evidence supports direct pepsin inhibition by HIV protease inhibitors, leading to active clinical trials investigating fosamprenavir for laryngopharyngeal reflux.
Advancing management requires targeted delivery systems like laryngopharyngeal inhalers, formal ICD-10-CM diagnostic codes, and validated clinical outcome tools for regulatory approval.

Cite This Study

Samuels et al. (2026) studied this question.

synapsesocial.com/papers/6a8019fe75c2e31742c8654a https://doi.org/10.1097/moo.0000000000001154

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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