Measurement of Salivary Pepsin to Detect Gastroesophageal Reflux Disease Is Not Ready for Clinical Application

Philip Woodland, Maartje M. J. Singendonk, Joanne Ooi, Kornilia Nikaki, Terry Wong, Chung Lee, Esteban Glasinovic, Romy Koning, Rene Lutter, Marc A. Benninga, Michiel P. van Wijk, Daniel Sifrim

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A noninvasive test for gastroesophageal reflux disease (GERD) is desirable for adults and children. Salivary pepsin measurement has been proposed as such a test.1–3 A previous study from our group demonstrated that a maximal salivary pepsin cutoff of >210 ng/mL using the PepTest device (RD Biomed, Hull, United Kingdom) had excellent specificity of 96% but modest sensitivity of 44% to diagnose GERD,4 leading to optimism about its potential use. In this study, we aimed to confirm the previously reported sensitivity and specificity in healthy volunteers and patients with heartburn, evaluate the association between a positive PepTest and response to proton pump inhibitor (PPI) therapy, assess if test-sensitivity can be improved for GERD when samples are taken over a 72-hour sampling period, and establish normal values of salivary pepsin in infants.
Original languageEnglish
Pages (from-to)563-565
Number of pages3
JournalClinical Gastroenterology and Hepatology
Issue number3
Early online date18 May 2018
Publication statusPublished - 1 Feb 2019

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