Pepsin, trypsin, and MUC5B are independent risk factors for hearing impairment in patients with laryngopharyngeal reflux-related chronic secretory otitis media

This study evaluated the potential diagnostic utility of pepsin, trypsin, and mucin 5B (MUC5B) in hearing impairment in patients with laryngopharyngeal reflux (LPR)-related chronic secretory OM (CSOM). Patients with LPR-related CSOM were enrolled and assigned into the normal hearing (NH), and mild (Mi-HI) and moderate-to-severe hearing impairment (Mo-HI) groups. Pepsin, trypsin, and MUC5B contents were determined by ELISA, with their correlations with Eustachian tube dysfunction questionnaire-7 (ETDQ-7) score and inflammatory factors (interleukin [IL]-2, IL6, IL-8), and diagnostic performance in hearing impairment assessed by Pearson, Spearman, and ROC curves. Factors influencing hearing impairment were identified using logistic regression models. Pepsin, trypsin, and MUC5B contents were upregulated in patients’ middle ear effusion as hearing impairment worsened. The three indicators correlated to EDTQ-7 and inflammatory factors, and exhibited high diagnostic value for hearing impairment in LPR-related CSOM patients. Remarkably, their combination created significantly higher diagnostic value than a single indicator. Abundantly-increased pepsin, trypsin, and MUC5B amplified hearing impairment incidence. Pepsin, trypsin, and MUC5B are independent risk factors for hearing impairment in LPR-related CSOM patients. Their combination assists hearing impairment diagnosis in patients, providing a tool in clinical practice to stratify patients and offering a theoretical basis for exploring therapeutic targets.