Abstract
This pilot study aimed to assess oral microbiome diversity between patients with and without elevated salivary pepsin concentrations. Over 9 months, 85 enrolled subjects (73 symptomatic patients; 12 asymptomatic volunteers) provided salivary samples off acid suppression. Subjects with elevated pepsin (≥25 ng/mL) had significantly greater Shannon entropy diversity compared to subjects with normal pepsin (<25 ng/mL) on 16S rRNA sequencing ( P = .015), indicating increased oral microbiome biodiversity in patients with elevated salivary pepsin. Repeated gastro-esophageal reflux events from the stomach to the oral cavity may contribute to this observed change in oral microbiome diversity with potential implications in symptom generation and/or therapy.
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