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Cells of Larynx May Have Significant Immune Functions

WINSTON-SALEM, N.C. – The cells that line the larynx or voice box have strategic immune functions that could have a major impact on diseases and conditions such as cancer and asthma, according to a British researcher who spoke today at an international conference here.

Martin Birchall, M.D., who heads a laryngeal research group in the United Kingdom, said that historically the voice box or larynx has been viewed as a gatekeeper – it opens and closes and allows people to speak. The biology of the larynx had virtually been ignored; but that has changed, he said.

“It’s like a buried city filled with people scurrying about doing all kinds of jobs. We need to find out what those jobs are. It’s almost certain they have a role in stopping cancer. And, we think these immune cells are crucial in the development of asthma. We are designing experiments to test these hypotheses.”

Birchall spoke at the “Laryngopharyngeal Reflux (LPR), Dysphagia, and Laryngology” conference that is being held here at the Wake Forest University Baptist Medical Center May 20-22 to discuss new technology, diagnosis techniques and the impact of LPR on swallowing and voice disorders. The conference is cosponsored by the Center for Voice and Swallowing Disorders of Wake Forest Baptist and the American Broncho-Esophagological Association.

Presentations include the role of laryngopharyngeal reflux (LPR), the backflow of gastric contents into the voice box and throat, and the differences between LPR and gastroesophageal reflux disease (GERD), commonly referred to as acid reflux.

By studying the immune response within the lining of the larynx, Birchall said, his research team is trying to understand how the lining responds to different stimuli, including acid reflux or LPR in the voice box. They also are searching for better means of diagnosing LPR, perhaps through biopsies, as well as looking for new treatments aimed at preventing the effects of problems like reflux.

“The larynx is not designed to have acid poured on it,” Birchall said. His team wants to understand how reflux may interfere with the lining’s role in tolerating inhaled antigens and screening for cancer cells. Asthma is a major concern in the United Kingdom, where it causes an average of about five deaths each day, the highest in Europe, Birchall said.

They are looking not only for diagnostic tools and novel treatments, but also ways to stimulate these laryngeal mucosa to fend off harmful antigens that cause asthma or to wipe out cancer cells, as they are designed to do, Birchall said. “We are really just scratching the surface.”

Course directors for the international conference are Jamie Koufman, M.D., Greg Postma, M.D., and Peter Dettmar, Ph.D., from Wake Forest Baptist, and Julian McGlashan, M.D., of University Hospital, Queens Medical Centre, Nottingham, England.

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