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Many LPR patients suffer from non-acid or weakly acidic reflux. In these cases, duodenal contents—including bile salts and trypsin—are aerosolized into the pharynx. Bile salts can disrupt the lipid bilayer of epithelial cell membranes, causing mucosal breakdown even in the absence of a low pH. 4. Epithelial Defenses and Cellular Dysfunction Lpr Physiology Book Pdf
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