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Li Q, Shen J, Qin T, Zhou G, Li Y, Chen Z, Li M. A Qualitative and Comprehensive Analysis of Caries Susceptibility for Dental Fluorosis Patients. Antibiotics (Basel) 2021; 10:antibiotics10091047. [PMID: 34572628 PMCID: PMC8464924 DOI: 10.3390/antibiotics10091047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
Dental fluorosis (DF) is an endemic disease caused by excessive fluoride exposure during childhood. Previous studies mainly focused on the acid resistance of fluorotic enamel and failed to reach a consensus on the topic of the caries susceptibility of DF patients. In this review, we discuss the role of DF classification in assessing this susceptibility and follow the “four factors theory” in weighing the pros and cons of DF classification in terms of host factor (dental enamel and saliva), food factor, bacteria factor, and DF treatment factor. From our analysis, we find that susceptibility is possibly determined by various factors such as the extent of structural and chemical changes in fluorotic enamel, eating habits, fluoride levels in diets and in the oral cavity, changes in quantity and quality of saliva, and/or oral hygiene. Thus, a universal conclusion regarding caries susceptibility might not exist, instead depending on each individual’s situation.
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Affiliation(s)
- Qianrui Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Jiaqi Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Tao Qin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Ge Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Yifeng Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Zhu Chen
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi 563000, China;
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
- Correspondence:
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Lee S, Jo K, Jeong HG, Choi YS, Yong HI, Jung S. Understanding protein digestion in infants and the elderly: Current in vitro digestion models. Crit Rev Food Sci Nutr 2021; 63:975-992. [PMID: 34346822 DOI: 10.1080/10408398.2021.1957765] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The last decades have witnessed a surge of interest in the fate of dietary proteins during gastrointestinal (GI) digestion. Although several in vitro digestion models are available as alternatives to clinical experiments, most of them focus on the digestive conditions of healthy young adults. This study investigates the static/dynamic models used to simulate digestion in infants and the elderly and considers the related in vivo conditions. The in vitro digestive protocols targeting these two groups are summarized, and the challenges associated with the further development of in vitro digestion models are discussed. Static models rely on several factors (e.g., enzyme concentration, pH, reaction time, and rotation speed) to differentiate digestive conditions depending on age. Dynamic models can more accurately simulate the complex digestion process and allow the inclusion of further parameters (sequential secretion of digestive fluids, gradual changes in pH, peristaltic mixing, GI emptying, and the inoculation of luminal microbiota). In the case of infants, age or growth stage clarification and the differentiation of digestive protocols between full-term and preterm infants are required, whereas protocols dealing with various health statuses are required in the case of the elderly, as this group is prone to oral cavity and GI function deterioration.
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Affiliation(s)
- Seonmin Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, Republic of Korea
| | - Kyung Jo
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, Republic of Korea
| | - Hyun Gyung Jeong
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, Republic of Korea
| | - Yun-Sang Choi
- Research Group of Food Processing, Korea Food Research Institute, Wanju, Republic of Korea
| | - Hae In Yong
- Research Group of Food Processing, Korea Food Research Institute, Wanju, Republic of Korea
| | - Samooel Jung
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, Republic of Korea
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Lorieau L, Floury J, Septier C, Laguerre A, Le Roux L, Hazart E, Ligneul A, Dupont D, Vigneau E, Hanafi M, Feron G, Labouré H. Relationship among oral health status, bolus formation and food comfortability during consumption of model cheeses in elderly. Food Funct 2021; 12:7379-7389. [PMID: 34184693 DOI: 10.1039/d1fo00767j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to investigate the impact of oral impairment on chewing behaviour, food bolus properties and food comfortability during elderly consumption of model cheeses. Seventy-two elderly persons (aged 66 to 88) was recruited and classified into two groups according to dental status (poor vs. satisfactory). They showed a wide range of salivary flow rates whatever their dental status (stimulated: 0.2-3.8 mL min-1, resting: 0.1-0.8 mL min-1). Standardized bites of four model cheeses with an identical composition but different textures (soft, hard, processed and whipped) were tested. The time and number of chewing cycles required to form a bolus were measured. The rheological properties of the bolus were studied, as was saliva moistening. Food comfortability was assessed by means of a questionnaire composed of 5 sections (1-oral comfort, 2-bolus formation, 3-pain, 4-texture and 5-flavour perception). The chewing parameters measured were not modified by the oral health. However, elderly with poor dentition formed harder boluses than elderly with satisfactory dentition. Moreover, for elderly with poor dentition, the quantity of saliva incorporated into the bolus was correlated with the stimulated salivary flow rate, which was not the case for elderly with satisfactory dentition. General oral comfort and its different attributes were poorly associated with the oral health of the elderly. A multifactorial analysis performed on an average cheese showed that food comfortability is independent of changes in the hardness and moistening of the bolus, regardless of dental status. In particular, poor dental status increases the hardness of the bolus without modifying its comfortability.
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Affiliation(s)
- L Lorieau
- STLO, INRAE, Institut Agro, 35042, Rennes, France
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Older age, smoking, tooth loss and denture-wearing but neither xerostomia nor salivary gland hypofunction are associated with low intakes of fruit and vegetables in older Danish adults. J Nutr Sci 2021; 10:e47. [PMID: 34267893 PMCID: PMC8256315 DOI: 10.1017/jns.2021.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022] Open
Abstract
Xerostomia and salivary gland hypofunction are prevalent conditions in older people and may adversely influence the intake of certain foods, notably fruit and vegetables. Here, we aimed to investigate whether xerostomia and salivary gland hypofunction were associated with a lower intake of fruit and vegetables. The study included 621 community-dwelling adults, mean age 75⋅2 ± 6⋅4 years, 58⋅9 % female, who had participated in the Copenhagen City Heart Study follow-up, and undergone interviews regarding food intake (preceding month), oral and general health (xerostomia, taste alterations, diseases, medication, alcohol consumption and smoking), clinical oral examination and measurements of unstimulated and chewing-stimulated whole saliva flow rates. The average total energy intake (8⋅4 ± 2⋅7 MJ) and protein energy percentage (14⋅8 ± 3⋅1 %) were slightly below recommendations. The average fruit (234⋅7 ± 201⋅2 g/d) and vegetables (317⋅3 ± 157⋅4 g/d) intakes were within recommendations. Xerostomia and hyposalivation were more prevalent in women than in men (16⋅4 v. 7⋅1 %, P < 0⋅001 and 40⋅7 v. 27⋅5 %, P < 0⋅001). Multiple linear regression analyses revealed that older age (β -0⋅009, se 0⋅003, P = 0⋅005), smoking (β -0⋅212, se 0⋅060, P = 0⋅0005) and wearing complete dentures/being partially or fully edentulous (β -0⋅141, se 0⋅048, P = 0⋅003), but neither xerostomia nor salivary flow rates were associated with an inadequate fruit and vegetable intake, after adjustment for covariates. Older age, smoking, tooth loss and denture-wearing were stronger determinants of low fruit and vegetable intakes than xerostomia and salivary hypofunction supporting the importance of dietary counselling and maintenance of oral health and an adequate masticatory performance.
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Shannon OM, Easton C, Shepherd AI, Siervo M, Bailey SJ, Clifford T. Dietary nitrate and population health: a narrative review of the translational potential of existing laboratory studies. BMC Sports Sci Med Rehabil 2021; 13:65. [PMID: 34099037 PMCID: PMC8186051 DOI: 10.1186/s13102-021-00292-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dietary inorganic nitrate (NO3-) is a polyatomic ion, which is present in large quantities in green leafy vegetables and beetroot, and has attracted considerable attention in recent years as a potential health-promoting dietary compound. Numerous small, well-controlled laboratory studies have reported beneficial health effects of inorganic NO3- consumption on blood pressure, endothelial function, cerebrovascular blood flow, cognitive function, and exercise performance. Translating the findings from small laboratory studies into 'real-world' applications requires careful consideration. MAIN BODY This article provides a brief overview of the existing empirical evidence basis for the purported health-promoting effects of dietary NO3- consumption. Key areas for future research are then proposed to evaluate whether promising findings observed in small animal and human laboratory studies can effectively translate into clinically relevant improvements in population health. These proposals include: 1) conducting large-scale, longer duration trials with hard clinical endpoints (e.g. cardiovascular disease incidence); 2) exploring the feasibility and acceptability of different strategies to facilitate a prolonged increase in dietary NO3- intake; 3) exploitation of existing cohort studies to explore associations between NO3- intake and health outcomes, a research approach allowing larger samples sizes and longer duration follow up than is feasible in randomised controlled trials; 4) identifying factors which might account for individual differences in the response to inorganic NO3- (e.g. sex, genetics, habitual diet) and could assist with targeted/personalised nutritional interventions; 5) exploring the influence of oral health and medication on the therapeutic potential of NO3- supplementation; and 6) examining potential risk of adverse events with long term high- NO3- diets. CONCLUSION The salutary effects of dietary NO3- are well established in small, well-controlled laboratory studies. Much less is known about the feasibility and efficacy of long-term dietary NO3- enrichment for promoting health, and the factors which might explain the variable responsiveness to dietary NO3- supplementation between individuals. Future research focussing on the translation of laboratory data will provide valuable insight into the potential applications of dietary NO3- supplementation to improve population health.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, Scotland, UK
| | - Anthony I Shepherd
- School of Sport, Health & Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Tom Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
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56
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Toan NK, Ahn SG. Aging-Related Metabolic Dysfunction in the Salivary Gland: A Review of the Literature. Int J Mol Sci 2021; 22:5835. [PMID: 34072470 PMCID: PMC8198609 DOI: 10.3390/ijms22115835] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022] Open
Abstract
Aging-related salivary dysfunction commonly induces the poor oral health, including decreased saliva flow and dental caries. Although the clinical significance of the salivary glands is well-known, the complex metabolic pathways contributing to the aging-dysfunction process are only beginning to be uncovered. Here, we provide a comprehensive overview of the metabolic changes in aging-mediated salivary gland dysfunction as a key aspect of oral physiology. Several metabolic neuropeptides or hormones are involved in causing or contributing to salivary gland dysfunction, including hyposalivation and age-related diseases. Thus, aging-related metabolism holds promise for early diagnosis, increased choice of therapy and the identification of new metabolic pathways that could potentially be targeted in salivary gland dysfunction.
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Affiliation(s)
| | - Sang-Gun Ahn
- Department of Pathology, School of Dentistry, Chosun University, Gwangju 61452, Korea;
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57
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Chambon C, Neyraud E, Sayd T, Bros P, Di Biagio R, Hyvrier F, Féart C, André P, Rodriguez-Artalejo F, Lopez-Garcia E, Garcia-Esquinas E, Gomez-Cabrero D, Proctor G, Morzel M. The salivary proteome reflects some traits of dietary habits in diabetic and non-diabetic older adults. Eur J Nutr 2021; 60:4331-4344. [PMID: 34041584 DOI: 10.1007/s00394-021-02584-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/11/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Objective markers of usual diet are of interest as alternative or validating tools in nutritional epidemiology research. The main purpose of the work was to assess whether saliva protein composition can reflect dietary habits in older adults, and how type 2 diabetes impacted on the saliva-diet correlates. METHODS 214 participants were selected from 2 European cohorts of community-dwelling older adults (3C-Bordeaux and Seniors-ENRICA-2), using a case-control design nested in each cohort. Cases were individuals with type 2 diabetes. Dietary information was obtained using the Mediterranean Diet Adherence Screener (MEDAS). Saliva was successfully obtained from 211 subjects, and its proteome analyzed by liquid chromatography-tandem mass spectrometry. RESULTS The relative abundance of 246 saliva proteins was obtained across all participants. The salivary proteome differed depending on the intake level of some food groups (especially vegetables, fruits, sweet snacks and red meat), in a diabetic status- and cohort-specific manner. Gene Set Enrichment Analysis suggested that some biological processes were consistently affected by diet across cohorts, for example enhanced platelet degranulation in high consumers of sweet snacks. Minimal models were then fitted to predict dietary variables by sociodemographic, clinical and salivary proteome variables. For the food group «sweet snacks», selected salivary proteins contributed to the predictive model and improved its performance in the Seniors-ENRICA-2 cohort and when both cohorts were combined. CONCLUSION Saliva proteome composition of elderly individuals can reflect some aspects of dietary patterns.
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Affiliation(s)
- Christophe Chambon
- INRAE, Plateforme d'Exploration du Métabolisme Composante Protéome PFEMcp, St-Genès-Champanelle, France
| | - Eric Neyraud
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, Dijon, France
| | - Thierry Sayd
- INRAE, Plateforme d'Exploration du Métabolisme Composante Protéome PFEMcp, St-Genès-Champanelle, France
| | - Pauline Bros
- INRAE, Plateforme d'Exploration du Métabolisme Composante Protéome PFEMcp, St-Genès-Champanelle, France
| | - Romane Di Biagio
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, Dijon, France
| | - Frank Hyvrier
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, Dijon, France
| | - Catherine Féart
- Université de Bordeaux, Inserm, BPH, Team LEHA, UMR 1219, Bordeaux, France
| | - Perrine André
- Université de Bordeaux, Inserm, BPH, Team LEHA, UMR 1219, Bordeaux, France
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBERESP, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,IMDEA-Food Institute, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBERESP, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,IMDEA-Food Institute, Madrid, Spain
| | - Esther Garcia-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBERESP, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain
| | - David Gomez-Cabrero
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College, London, UK
| | - Gordon Proctor
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College, London, UK
| | - Martine Morzel
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, Dijon, France.
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Muñoz-González C, Brule M, Martin C, Feron G, Canon F. Influence of Prebiotic Fructans on Retronasal Aroma from Elderly Individuals. Molecules 2021; 26:2906. [PMID: 34068432 PMCID: PMC8153581 DOI: 10.3390/molecules26102906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/04/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
This study investigates for the first time the role of fructans with prebiotic effects (oligofructose and inulin) on retronasal aroma among elderly individuals. The impact of oligofructose (20% w/w) on retronasal aroma release was investigated using proton transfer reaction-mass spectrometry (PTR-MS) after 73 elderly individuals consumed aqueous solutions aromatized with five aroma compounds (pentan-2-one, nonan-2-one, hexan-2,3-dione, octanal and linalool). The influence of oligofructose and inulin (10% w/w) on the perceived intensity (n = 26) of two aroma descriptors (butter and floral) was also studied together with the possibility of a dumping effect on aroma evaluation due to the sweetness provided by the fructans. The results showed that the presence of oligofructose produced a significant reduction in retronasal aroma release, which could be generally explained by the physicochemical properties of aroma compounds. The presence of prebiotic fructans did not significantly affect the perceived intensity of butter and floral notes, although a dumping effect for the butter descriptor in the presence of oligofructose was observed. To conclude, these findings suggest that although fructans can exert an impact on retronasal aroma, they can be used at precise concentrations to increase the prebiotic fibre content of food products without affecting the aroma profile of foods.
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Affiliation(s)
- Carolina Muñoz-González
- Centre for Taste and Feeding Behavior (CSGA), UMR1324 INRAe, UMR6265 CNRS University of Burgundy, Agrosup Dijon, F-21000 Dijon, France; (M.B.); (C.M.); (G.F.); (F.C.)
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Alvariño C, Bagan L, Murillo-Cortes J, Calvo J, Bagan J. Stimulated whole salivary flow rate: The most appropriate technique for assessing salivary flow in Sjögren syndrome. Med Oral Patol Oral Cir Bucal 2021; 26:e404-e407. [PMID: 33772564 PMCID: PMC8141317 DOI: 10.4317/medoral.24736] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/14/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We sought to determine the most appropriate method for measuring salivary flow to aid the diagnosis of Sjögren's syndrome (SS). Specifically, we compared the unstimulated whole salivary flow rate (UWSFR) with the stimulated whole salivary flow rate (SWSFR). MATERIAL AND METHODS This case-control study comprised one group of 103 patients with SS and a control group of 50 healthy people. We measured the UWSFR and SWSFR in both groups according to the guidelines established by Navacet [1993]. RESULTS The UWSFR and SWSFR were significantly lower in the patient group compared with the controls (p < 0.01). Among the participants in the patient group, we found a decreased UWSFR in 84 individuals (81.5%) and a decreased SWSFR in 90 individuals (87.4%). We encountered difficulties obtaining saliva in 37 (35.9%) patients during the UWSFR test, and in 12 (11.7%) patients during the SWSFR test. There was no significant statistical difference in the UWSFR or SWSFR between patients with primary and secondary SS. CONCLUSIONS Compared with the UWSFR, the SWSFR is a more suitable and effective method for measuring salivary flow in patients with SS, as well as for qualitative analysis of the obtained saliva.
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Affiliation(s)
- C Alvariño
- Prof. Jose Vte. Bagan Service of Stomatology and Maxillofacial Surgery University General Hospital Avda Tres Cruces 2, 46014, Valencia, Spain
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Proctor GB, Shaalan AM. Disease-Induced Changes in Salivary Gland Function and the Composition of Saliva. J Dent Res 2021; 100:1201-1209. [PMID: 33870742 PMCID: PMC8461045 DOI: 10.1177/00220345211004842] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Although the physiological control of salivary secretion has been well studied, the impact of disease on salivary gland function and how this changes the composition and function of saliva is less well understood and is considered in this review. Secretion of saliva is dependent upon nerve-mediated stimuli, which activate glandular fluid and protein secretory mechanisms. The volume of saliva secreted by salivary glands depends upon the frequency and intensity of nerve-mediated stimuli, which increase dramatically with food intake and are subject to facilitatory or inhibitory influences within the central nervous system. Longer-term changes in saliva secretion have been found to occur in response to dietary change and aging, and these physiological influences can alter the composition and function of saliva in the mouth. Salivary gland dysfunction is associated with different diseases, including Sjögren syndrome, sialadenitis, and iatrogenic disease, due to radiotherapy and medications and is usually reported as a loss of secretory volume, which can range in severity. Defining salivary gland dysfunction by measuring salivary flow rates can be difficult since these vary widely in the healthy population. However, saliva can be sampled noninvasively and repeatedly, which facilitates longitudinal studies of subjects, providing a clearer picture of altered function. The application of omics technologies has revealed changes in saliva composition in many systemic diseases, offering disease biomarkers, but these compositional changes may not be related to salivary gland dysfunction. In Sjögren syndrome, there appears to be a change in the rheology of saliva due to altered mucin glycosylation. Analysis of glandular saliva in diseases or therapeutic interventions causing salivary gland inflammation frequently shows increased electrolyte concentrations and increased presence of innate immune proteins, most notably lactoferrin. Altering nerve-mediated signaling of salivary gland secretion contributes to medication-induced dysfunction and may also contribute to altered saliva composition in neurodegenerative disease.
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Affiliation(s)
- G B Proctor
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - A M Shaalan
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Sebastian A, Woytala P, Madej M, Proc K, Czesak-Woytala K, Sebastian M, Zub K, Wiland P. Is it possible to not perform salivary gland biopsy in targeted patients according to unstimulated salivary flow results in patients with suspected Sjögren's syndrome? Rheumatol Int 2021; 41:1125-1131. [PMID: 33844038 PMCID: PMC8079304 DOI: 10.1007/s00296-021-04840-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION/OBJECTIVE Xerostomia is one of the main symptoms of primary Sjögren's syndrome (pSS). The unstimulated salivary flow (UWS) test is one of the objective Sjögren's syndrome classification criteria used to assess xerostomia's severity. The study's objective was to evaluate UWS rate measurements (with a threshold rate of 0.1 mL/min) in the screening of patients suspected with pSS, presenting with xerostomia in whom labial salivary gland biopsy (LSGB) should be performed. We will try to answer whether it is possible not to perform LSGB in targeted patients according to UWS results? We analyze the correlation between UWS value and focus score (FS) and anti-SSA antibodies. METHODS The study group consisted of subjects above 18 years of age with a subjective feeling of oral dryness. RESULTS A total of 105 subjects were qualified for the study. The final diagnosis of pSS was made in 44 patients according to the classification criteria from 2016. No age differences were identified between pSS patients and control group subjects (patients with dry mouth without autoimmune background). UWS rates were significantly lower in pSS patients than in the control group. No association was identified between UWS and focus score (FS) ≥ 1 in LSGB. No differences were observed between anti-SSA-positive and anti-SSA-negative patients in terms of age, UWS rates, FS. CONCLUSION LSGB should be performed in all suspected pSS cases regardless of the UWS rate value, particularly in subjects without specific anti-SSA antibodies. In patients with suspected pSS, only less than one-half of the UWS measurements are below the value of 0.1 mL/min adopted as the threshold in the classification criteria for pSS.
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Affiliation(s)
- Agata Sebastian
- Department of Rheumatology and Internal Medicine, Medical University of Wroclaw, Borowska 213, 50-556, Wroclaw, Poland.
| | - Patryk Woytala
- Department of Rheumatology and Internal Medicine, Medical University of Wroclaw, Borowska 213, 50-556, Wroclaw, Poland
| | - Marta Madej
- Department of Rheumatology and Internal Medicine, Medical University of Wroclaw, Borowska 213, 50-556, Wroclaw, Poland
| | - Krzysztof Proc
- Department of Rheumatology and Internal Medicine, Medical University of Wroclaw, Borowska 213, 50-556, Wroclaw, Poland
| | | | - Maciej Sebastian
- Department of General, Minimally Invasive and Endocrine Surgery, Medical University of Wroclaw, Wroclaw, Poland
| | - Krzysztof Zub
- Department and Clinic of Otolaryngology-Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Wiland
- Department of Rheumatology and Internal Medicine, Medical University of Wroclaw, Borowska 213, 50-556, Wroclaw, Poland
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Laugisch O, Holtfreter B, Pink C, Samietz S, Völzke H, Kocher T. Polypharmacy and saliva volumes in the northeast of Germany - The Study of Health in Pomerania. Community Dent Oral Epidemiol 2021; 50:139-146. [PMID: 33829548 DOI: 10.1111/cdoe.12644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Associations between saliva volumes or salivary flow rates and potentially xerogenic medication are rarely evaluated in cohorts with a wide age range. This cross-sectional cohort study investigated possible relationships between the regular consumption of potentially xerogenic medication and stimulated saliva volumes. METHODS Data from the German Studies of Health in Pomerania (SHIP-2 and SHIP-Trend-0) were pooled. Potentially xerogenic medications were identified using the Workshop on Oral Medicine VI criteria. Stimulated saliva was sampled using Salivette®, and saliva volumes expressed as μl/min were determined. Applying linear mixed models with adjustment for time point of saliva collection, associations of (a) age and sex with regularly consumed medication, (b) age and sex with saliva volumes, and (c) the number of regularly consumed xerogenic medications with saliva volumes were evaluated. RESULTS Six thousand seven hundred and fifty-three participants aged 20-83 years (mean 53.4 ± 14.9) were included. The average number of medications did not differ markedly between females (2.21 ± 2.46) and males (2.24 ± 2.83). Males took more potentially xerogenic medication (1.0 ± 1.3) than did females (0.9 ± 1.3). Also, males took more potentially xerogenic cardiovascular medications than did females (0.9 ± 1.2 versus 0.7 ± 1.1), while females were prescribed a higher number of potentially xerogenic medications affecting the nervous system (0.2 ± 0.5 versus 0.1 ± 0.4). The average stimulated saliva volume was 967.0 ± 433.3 µL/min. Regularly consumed and potentially xerogenic medications were associated with lower saliva volumes. Older age correlated not only with a higher number of total medications and a higher number of xerogenic medications affecting either the cardiovascular (in males) or the nervous system (in females), but also with lower saliva volumes. CONCLUSIONS Ageing was associated with polypharmacy, especially with the intake of potentially xerogenic medication, and lower average saliva volumes. With regard to complications of dry mouth, anamnesis of medication consumption is of high importance.
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Affiliation(s)
- Oliver Laugisch
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.,Department of Periodontology and Peri-implant Diseases, Philipps University, Marburg, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Christiane Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Stefanie Samietz
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Ketel EC, Zhang Y, Jia J, Wang X, de Wijk RA, Chen J, Stieger M. Comparison of and relationships between oral physiology, anatomy and food oral processing behavior of Chinese (Asian) and Dutch (Caucasian) consumers differing in age. Physiol Behav 2021; 232:113284. [DOI: 10.1016/j.physbeh.2020.113284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 12/25/2022]
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Hatirli H, Yasa B, Çelik EU. Clinical performance of high-viscosity glass ionomer and resin composite on minimally invasive occlusal restorations performed without rubber-dam isolation: a two-year randomised split-mouth study. Clin Oral Investig 2021; 25:5493-5503. [PMID: 33683465 DOI: 10.1007/s00784-021-03857-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 02/22/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this clinical trial was to evaluate the 2-year clinical performances of high-viscosity glass ionomer and nanohybrid resin composite restorations performed without rubber dam isolation. MATERIALS AND METHODS Occlusal carious lesions on the right and left mandibular second molars of 56 patients (26 female, 30 male patients) were restored in a split-mouth design. High-viscosity glass ionomer (Hv-GIC) (Equia, GC) and nanohybrid resin composite (GrandioSO, Voco) were used as restorative materials. Clinical evaluations of the restorations were performed according to the Fédération Dentaire Internationale criteria. Data were analysed using the Friedman's analysis of variance and Mann-Whitney U tests (α=0.05). RESULTS After 2 years, the success rate of Hv-GIC restorations was 96% and that of resin composite restorations was 100%. Hv-GIC showed lower marginal discoloration and greater surface wear and loss of anatomic form (p<0.05). Resin composite showed significantly better surface lustre. CONCLUSION The 2-year performance of resin composite was similar to that of Hv-GIC for the occlusal restorations of mandibular second molars, in spite of being performed without rubber-dam isolation. CLINICAL RELEVANCE Saliva contamination can be a clinically significant problem for dental restorations. High-viscosity glass ionomers are a satisfactory alternative to resin composites with the advantage of fast application in such situations. TRIAL REGISTRATION Clinical Trials Registration number-date: NCT04488380-22/07/2020, retrospectively registered.
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Affiliation(s)
- Hüseyin Hatirli
- Department of Restorative Dentistry, Faculty of Dentistry, Tokat Gaziosmanpasa University, 60030, Tokat, Turkey.
| | - Bilal Yasa
- Department of Restorative Dentistry, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Esra Uzer Çelik
- Department of Restorative Dentistry, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Therapeutic Recommendations for the Management of Older Adult Patients with Sjögren's Syndrome. Drugs Aging 2021; 38:265-284. [PMID: 33619703 DOI: 10.1007/s40266-021-00838-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2021] [Indexed: 10/22/2022]
Abstract
Primary Sjögren's syndrome (SjS) is a systemic autoimmune disease most commonly diagnosed in middle-aged women. Although the disease can occur at all ages, it is diagnosed between 30 and 60 years of age in two-thirds of patients. In more than 20% of cases, the people are older than 65 years. In this review, we focus on the therapeutic management of primary SjS in older patients, following the recently published 2020 European League Against Rheumatism (EULAR) recommendations for the management of the disease with topical and systemic therapies. These recommendations are applicable to all patients with primary SjS regardless of age at diagnosis, although the therapeutic management in older patients requires additional considerations. Older patients are more likely to have pulmonary, liver, kidney, or heart-related comorbidities (even cognitive disturbances); caution is required when most drugs are used, including muscarinic agents, systemic corticosteroids and synthetic immunosuppressants. It is also important to monitor the use of eye drops containing steroids due to the increased risk of developing cataracts, a frequent ocular complication in the older population. In contrast, the majority of drugs that can be used topically (pilocarpine rinses, eye drops containing topical non-steroidal anti-inflammatory drugs (NSAIDs) or cyclosporine A, topical dermal formulations of NSAIDs) have shown an acceptable safety profile in older patients, as well as rituximab. A rigorous evaluation of the medical history of older patients is essential when drugs included in the EULAR guidelines are prescribed, with special attention to factors frequently related to ageing, such as polypharmacy, the existence of organ-specific comorbidities, or the enhanced susceptibility to infections.
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Norton V, Lignou S, Methven L. Influence of Age and Individual Differences on Mouthfeel Perception of Whey Protein-Fortified Products: A Review. Foods 2021; 10:433. [PMID: 33669435 PMCID: PMC7920461 DOI: 10.3390/foods10020433] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 12/22/2022] Open
Abstract
Protein needs are considered to increase with age, with protein consumption being associated with many positive outcomes. Protein-fortified products are often used to improve nutritional status and prevent age-related muscle mass loss in older adults. Accordingly, older adults are commonly provided with products fortified with whey protein; however, such products can cause mouthdrying, limiting consumption and product enjoyment. Currently, the extent to which age and individual differences (e.g., saliva, oral health, food oral processing) influence the perception of whey protein-derived mouthdrying is relatively unclear. Previous research in this area has mainly focused on investigating mouthdrying, without taking into account individual differences that could influence this perception within the target population. Therefore, the main focus of this review is to provide an overview of the relevant individual differences likely to influence mouthfeel perception (specifically mouthdrying) from whey protein-fortified products, thereby enabling the future design of such products to incorporate better the needs of older adults and improve their nutritional status. This review concludes that age and individual differences are likely to influence mouthdrying sensations from whey protein-fortified products. Future research should focus more on the target population and individual differences to maximise the benefits from whey protein fortification.
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Affiliation(s)
| | | | - Lisa Methven
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading RG6 6DZ, UK; (V.N.); (S.L.)
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Watanabe S, Izuhara E, Oh-Shige H, Miyachi H, Goto M, Hasegawa S, Miyabe S, Nagasaka Y, Shimozato K, Nagao T. Relationship between age and sex and the numbers of ingestions and swallows for foods of different textures among healthy adults. Physiol Behav 2021; 229:113225. [PMID: 33122093 DOI: 10.1016/j.physbeh.2020.113225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/23/2020] [Accepted: 10/24/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The number of swallows needed per single ingestion of food is an important index when assisting a patient with dysphagia in eating. While providing meal assistance, the caregiver may assume that one ingestion is completed with one swallow and then may administer the next ingestion even if the individual's mouth still has remaining food from the previous ingestions, increasing the risk for aspiration and choking. OBJECTIVE The objective of this pilot study was to clarify the differences in foods ingested and swallowed because of influencing factors such as age and gender among healthy adults. METHODS The study enrolled 110 healthy adults (47.4 ± 15.8 years; 57 males, 53 females). The numbers of ingestions and swallows were counted and evaluated by food type (pilaf, 100 g; yogurt 80 g; and sponge cake, 35 g) and participant age and sex and analyzed by least-squares multiple regression analysis. RESULTS The mean numbers of ingestion/swallows were pilaf, 12.5 ± 3.2/13.4 ± 4.2; yogurt, 8.8 ± 2.1/10.8 ± 2.1; and sponge cake, 5.8 ± 2.1/7.0 ± 2.1. The mean number of ingestions and swallows for all foods were higher for female participants compared with male participants. Statistical analysis identified sex as a significant influencing factor for the number of ingestion for all foods. For the number of swallows, the significant influencing factors were sex for sponge cake and age for pilaf and yogurt. CONCLUSION For the test foods of different textures, sex and age were significant influencing factors for the numbers of ingestions and swallows. Further research is needed to elucidate the problem areas in this pilot study.
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Affiliation(s)
- Satoshi Watanabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan.
| | - Eri Izuhara
- Department of Oral and Maxillofacial Surgery, Handa City Hospital, Aichi, Japan
| | - Hideo Oh-Shige
- Department of Oral and Maxillofacial Surgery, Kuwana City Medical Center, Mie, Japan
| | - Hitoshi Miyachi
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Mitsuo Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Shogo Hasegawa
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Satoru Miyabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Yoshiki Nagasaka
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Kazuo Shimozato
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
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Choline Acetyltransferase Induces the Functional Regeneration of the Salivary Gland in Aging SAMP1/Kl -/- Mice. Int J Mol Sci 2021; 22:ijms22010404. [PMID: 33401680 PMCID: PMC7796039 DOI: 10.3390/ijms22010404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 01/09/2023] Open
Abstract
Salivary gland dysfunction induces salivary flow reduction and a dry mouth, and commonly involves oral dysfunction, tooth structure deterioration, and infection through reduced salivation. This study aimed to investigate the impact of aging on the salivary gland by a metabolomics approach in an extensive aging mouse model, SAMP1/Klotho -/- mice. We found that the salivary secretion of SAMP1/Klotho -/- mice was dramatically decreased compared with that of SAMP1/Klotho WT (+/+) mice. Metabolomics profiling analysis showed that the level of acetylcholine was significantly decreased in SAMP1/Klotho -/- mice, although the corresponding levels of acetylcholine precursors, acetyl-CoA and choline, increased. Interestingly, the mRNA and protein expression of choline acetyltransferase (ChAT), which is responsible for catalyzing acetylcholine synthesis, was significantly decreased in SAMP1/Klotho -/- mice. The overexpression of ChAT induced the expression of salivary gland functional markers (α–amylase, ZO-1, and Aqua5) in primary cultured salivary gland cells from SAMP1/Klotho +/+ and -/- mice. In an in vivo study, adeno-associated virus (AAV)-ChAT transduction significantly increased saliva secretion compared with the control in SAMP1/Klotho -/- mice. These results suggest that the dysfunction in acetylcholine biosynthesis induced by ChAT reduction may cause impaired salivary gland function
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Criado C, Muñoz-González C, Pozo-Bayón MÁ. Differences in salivary flow and composition between age groups are correlated to dynamic retronasal aroma perception during wine consumption. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2020.104046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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70
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Kodintsev AN, Kovtun OP, Volkova LI. Saliva Biomarkers in Diagnostics of Early Stages of Alzheimer’s Disease. NEUROCHEM J+ 2020. [DOI: 10.1134/s1819712420040042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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71
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Abstract
Background:Burning mouth syndrome (BMS) is a chronic and debilitating oral pain of the normal oral mucosa. It mainly affects women in their fifth to seventh decade. Its aetiopathogenesis remains unclear and is probably of multifactorial origin, with increasing evidence that BMS may be a neuropathic disorder. BMS is classified as an idiopathic (nociplastic) orofacial pain with or without somatosensory changes by International Classification of Orofacial Pain (ICOP 2020). The diagnosis of BMS, having excluded ‘oral burning mouth symptoms’, has evolved from basic intraoral exclusion screening to extensive clinical and laboratory investigations, which include the screening of comorbidities and other chronic pains and somatosensory testing. There is no standardised treatment in managing BMS, but a proposed combination of supportive and pharmacological treatment has been recommended.Aim:To review the current concepts of BMS definitions, classifications, aetiopathogenesis, diagnosis techniques, and evidence-based treatments in managing BMS patients.Conclusion:As BMS is a diagnosis by exclusion, thus a stratified approach is required for assessment of patients presenting BMS. A BMS diagnosis protocol is desired using a standardised screening to distinguish BMS from patient’s presenting with ‘oral burning symptoms’, and evaluation of comorbid chronic pain disorders or other medical comorbidities, which will include haematological, fungal, salivary flow, and qualitative sensory testing. Axis II and other additional quantitative sensory testing may further elucidate the causes of this condition. For future BMS prediction and prevention, will be based upon research on the relationship between other chronic pain disorders and familial history, environmental and genetic information.
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Affiliation(s)
- Huann Lan Tan
- King’s College London, London, UK
- Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Tara Renton
- Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
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72
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Ohara Y, Kawai H, Shirobe M, Motokawa K, Fujiwara Y, Kim H, Ihara K, Obuchi S, Edahiro A, Iwasaki M, Watanabe Y, Hirano H. Association between anorexia and hyposalivation in community-dwelling older adults in Japan: a 6-year longitudinal study. BMC Geriatr 2020; 20:504. [PMID: 33238938 PMCID: PMC7691094 DOI: 10.1186/s12877-020-01905-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hyposalivation is associated with the nutritional status. Anorexia of ageing, defined as an age-related decrease in appetite and food intake, presents even in healthy adults and is considered an independent predictor of malnutrition, frailty, and mortality. However, the relationship between anorexia and hyposalivation of ageing is unclear. Thus, the present longitudinal study aimed to investigate the incidence of hyposalivation and its relationship with anorexia in community-dwelling older people in Japan. METHODS The study population comprised 220 individuals (80 men and 140 women) aged 65-86 years at baseline. The participants underwent comprehensive health check-ups, including dental examinations and anthropometry, and face-to-face interviews in 2013 and 2019. Hyposalivation was determined on the basis of the unstimulated salivary flow rate measured using the modified cotton roll method. Anorexia was defined as a score of ≤29 in the Japanese version of the Council on Nutrition Appetite Questionnaire. Logistic regression analyses were used to test whether the presence of anorexia at baseline was an independent predictor of hyposalivation. RESULTS Hyposalivation developed at a rate of 19.5% during the 6-year observation period. Anorexia was observed in 95 (43.2%) participants at baseline. After adjusting for potential confounding factors, anorexia (adjusted odds ratio [AOR], 2.65; 95% confidence interval [CI], 1.26-5.57) and polypharmacy (AOR, 3.29; CI, 1.06-10.19) were significant predictors of hyposalivation. CONCLUSION Loss of appetite is independently correlated with and a risk factor for hyposalivation in older adults. Anorexia of ageing may have negative effects on the salivary flow rate in such settings. Salivation should be a standard feature in clinical assessments of the older adults.
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Affiliation(s)
- Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan.
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Maki Shirobe
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yutaka Watanabe
- Department of Oral Health Science, Gerodontology, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
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Gavrilović I, Musenga A, Cowan D, Woffendin A, Smart A, Gong F, Harding D, Wolff K. Artificial oral fluid characterisation: Potential for use as a reference matrix in drug testing. Drug Test Anal 2020; 13:709-719. [PMID: 33025712 DOI: 10.1002/dta.2938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/29/2022]
Abstract
Quality assurance schemes for drug-screening programmes require access to large quantities of biological matrices for reference or control samples. This presents problems when the availability of a matrix, such as oral fluid (OF) for screening or for confirmatory purposes, limits the collection of large volumes. In such cases, synthetic alternatives of OF may provide a solution. The preparation of an artificial (synthetic) oral fluid (AOF) was conducted by dissolving its components (salts, surfactant, antimicrobial agent and mucin) in water. We characterised the physical properties of AOF to determine its suitability as a matrix for quality assurance purposes. The evaluation of pH, specific gravity (SG), conductivity (mS cm-1 ), freezing point depression (°C), light-scattering and kinematic viscosity (mm2 s-1 ) showed AOF to be a stable, reliable matrix. Synthetic OF was prepared using components (mucin, surfactants and so on) obtained from different suppliers and a comparison was performed. Our results suggest that AOF is a feasible matrix for the preparation of quality assurance samples for confirmatory or drug screening programmes.
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Affiliation(s)
- Ivana Gavrilović
- Drug Control Centre, King's Forensics, King's College London, London, UK
| | - Alessandro Musenga
- Drug Control Centre, King's Forensics, King's College London, London, UK.,Laboratoire Suisse d'Analyse du Dopage, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland
| | - David Cowan
- Drug Control Centre, King's Forensics, King's College London, London, UK.,Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK
| | - Alison Woffendin
- Drug Control Centre, King's Forensics, King's College London, London, UK
| | - Andrew Smart
- Drug Control Centre, King's Forensics, King's College London, London, UK
| | - Fan Gong
- Home Office, Centre for Applied Science and Technology (CAST), London, UK
| | - Duncan Harding
- Home Office, Centre for Applied Science and Technology (CAST), London, UK
| | - Kim Wolff
- Drug Control Centre, King's Forensics, King's College London, London, UK.,Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK
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Muñoz-González C, Feron G, Canon F. Physiological and oral parameters contribute prediction of retronasal aroma release in an elderly cohort. Food Chem 2020; 342:128355. [PMID: 33077286 DOI: 10.1016/j.foodchem.2020.128355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
Malnutrition is a serious problem in the elderly while understanding flavour perception could be a tool for controlling appetite or food choices. To increase our knowledge, we characterised the health and oral physiology (oral volume, swallowing tongue force, number of teeth and salivary flow rate, protein content and antioxidant capacity) of a cohort of 54 community-dwelling French elderly as well as their individual retronasal release of five aroma compounds (2-pentanone, 2-nonanone, 2,3-hexanedione, octanal and linalool) by proton-transfer-reaction mass spectrometry (PTR-MS). In general, large variability across participants was observed in both oral physiological (>40%) and retronasal aroma release (>56%) parameters. Multivariate analyses revealed a relationship between physiological parameters (mostly salivary antioxidant capacity) and retronasal aroma release that explained up to 46% of the variability observed. This study provides new insights to understand retronasal aroma release in the elderly that could contribute to the development of personalised nutrition strategies.
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Affiliation(s)
- Carolina Muñoz-González
- Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, UMR6265 CNRS Université de Bourgogne, Agrosup Dijon, F-21000 Dijon, France.
| | - Gilles Feron
- Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, UMR6265 CNRS Université de Bourgogne, Agrosup Dijon, F-21000 Dijon, France
| | - Francis Canon
- Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, UMR6265 CNRS Université de Bourgogne, Agrosup Dijon, F-21000 Dijon, France
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Pina GDMS, Mota Carvalho R, Silva BSDF, Almeida FT. Prevalence of hyposalivation in older people: A systematic review and meta-analysis. Gerodontology 2020; 37:317-331. [PMID: 32965067 DOI: 10.1111/ger.12497] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/16/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The proportion of elders is increasing worldwide, and hyposalivation has been associated with the ageing process. Therefore, there has been growing interest in the frequency of hyposalivation in older people since it can cause transient or permanent problems that could affect oral health. OBJECTIVE To determine the prevalence of hyposalivation in older people (aged ≥ 60 years). METHODS The review was registered at Prospero - International Prospective Register of Systematic Reviews under number CRD42018106322. The search was performed in six electronic databases (Embase, LILACS, Medline, PubMed, Web of Science and Abstracts in Social Gerodontology) and grey literature (Google Scholar) for articles published up to February 2019. The methodology of selected studies was evaluated using the Meta-Analysis of Statistics Assessment and Review (MAStARI) risk of bias checklist. Meta-analyses were performed using Medcalc and Stata 15. RESULTS Thirteen studies totalising 3,885 individuals (≥60 years) were included in this systematic review. The meta-analysis showed an overall hyposalivation prevalence of 33.37% (95% confidence interval [CI] 23.90 - 43.57, P < .0001, n = 3,447). The prevalence of hyposalivation for unstimulated and stimulated methods was 33.39% (95% CI 21.08 - 46.96, P < .0001, n = 2,425 individuals) and 30.47% (95% CI 22.53-39.04, P < .0001, n = 1,495 individuals), respectively. Most of the studies were evaluated as low risk of bias. Some study limitations were related to the observational studies potential risk of bias, and different criteria to measure saliva flow rate. CONCLUSION This study suggests that the overall prevalence of hyposalivation in older people is 33.37%. When considering stimulated methods, the prevalence of hyposalivation was slightly lower (30.47%).
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Norton V, Lignou S, Bull SP, Gosney MA, Methven L. Consistent Effects of Whey Protein Fortification on Consumer Perception and Liking of Solid Food Matrices (Cakes and Biscuits) Regardless of Age and Saliva Flow. Foods 2020; 9:foods9091328. [PMID: 32967299 PMCID: PMC7555850 DOI: 10.3390/foods9091328] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/23/2022] Open
Abstract
Although there are numerous high protein products on the market, they are typically not designed with, or for, older consumers. This is surprising considering that dietary guidelines recognise the need for higher protein intake in later life. Protein fortified products are, however, associated with negative sensory attributes and poor consumer acceptance. This paper investigates the extent of mouthdrying sensations within a high protein solid food matrix, along with the effect of age and saliva flow. Solid models using cakes and biscuits, with or without protein fortification, were investigated. The sensory profile and physical properties were analysed and two volunteer studies (n = 84; n = 70) were carried out using two age groups (18–30; 65+). Volunteers rated individual perception and liking of products, and salivary flow rates (mL/min) were measured. Unstimulated salivary flow rates were significantly lower (p < 0.05) in older adults, although this was not found to influence product perception. Protein fortification of cakes and biscuits significantly increased (p < 0.05) perceived mouthdrying, hardness and “off” flavours, and significantly reduced (p < 0.05) melting rate, moistness and liking compared with the control versions. There is a clear need to address negative sensory attributes associated with protein fortification of cakes and biscuits to ensure product suitability for older adults.
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Affiliation(s)
- Victoria Norton
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading RG6 6DZ, UK; (V.N.); (S.L.); (S.P.B.)
| | - Stella Lignou
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading RG6 6DZ, UK; (V.N.); (S.L.); (S.P.B.)
| | - Stephanie P. Bull
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading RG6 6DZ, UK; (V.N.); (S.L.); (S.P.B.)
| | - Margot A. Gosney
- Royal Berkshire NHS Foundation Trust, London Road, Reading RG1 5AN, UK;
| | - Lisa Methven
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading RG6 6DZ, UK; (V.N.); (S.L.); (S.P.B.)
- Correspondence: ; Tel.: +44-(0)118-378-8714
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Wati SM, Matsumaru D, Motohashi H. NRF2 pathway activation by KEAP1 inhibition attenuates the manifestation of aging phenotypes in salivary glands. Redox Biol 2020; 36:101603. [PMID: 32590331 PMCID: PMC7322188 DOI: 10.1016/j.redox.2020.101603] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 12/20/2022] Open
Abstract
Saliva plays an essential role in the maintenance of oral health. The oral cavity environment changes during aging mainly due to alterations in the secretion and composition of saliva. In particular, unstimulated basal salivary flow decreases with age. The functional decline of the salivary glands impairs chewing and swallowing abilities and often becomes one of the predispositions for aging-related disorders, including aspiration pneumonia. The KEAP1-NRF2 system plays a central role in the regulation of the oxidative stress response. NRF2 is a transcription factor that coordinately regulates cytoprotective genes, and KEAP1 is a negative regulator of NRF2. Although NRF2 activation has been suggested to be advantageous for the prevention of aging-related diseases, its role in the course of physiological aging is not well understood. To investigate the impact of NRF2 activation on salivary gland aging, we compared the submandibular glands of Keap1-knockdown (KD) (Keap1FA/FA) mice in which NRF2 is activated with those of wild-type mice. Young mice did not show any apparent differences between the two genotypes, whereas in old mice, clear differences were observed. Aged wild-type submandibular glands exhibited iron and collagen depositions, immune cell infiltration and increased DNA damage and apoptosis accompanied by elevated oxidative stress, which were all markedly attenuated in Keap1-KD mice, suggesting that NRF2 activation has antiaging effects on salivary glands. We propose that appropriate activation of NRF2 is effective for the maintenance of healthy salivary gland conditions and for the prevention of hyposalivation in the elderly.
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Affiliation(s)
- Sisca Meida Wati
- Department of Gene Expression Regulation, Institute of Development, Aging and Cancer, Tohoku University, Japan
| | - Daisuke Matsumaru
- Department of Gene Expression Regulation, Institute of Development, Aging and Cancer, Tohoku University, Japan
| | - Hozumi Motohashi
- Department of Gene Expression Regulation, Institute of Development, Aging and Cancer, Tohoku University, Japan.
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Norton V, Lignou S, Bull SP, Gosney MA, Methven L. An Investigation of the Influence of Age and Saliva Flow on the Oral Retention of Whey Protein and Its Potential Effect on the Perception and Acceptance of Whey Protein Beverages. Nutrients 2020; 12:E2506. [PMID: 32825104 PMCID: PMC7551043 DOI: 10.3390/nu12092506] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/07/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Protein fortified products are regularly recommended to older adults to improve nutritional status and limit sarcopenia. However protein fortification can elicit negative sensory attributes such as mouthdrying. Sensitivity to mouthdrying can increase with age, yet the influence of saliva flow and mucoadhesion remain uncertain. Here, two studies tested different whey protein beverages (WPB); 22 healthy younger volunteers completed a pilot and 84 healthy volunteers from two age groups (18-30; 65+) completed the main study. In both studies salivary flow rates (mL/min) were measured and saliva samples were collected at time intervals post beverage consumption to measure mucoadhesion to the oral cavity, where protein concentration was analysed by Bradford Assay. Volunteers rated perception and acceptability of WPBs in the main study. WPB consumption resulted in significantly increased protein concentration (p < 0.0001) in saliva samples compared with a control whey permeate beverage. Older adults had significantly lower unstimulated saliva flow (p = 0.003) and significantly increased protein concentration (p = 0.02) in saliva samples, compared with younger adults. Heating of WPB significantly (p < 0.05) increased mouthdrying and thickness perception and reduced sweetness compared with unheated WPB. Mucoadhesion is concluded to be a true phenomenon in WPBs and increases with age.
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Affiliation(s)
- Victoria Norton
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, Berkshire RG6 6AD, UK; (V.N.); (S.L.); (S.P.B.)
| | - Stella Lignou
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, Berkshire RG6 6AD, UK; (V.N.); (S.L.); (S.P.B.)
| | - Stephanie P. Bull
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, Berkshire RG6 6AD, UK; (V.N.); (S.L.); (S.P.B.)
| | - Margot A. Gosney
- Royal Berkshire NHS Foundation Trust, London Road, Reading RG1 5AN, UK;
| | - Lisa Methven
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, Berkshire RG6 6AD, UK; (V.N.); (S.L.); (S.P.B.)
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Rogus-Pulia NM, Plowman EK. Shifting Tides Toward a Proactive Patient-Centered Approach in Dysphagia Management of Neurodegenerative Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1094-1109. [PMID: 32650651 PMCID: PMC7844336 DOI: 10.1044/2020_ajslp-19-00136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Purpose Persons with neurodegenerative disease frequently develop comorbid dysphagia as part of their disease process. Current "reactive" approaches to dysphagia management address dysphagia once it manifests clinically and consist of compensatory approaches. The purpose of this article is to propose a paradigm shift in dysphagia management of patients with neurodegenerative disease from a "reactive to proactive" approach by highlighting amyotrophic lateral sclerosis (ALS) and dementia as case examples. Method The authors present several areas of special consideration for speech-language pathologists (SLPs) treating dysphagia in patients with neurodegenerative disease. The drawbacks of historical "reactive" approaches to dysphagia management are described. Concepts of functional reserve for swallowing and homeostenosis are discussed. A "proactive" patient-centered paradigm of care for these patients is proposed with evidence to support its importance. A rationale for use of this approach in patients with ALS and dementia is provided with strategies for implementation. Results When treating dysphagia in patients with neurodegenerative disease, SLPs must balance a variety of factors in their decision making, including disease severity and expected progression, cultural considerations, goals of care, patient empowerment, and caregiver support. Reactive approaches to dysphagia management in these populations are problematic in that they disempower patients by focusing on use of compensatory techniques (e.g., diet modification, postural changes, feeding tube placement). Proactive approaches that employ rehabilitative interventions to increase functional reserve, such as resistance training, may result in improvement or maintenance of swallowing function longer into disease progression. An interdisciplinary team with early SLP involvement is necessary. Conclusions SLPs play a critical role in the management of dysphagia in patients with neurodegenerative disease and should be integrated early in the care of these patients. By focusing on a proactive patient-centered approach, patients with neurodegenerative conditions, such as ALS and dementia, will experience improved quality of life and health outcomes for a longer time.
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Affiliation(s)
- Nicole M. Rogus-Pulia
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health
- Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Emily K. Plowman
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville
- Aerodigestive Research Core, University of Florida, Gainesville
- Department of Neurology, College of Medicine, University of Florida, Gainesville
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D’Agostino C, Elkashty OA, Chivasso C, Perret J, Tran SD, Delporte C. Insight into Salivary Gland Aquaporins. Cells 2020; 9:cells9061547. [PMID: 32630469 PMCID: PMC7349754 DOI: 10.3390/cells9061547] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022] Open
Abstract
The main role of salivary glands (SG) is the production and secretion of saliva, in which aquaporins (AQPs) play a key role by ensuring water flow. The AQPs are transmembrane channel proteins permeable to water to allow water transport across cell membranes according to osmotic gradient. This review gives an insight into SG AQPs. Indeed, it gives a summary of the expression and localization of AQPs in adult human, rat and mouse SG, as well as of their physiological role in SG function. Furthermore, the review provides a comprehensive view of the involvement of AQPs in pathological conditions affecting SG, including Sjögren's syndrome, diabetes, agedness, head and neck cancer radiotherapy and SG cancer. These conditions are characterized by salivary hypofunction resulting in xerostomia. A specific focus is given on current and future therapeutic strategies aiming at AQPs to treat xerostomia. A deeper understanding of the AQPs involvement in molecular mechanisms of saliva secretion and diseases offered new avenues for therapeutic approaches, including drugs, gene therapy and tissue engineering. As such, AQP5 represents a potential therapeutic target in different strategies for the treatment of xerostomia.
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Affiliation(s)
- Claudia D’Agostino
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, 808 Route de Lennik, Blg G/E CP 611, B-1070 Brussels, Belgium; (C.D.); (C.C.); (J.P.)
| | - Osama A. Elkashty
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada; (O.A.E.); (S.D.T.)
- Oral Pathology Department, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt
| | - Clara Chivasso
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, 808 Route de Lennik, Blg G/E CP 611, B-1070 Brussels, Belgium; (C.D.); (C.C.); (J.P.)
| | - Jason Perret
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, 808 Route de Lennik, Blg G/E CP 611, B-1070 Brussels, Belgium; (C.D.); (C.C.); (J.P.)
| | - Simon D. Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada; (O.A.E.); (S.D.T.)
| | - Christine Delporte
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, 808 Route de Lennik, Blg G/E CP 611, B-1070 Brussels, Belgium; (C.D.); (C.C.); (J.P.)
- Correspondence: ; Tel.: +32-2-5556210
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Flink H, Tegelberg Å, Arnetz JE, Birkhed D. Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults. Acta Odontol Scand 2020; 78:229-235. [PMID: 31729277 DOI: 10.1080/00016357.2019.1690677] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective: The aim was to study prevalence of xerostomia, hyposalivation and quality of life among caries active younger adults.Materials and methods: A questionnaire regarding oral and general health, xerostomia and quality of life was mailed to 134 caries active (CA) and 40 caries inactive (CI) patients, 25-50 years of age (mean age 39.9 ± 6.2 years) treated at a Swedish Public Dental Service clinic, regarding oral and general health, xerostomia and quality of life. Caries data and unstimulated whole salivary flow rates were obtained from dental records.Results: The overall response rate was 69%. Dental records confirmed that CA patients had more decayed teeth over time than CI patients (p < .001). The CA group reported worse oral health (p < .001) and general health (p < .01), more xerostomia (p < .001) and lower salivary flow rate (p < .01) compared to CI patients. Xerostomia was inversely related to unstimulated whole salivary flow rates as well as to oral and general health (p < .01). There were no differences between groups in quality of life.Conclusion: Younger caries active adult patients reported significantly more xerostomia and hyposalivation compared to caries inactive patients. Xerostomia and hyposalivation were inversely related to perceptions of oral and general health, but not to quality of life.
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Affiliation(s)
- Håkan Flink
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
- Public Dental Clinic Sala, Public Dental Health Västmanland, Sala, Sweden
| | - Åke Tegelberg
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Judith E. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Murugesan S, Al Ahmad SF, Singh P, Saadaoui M, Kumar M, Al Khodor S. Profiling the Salivary microbiome of the Qatari population. J Transl Med 2020; 18:127. [PMID: 32169076 PMCID: PMC7071716 DOI: 10.1186/s12967-020-02291-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/04/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The role of the human microbiome in human health and disease has been studied in various body sites. However, compared to the gut microbiome, where most of the research focus is, the salivary microbiome still bears a vast amount of information that needs to be revealed. This study aims to characterize the salivary microbiome composition in the Qatari population, and to explore specific microbial signatures that can be associated with various lifestyles and different oral conditions. MATERIALS AND METHODS We characterized the salivary microbiome of 997 Qatari adults using high-throughput sequencing of the V1-V3 region of the 16S rRNA gene. RESULTS In this study, we have characterized the salivary microbiome of 997 Qatari participants. Our data show that Bacteroidetes, Firmicutes, Actinobacteria and Proteobacteria are the common phyla isolated from the saliva samples, with Bacteroidetes being the most predominant phylum. Bacteroidetes was also more predominant in males versus females in the study cohort, although differences in the microbial diversity were not statistically significant. We also show that, a lower diversity of the salivary microbiome is observed in the elderly participants, with Prevotella and Treponema being the most significant genera. In participants with oral conditions such as mouth ulcers, bleeding or painful gum, our data show that Prevotella and Capnocytophaga are the most dominant genera as compared to the controls. Similar patterns were observed in participants with various smoking habits as compared to the non-smoking participants. Our data show that Streptococcus and Neisseria are more dominant among denture users, as compared to the non-denture users. Our data also show that, abnormal oral conditions are associated with a reduced microbial diversity and microbial richness. Moreover, in this study we show that frequent coffee drinkers have higher microbial diversity compared to the non-drinkers, indicating that coffee may cause changes to the salivary microbiome. Furthermore, tea drinkers show higher microbial richness as compared to the non-tea drinkers. CONCLUSION This is the first study to assess the salivary microbiome in an Arab population, and one of the largest population-based studies aiming to the characterize the salivary microbiome composition and its association with age, oral health, denture use, smoking and coffee-tea consumption.
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Affiliation(s)
| | | | - Parul Singh
- Research Department, Sidra Medicine, Doha, Qatar
| | | | - Manoj Kumar
- Research Department, Sidra Medicine, Doha, Qatar
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Lacombe V, Lacout C, Lozac'h P, Ghali A, Gury A, Lavigne C, Urbanski G. Unstimulated whole saliva flow for diagnosis of primary Sjögren's syndrome: time to revisit the threshold? Arthritis Res Ther 2020; 22:38. [PMID: 32093745 PMCID: PMC7041275 DOI: 10.1186/s13075-020-2132-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background Unstimulated whole saliva (UWS) flow rate is one of the ACR/EULAR 2016 criteria for primary Sjögren’s syndrome (pSS). With a single threshold of ≤ 0.1 mL/min, UWS flow does not take into account the age- and sex-related physiological variations. Furthermore, it has a low sensitivity for the diagnosis of pSS (about 50%), contrary to the screening test for xerophthalmia, Schirmer’s test (sensitivity of about 70%). We aimed to identify UWS thresholds allowing better performances for a screening test for pSS comparable to Schirmer’s test, and considering age- and sex-related variations. Methods A prospective cohort of 185 patients with oral and/or ocular dryness was classified into 3 groups: men, women < 50 (< 50 years old), and women ≥ 50 (≥ 50 years old). The diagnostic performances of UWS flow rate in these groups were compared in terms of sensitivity, specificity, positive and negative predictive values, and ROC curves. The identification of thresholds that optimize diagnostic performances was carried out using Youden’s index. Results The diagnostic performances of UWS flow rate varied according to age and sex. UWS had poor diagnostic performances whatever the threshold in the women ≥ 50 group. The threshold of 0.2 mL/min had a sensitivity of ≥ 70% and a specificity of ≥ 50% in both men and women < 50 groups. In the whole population and compared to the current cutoff, a threshold of 0.2 mL/min increased sensitivity (+ 19.8%) and positive (+ 2.3%) and negative (+ 7.0%) predictive values, with a better specificity (65.2%) than Schirmer’s test. Conclusion For objective assessment of xerostomia, raising the threshold of the UWS flow rate to 0.2 mL/min would optimize its screening performances for pSS.
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Affiliation(s)
- Valentin Lacombe
- Department of Internal Medicine, University Hospital, 4 rue Larrey, 49000, Angers, France
| | - Carole Lacout
- Department of Internal Medicine, University Hospital, 4 rue Larrey, 49000, Angers, France
| | - Pierre Lozac'h
- Department of Internal Medicine, University Hospital, 4 rue Larrey, 49000, Angers, France
| | - Alaa Ghali
- Department of Internal Medicine, University Hospital, 4 rue Larrey, 49000, Angers, France
| | - Aline Gury
- Department of Internal Medicine, University Hospital, 4 rue Larrey, 49000, Angers, France
| | - Christian Lavigne
- Department of Internal Medicine, University Hospital, 4 rue Larrey, 49000, Angers, France
| | - Geoffrey Urbanski
- Department of Internal Medicine, University Hospital, 4 rue Larrey, 49000, Angers, France.
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Abu-Ghanem S, Chen S, Amin MR. Oropharyngeal Dysphagia in the Elderly: Evaluation and Prevalence. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00258-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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85
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Pedrosa MDS, Sipert CR, Nogueira FN. Salivary Glands, Saliva and Oral Findings in COVID-19 Infection. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Ogawa Y, Kohyama K, Kusakabe Y. Salivation Correlates with Masseter Muscle Activity and Partially Depends on the Physical Characteristics and Volume of Food Consumed at One Time. FOOD SCIENCE AND TECHNOLOGY RESEARCH 2020. [DOI: 10.3136/fstr.26.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Yukino Ogawa
- Food Research Institute, National Agriculture and Food Research Organization (NARO)
| | - Kaoru Kohyama
- Food Research Institute, National Agriculture and Food Research Organization (NARO)
| | - Yuko Kusakabe
- Food Research Institute, National Agriculture and Food Research Organization (NARO)
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Ketel EC, de Wijk RA, de Graaf C, Stieger M. Relating oral physiology and anatomy of consumers varying in age, gender and ethnicity to food oral processing behavior. Physiol Behav 2019; 215:112766. [PMID: 31812520 DOI: 10.1016/j.physbeh.2019.112766] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/11/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022]
Abstract
The aim of this study was to link parameters describing oral physiology and anatomy of consumers varying in age, gender and ethnicity to food oral processing behavior. Three groups of healthy consumers were compared: Dutch, Caucasian adults (18-30 yrs, n =32), Chinese, Asian adults (18-30 yrs, n =32) and Dutch, Caucasian older adults (65-85 yrs, n =32). Mastication performance, salivary flow rate (stimulated and unstimulated) and dental status were quantified to characterize oral physiology. Volume of oral cavity, tongue dimensions, facial anthropometry, height and weight were quantified to characterize anatomy. Oral processing behavior of three solid foods (carrot, cheese and sausage) was quantified by video recordings and eating rate (g/s), average consumption time (s), chews per bite (-) and average bite size (g) were determined. Dutch, Caucasian older adults had smaller volume of oral cavity, lower number of teeth and larger head width compared to Dutch, Caucasian adults. Chinese, Asian adults showed significantly higher mastication performance and larger head width compared to Dutch, Caucasian consumers, while dental status did not significantly differ between groups. Males had significantly larger volumes of oral cavity and larger head height and width compared to females. Dutch, Caucasian adults had a shorter average consumption time (s), less chews per bite and consumed the three foods with higher eating rate (g/s) compared to Dutch, Caucasian older adults. Chinese, Asian adults had a significantly longer average consumption time (s), more chews per bite, smaller average bite size (g) and lower eating rate (g/s) compared to Dutch, Caucasian adults. Twenty-one significant relationships were found between oral physiological and anatomical parameters and oral processing behavior. Body weight resulted in the largest β-values, indicating to be the anatomical parameter of largest influence on oral processing behavior. We conclude that only few oral physiological and anatomical parameters related with food oral processing behavior. We suggest that other factors, including cultural factors contribute to variation in food oral processing behavior between different consumer groups more than saliva flow, volume of oral cavity, mastication performance and dental status.
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Affiliation(s)
- Eva C Ketel
- TiFN, P.O. Box 557, AN Wageningen 6700, the Netherlands; Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.
| | - Rene A de Wijk
- TiFN, P.O. Box 557, AN Wageningen 6700, the Netherlands; Food and Biobased Research, Wageningen University, Wageningen, the Netherlands
| | - Cees de Graaf
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Markus Stieger
- TiFN, P.O. Box 557, AN Wageningen 6700, the Netherlands; Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
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Ashton NJ, Ide M, Zetterberg H, Blennow K. Salivary Biomarkers for Alzheimer's Disease and Related Disorders. Neurol Ther 2019; 8:83-94. [PMID: 31833026 PMCID: PMC6908535 DOI: 10.1007/s40120-019-00168-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Indexed: 12/13/2022] Open
Abstract
The search for accessible and cost-effective biomarkers to complement current cerebrospinal fluid (CSF) and imaging biomarkers in the accurate detection of Alzheimer disease (AD) and other common neurodegenerative disorders remains a challenging task. The advances in ultra-sensitive detection methods has highlighted blood biomarkers (e.g. amyloid-β and neurofilament light) as a valuable and realistic tool in a diagnostic or screening process. Saliva, however, is also a rich source of potential biomarkers for disease detection and offers several practical advantages over biofluids that are currently examined for neurodegenerative disorders. However, while this may be true for the general population, challenges in collecting saliva from an elderly population should be seriously considered. In this review, we begin by discussing how saliva is produced and how age-related conditions can modify saliva production and composition. We then focus on the data available which support the concept of salivary amyloid-β, tau species and novel biomarkers in detecting AD and alpha-synuclein (α-syn) in Parkinson's disease (PD).
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Affiliation(s)
- Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK.
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK.
| | - Mark Ide
- Periodontology, Centre for Host Microbiome Interactions, Faculty of Dental, Oral and Craniofacial Sciences, King's College London, London, UK
- Mucosal and Salivary Biology, Centre for Host Microbiome Interactions, Faculty of Dental, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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89
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Azzolino D, Passarelli PC, De Angelis P, Piccirillo GB, D’Addona A, Cesari M. Poor Oral Health as a Determinant of Malnutrition and Sarcopenia. Nutrients 2019; 11:E2898. [PMID: 31795351 PMCID: PMC6950386 DOI: 10.3390/nu11122898] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 12/13/2022] Open
Abstract
Aging is accompanied by profound changes in many physiological functions, leading to a decreased ability to cope with stressors. Many changes are subtle, but can negatively affect nutrient intake, leading to overt malnutrition. Poor oral health may affect food selection and nutrient intake, leading to malnutrition and, consequently, to frailty and sarcopenia. On the other hand, it has been highlighted that sarcopenia is a whole-body process also affecting muscles dedicated to chewing and swallowing. Hence, muscle decline of these muscle groups may also have a negative impact on nutrient intake, increasing the risk for malnutrition. The interplay between oral diseases and malnutrition with frailty and sarcopenia may be explained through biological and environmental factors that are linked to the common burden of inflammation and oxidative stress. The presence of oral problems, alone or in combination with sarcopenia, may thus represent the biological substratum of the disabling cascade experienced by many frail individuals. A multimodal and multidisciplinary approach, including personalized dietary counselling and oral health care, may thus be helpful to better manage the complexity of older people. Furthermore, preventive strategies applied throughout the lifetime could help to preserve both oral and muscle function later in life. Here, we provide an overview on the relevance of poor oral health as a determinant of malnutrition and sarcopenia.
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Affiliation(s)
- Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Pier Carmine Passarelli
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Paolo De Angelis
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Giovan Battista Piccirillo
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Antonio D’Addona
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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90
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Strategies for Developing Functional Secretory Epithelia from Porcine Salivary Gland Explant Outgrowth Culture Models. Biomolecules 2019; 9:biom9110657. [PMID: 31717706 DOI: 10.3390/biom9110657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 12/15/2022] Open
Abstract
Research efforts have been made to develop human salivary gland (SG) secretory epithelia for transplantation in patients with SG hypofunction and dry mouth (xerostomia). However, the limited availability of human biopsies hinders the generation of sufficient cell numbers for epithelia formation and regeneration. Porcine SG have several similarities to their human counterparts, hence could replace human cells in SG modelling studies in vitro. Our study aims to establish porcine SG explant outgrowth models to generate functional secretory epithelia for regeneration purposes to rescue hyposalivation. Cells were isolated and expanded from porcine submandibular and parotid gland explants. Flow cytometry, immunocytochemistry, and gene arrays were performed to assess proliferation, standard mesenchymal stem cell, and putative SG epithelial stem/progenitor cell markers. Epithelial differentiation was induced and different SG-specific markers investigated. Functional assays upon neurostimulation determined α-amylase activity, trans-epithelial electrical resistance, and calcium influx. Primary cells exhibited SG epithelial progenitors and proliferation markers. After differentiation, SG markers were abundantly expressed resembling epithelial lineages (E-cadherin, Krt5, Krt14), and myoepithelial (α-smooth muscle actin) and neuronal (β3-tubulin, Chrm3) compartments. Differentiated cells from submandibular gland explant models displayed significantly greater proliferation, number of epithelial progenitors, amylase activity, and epithelial barrier function when compared to parotid gland models. Intracellular calcium was mobilized upon cholinergic and adrenergic neurostimulation. In summary, this study highlights new strategies to develop secretory epithelia from porcine SG explants, suitable for future proof-of-concept SG regeneration studies, as well as for testing novel muscarinic agonists and other biomolecules for dry mouth.
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91
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Christmas C, Rogus-Pulia N. Swallowing Disorders in the Older Population. J Am Geriatr Soc 2019; 67:2643-2649. [PMID: 31430395 DOI: 10.1111/jgs.16137] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/12/2019] [Accepted: 07/20/2019] [Indexed: 12/12/2022]
Abstract
Swallowing problems, or dysphagia, are common as people age, and are associated with significant negative outcomes, including weight loss, pneumonia, dehydration, shortened life expectancy, reduced quality of life, and increased caregiver burden. In this article, we will discuss the complex process of swallowing in normal circumstances and with healthy aging, then review etiologies that contribute to dysphagia. We will discuss approaches to evaluating and treating dysphagia, providing relevant data where they are available. We highlight the desperate need for high-quality research to guide best practices in treating dysphagia in older adults. J Am Geriatr Soc 67:2643-2649, 2019.
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Affiliation(s)
- Colleen Christmas
- Divisions of Geriatric Medicine and General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nicole Rogus-Pulia
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
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92
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Pushpass RAG, Daly B, Kelly C, Proctor G, Carpenter GH. Altered Salivary Flow, Protein Composition, and Rheology Following Taste and TRP Stimulation in Older Adults. Front Physiol 2019; 10:652. [PMID: 31214042 PMCID: PMC6555201 DOI: 10.3389/fphys.2019.00652] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/08/2019] [Indexed: 11/13/2022] Open
Abstract
Taste and smell perceptions diminish in older age, impacting upon quality of life and nutrition, yet the causes of taste loss are largely unknown. Transient receptor potential channels (TRP) found on the oral mucosa are also involved in oral sensations including cooling and burning and may contribute to the eating experience of older people. Older adults often have reduced salivary flow and the physical properties of saliva may change, but the role of saliva in oral sensations of older adults is yet to be elucidated. Here, the effect of older age on subjective (perception) and objective (stimulated salivary response) measures of TRP stimulants, odors, and basic tastants was investigated. Whole mouth saliva was collected from younger (mean age 24 years) and older adults (mean age 72 years) following stimulation of taste [mono sodium glutamate (MSG) and caffeine], olfaction (menthol), and TRP receptors (capsaicin). Participants rated perceived intensity of each stimulus, and salivary properties were assessed. Older age was associated with 15% lower umami taste and 26% lower menthol odor perception, coupled with 17% lower salivary response to MSG. Interestingly, there were no differences for perception of TRP stimulants, so chemo-sensation was not affected by age. Younger adults had four times greater elasticity (Spinnbarkeit) with MUC7 levels almost double and 66% greater resting salivary flow rate. Stimulated salivary responses in the younger group were also higher compared to the older group, with changes in protein and viscoelasticity in response to taste and TRP stimulation. These results show the impact of older age upon taste and smell sensation which may lead to changes in the physical and compositional properties of saliva in response to taste/odor stimulation. Measurement of stimulated salivary flow and rheology provides an objective measure of taste in addition to subjective perceptions which can be influenced by participant bias. Chemo-sensation may be retained with age and trigeminal stimuli such as chili could be employed in future studies to enhance meals for an age group at risk of malnutrition. Alteration in salivary properties due to advanced age could impact on ability to taste due to poor diffusion of tastants and reduced oral surface protection.
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Affiliation(s)
- Rose-Anna Grace Pushpass
- Mucosal and Salivary Biology, Salivary Research, Faculty of Dental, Oral, Dental Sciences, Centre for Host Microbiome Interactions, King's College London, London, United Kingdom
| | - Blánaid Daly
- Child and Public Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Charles Kelly
- Mucosal and Salivary Biology, Salivary Research, Faculty of Dental, Oral, Dental Sciences, Centre for Host Microbiome Interactions, King's College London, London, United Kingdom
| | - Gordon Proctor
- Mucosal and Salivary Biology, Salivary Research, Faculty of Dental, Oral, Dental Sciences, Centre for Host Microbiome Interactions, King's College London, London, United Kingdom
| | - Guy Howard Carpenter
- Mucosal and Salivary Biology, Salivary Research, Faculty of Dental, Oral, Dental Sciences, Centre for Host Microbiome Interactions, King's College London, London, United Kingdom
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93
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Affiliation(s)
- Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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94
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Submandibular gland-specific inflammaging-induced hyposalivation in the male senescence-accelerated mouse prone -1 line (SAM-P1). Biogerontology 2019; 20:421-432. [PMID: 30684147 DOI: 10.1007/s10522-019-09797-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/04/2019] [Indexed: 12/20/2022]
Abstract
Aging has pronounced effects on mammalian tissues and cells, but the impacts of aging on salivary gland function are relatively unknown. This study aims to evaluate the effects of aging on submandibular gland (SMG) and parotid gland (PG) functions in the male senescence-accelerated mouse. In vivo analysis at the systemic level revealed that salivary secretion induced by pilocarpine, a muscarinic agonist, from the SMG was significantly decreased in aged mice, whereas salivary secretion from the PG was not affected. To evaluate organ-level function, the SMG was perfused with the muscarinic agonists carbachol and calcium ionophore A23187 ex vivo to induce salivary secretion, and decreased saliva production was also observed in the aged SMG. Histological analysis revealed the presence of CD4-positive lymphocytes infiltrating the aged SMG. Furthermore, real-time PCR revealed that the aged SMG exhibited accelerated cell aging, increased levels of the inflammatory cytokine interleukin-6, and decreased mRNA levels of the water channel protein aquaporin-5 (AQP5). In summary, these results demonstrate that SMG function in aged mice was diminished, and that cell senescence, chronic inflammation, and the decreased gene expression of AQP5 are the likely causes of hyposalivation in the SMG of aged mice.
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95
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A sialo-oligosaccharide-rich mucin-like molecule specifically detected in the submandibular glands of aged mice. Arch Oral Biol 2019; 97:52-58. [DOI: 10.1016/j.archoralbio.2018.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/04/2018] [Indexed: 11/20/2022]
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96
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Muñoz-González C, Brulé M, Feron G, Canon F. Does interindividual variability of saliva affect the release and metabolization of aroma compounds ex vivo? The particular case of elderly suffering or not from hyposalivation. J Texture Stud 2018; 50:36-44. [PMID: 30520036 DOI: 10.1111/jtxs.12382] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/11/2018] [Accepted: 11/22/2018] [Indexed: 12/25/2022]
Abstract
The aim of this work was to study the effects of interindividual variability of human elderly saliva on aroma release and metabolization by ex vivo approaches. Thirty individuals suffering or not from hyposalivation were selected from a panel formed by 110 elderly people (aged >65 years old) that were matched by age and sex. Then, their stimulated saliva samples were independently incubated in presence of three aroma compounds (ethyl hexanoate, octanal, 2-nonanone) to perform headspace-gas chromatography and liquid/liquid extraction-gas chromatography mass spectrometry analyses. These assays revealed that the extent of saliva effect on the release and metabolization of aroma compounds was highly dependent on the chemical family of the compounds (octanal>ethyl hexanoate>2-nonanone). Moreover, salivas from the hyposalivator (HPS) group exerted a significant lower release and/or higher metabolization than those of the control group for the three assayed compounds. Regarding the biochemical characterization of the saliva samples, no significant differences were found in the total protein content between the two groups. This does not preclude the involvement of specific proteins on the observed results that need to be clarified in further experiments. Saliva from the HPS group presented a significantly higher total antioxidant capacity than that of the control group, which suggests that this parameter could be related to the metabolization of aroma compounds by saliva. Such effects might alter aroma perception in individuals suffering from hyposalivation. PRACTICAL APPLICATIONS: The world population is getting older so fast that most countries are not prepared to handle this demographic challenge, characterized by an increasing prevalence of noncommunicable chronic diseases (e.g., diabetes, gastrointestinal disorders) associated to inadequate eating patterns. Thus, supporting a balanced diet is one of the most cost-effective strategies to maintain a good quality of life. A suitable diet needs to take into account both, specific sensory and nutritional individual needs. However, aging is often accompanied by deterioration in oral health (e.g., low salivary secretions), which could alter the capacities to taste and smell. Results from this work contribute to a better understanding of the role of human saliva in aroma release and metabolization, a first step to comprehend retronasal aroma release and perception. This knowledge will help to propose innovative solutions for the reformulation of food products better adapted to the elderly's needs, thus allowing delayed onset of dependency.
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Affiliation(s)
- Carolina Muñoz-González
- Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, UMR6265 CNRS Université de Bourgogne, Agrosup Dijon, Dijon, France
| | - Marine Brulé
- Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, UMR6265 CNRS Université de Bourgogne, Agrosup Dijon, Dijon, France
| | - Gilles Feron
- Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, UMR6265 CNRS Université de Bourgogne, Agrosup Dijon, Dijon, France
| | - Francis Canon
- Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, UMR6265 CNRS Université de Bourgogne, Agrosup Dijon, Dijon, France
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97
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Maniewicz S, Duvernay E, Srinivasan M, Perneger T, Schimmel M, Müller F. Effect of implant-supported mandibular overdentures versus reline on masticatory performance and salivary flow rates in very old adults-A randomized clinical trial. Clin Oral Implants Res 2018; 30:59-67. [PMID: 30500094 DOI: 10.1111/clr.13392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/02/2018] [Accepted: 11/04/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the masticatory efficiency (ME), maximum voluntary bite force (MBF), masseter muscle thickness (MMT), and salivary flow rates (SFR) in completely edentulous dependent elders treated either with a conversion of their existing mandibular complete removable dental prostheses (CRDPs) into a two-implant overdenture (IOD) or a conventional reline of the CRDP. MATERIAL AND METHODS Participants were randomly allocated into intervention (IG) and control (CG) groups. The IG received two implants in the mandibular canine regions, and their CRDPs were transformed into IODs. The CG received a conventional reline of their mandibular CRDPs. Outcomes were recorded at each recall visit (baseline, immediately, 3 months, 12 months after intervention, and subsequently on an annual basis). Statistical analyses used mixed linear regression models (level of significance: p < 0.05). RESULTS The IG comprised 16 participants (age = 85.0 ± 6.2 years), while the CG comprised 16 (age = 84.8 ± 5.4 years), with a mean follow-up of 2.7 ± 2.2 years (range: 3 months-7 years). A significant increase of MBF in the IG was observed with an overall gain of 80 N (p < 0.001) compared with the reline group. There were no significant long-term changes in SFR, MMT, or ME within/between groups. CONCLUSION Since dependent elders with mandibular IODs present a significant gain in MBF, but no relative increase in SFR, MMT, and ME, it seems that this increased capacity of MBF is not exploited by the elders during their habitual chewing.
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Affiliation(s)
- Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Elena Duvernay
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Thomas Perneger
- Division of Clinical Epidemiology, University Hospital of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospital of Geneva, Thônex, Switzerland
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98
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An R, Wilms E, Masclee AAM, Smidt H, Zoetendal EG, Jonkers D. Age-dependent changes in GI physiology and microbiota: time to reconsider? Gut 2018; 67:2213-2222. [PMID: 30194220 DOI: 10.1136/gutjnl-2017-315542] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/11/2018] [Accepted: 07/26/2018] [Indexed: 12/12/2022]
Abstract
Our life expectancy is increasing, leading to a rise in the ageing population. Ageing is associated with a decline in physiological function and adaptive capacity. Altered GI physiology can affect the amount and types of nutrients digested and absorbed as well as impact the intestinal microbiota. The intestinal microbiota is considered a key player in our health, and a variety of studies have reported that microbiota composition is changing during ageing. Since ageing is associated with a decline in GI function and adaptive capacity, it is crucial to obtain insights into this decline and how this is related to the intestinal microbiota in the elderly. Hence, in this review we focus on age-related changes in GI physiology and function, changes of the intestinal microbiota with ageing and frailty, how these are associated and how intestinal microbiota-targeted interventions may counteract these changes.
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Affiliation(s)
- Ran An
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Ellen Wilms
- Division Gastroenterology-Hepatology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ad A M Masclee
- Division Gastroenterology-Hepatology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Hauke Smidt
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Erwin G Zoetendal
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Daisy Jonkers
- Division Gastroenterology-Hepatology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
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99
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Oliveira MB, Lopes FF, Rodrigues VP, Alves CMC, Hugo FN. Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly. CIENCIA & SAUDE COLETIVA 2018; 23:3663-3674. [PMID: 30427439 DOI: 10.1590/1413-812320182311.26182016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 11/15/2016] [Indexed: 12/22/2022] Open
Abstract
This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.
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Affiliation(s)
- Marisa Borges Oliveira
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Fernanda Ferreira Lopes
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Vandilson Pinheiro Rodrigues
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Claudia Maria Coelho Alves
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Fernando Neves Hugo
- Centro de Pesquisas em Odontologia Social, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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100
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Khan MS, Roberts MS. Challenges and innovations of drug delivery in older age. Adv Drug Deliv Rev 2018; 135:3-38. [PMID: 30217519 DOI: 10.1016/j.addr.2018.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 08/31/2018] [Accepted: 09/07/2018] [Indexed: 12/12/2022]
Abstract
Both drug delivery performance and various age-related physical, mental and physiological changes can affect drug effectiveness and safety in elderly patients. The many drug delivery systems developed over the years include recent novel transdermal, nasal, pulmonary and orally disintegrating tablets that provide consistent, precise, timely and more targeted drug delivery. Certain drug delivery systems may be associated with suboptimal outcomes in the elderly because of the nature of drug present, a lack of appreciation of the impact of age-related changes in drug absorption, distribution and clearance, the limited availability of pharmacokinetic, safety and clinical data. Polypharmacy, patient morbidity and poor adherence can also contribute to sub-optimal drug delivery systems outcomes in the elderly. The development of drug delivery systems for the elderly is a poorly realised opportunity, with each system having specific advantages and limitations. A key challenge is to provide the innovation that best meets the specific physiological, psychological and multiple drug requirements of individual elderly patients.
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