Saliva and the Control of Its Secretion

Childhood Allergy Disease, Early Diagnosis, and the Potential of Salivary Protein Biomarkers

Allergic disease has risen to epidemic proportions since the last decade and is among the most common noncommunicable, chronic diseases in children and adolescents worldwide. Allergic disease usually occurs in early life; thus, early biomarkers of allergic susceptibility are required for preventive measures to high-risk infants which enable early interventions to decrease allergic severity. However, to date, there is no reliable general or specific allergy phenotype detection method that is easy and noninvasive for children. Most reported allergic phenotype detection methods are invasive, such as the skin prick test (SPT), oral food challenge (OFC), and blood test, and many involve not readily accessible biological samples, such as cord blood (CB), maternal blood, or newborn vernix. Saliva is a biological sample that has great potential as a biomarker measurement as it consists of an abundance of biomarkers, such as genetic material and proteins. It is easily accessible, noninvasive, collected via a painless procedure, and an easy bedside screening for real-time measurement of the ongoing human physiological system. All these advantages emphasise saliva as a very promising diagnostic candidate for the detection and monitoring of disease biomarkers, especially in children. Furthermore, protein biomarkers have the advantages as modifiable influencing factors rather than genetic and epigenetic factors that are mostly nonmodifiable factors for allergic disease susceptibility in childhood. Saliva has great potential to replace serum as a biological fluid biomarker in diagnosing clinical allergy. However, to date, saliva is not considered as an established medically acceptable biomarker. This review considers whether the saliva could be suitable biological samples for early detection of allergic risk. Such tools may be used as justification for targeted interventions in early childhood for disease prevention and assisting in reducing morbidity and mortality caused by childhood allergy.

Relationships between the response of the sweet taste receptor, salivation toward sweeteners, and sweetness intensity

Sweeteners are widely used in food products, and their sweetness potency is usually evaluated by comparing it with that of sucrose. This, however, has led to confusion as some sweeteners are evaluated based on their maximum value of sweet taste response, while others are evaluated by their threshold value. Here, we aimed to develop a novel nonverbal sweetness evaluation system through the sweet taste signal transduction by comparing the responses of the sweet taste receptor, salivation, taste intensity, and preference among six sweeteners. The hT1r2/hT1r3 sweet taste receptor responses represented the input signal of the sweet taste signal transduction, while salivation, sweet taste intensity, and participants' preferences represented the output signals by the gustatory-salivary reflex, primary gustatory cortex area, and the secondary gustatory cortex, respectively. Our results showed that the sweet taste receptor, sweet intensity, and salivary secretion responses were concentration-dependent and expressed exponentially. Moreover, the results comparing coefficients showed 15-35 times more sensitivity between the response of hT1r2/hT1r3 and the salivation or the sweet taste intensity in non-nutrient sweeteners. The preference graph curve was not exponential, suggesting that the sweetener preference was not related to the sweet taste receptor, salivation, or sweet taste intensity. These results may suggest that the sweet taste signal of the non-nutritive sweeteners might be maintained by taste reception by hT1r2/hT1r3 to taste recognition in the primary gustatory area and that receptor responses and salivation could be used as indicators of sweetness intensity.

Interactions between polyphenol oxidation products and salivary proteins: Specific affinity of CQA dehydrodimers with cystatins and P-B peptide

Throughout the apple juice and cider making process, polyphenols undergo enzymatic oxidation which generates a great variety of polyphenol oxidation products. Since 5'-O-Caffeoylquinic acid (CQA) is one of the major phenolic compounds and the preferential substrate for polyphenoloxidase in apple juice, its oxidation leads to the formation of newly formed molecules by which dehydrodimers (MW 706 Da) are included. Interactions of salivary proteins (SP) with native polyphenols is a well-known phenomenon, but their interactions with polyphenol oxidation products has not been studied yet. In this work, we decided to decipher the interactions between CQA dehydrodimers and SP (gPRPs, aPRPs, statherins/P-B peptide, and cystatins) using HPLC-UV and fluorescence. These results showed that contrary to what was expected, CQA dehydrodimers presented a low interaction with PRPs, but revealed a specific interaction with statherins/P-B peptide and cystatins. This work settles for the first time the interactions between SP and polyphenol oxidation products.

The effect of sublingual atropine sulfate on clozapine-induced hypersalivation: a multicentre, randomised placebo-controlled trial

BACKGROUND

Hypersalivation and drooling are commonly reported in clozapine-treated patients. Current management strategies have been evaluated using subjective measures. Many case reports describe the successful use of atropine in the treatment of the condition.

AIMS

To measure the effect and safety of sublingual atropine on nocturnal unstimulated saliva secretion. Secondary aims were to evaluate the patient's satisfaction with the atropine effect on hypersalivation (or sialorrhea), drooling, and sleep.

METHOD

Twenty-one clozapine-treated patients with hypersalivation, or drooling, were randomised to take a single 600-μg dose of sublingual atropine drops or a matching placebo. The saliva secretion was measured over 5 min at baseline and 2 h after the administration of the study medication.

RESULTS

Sublingual atropine reduced the saliva secretion significantly more than the placebo (mean difference = - 57.21%, 95% CI: - 104.30, - 10.11, P = 0.02). A significant decrease in standing pulse rate was recorded in the participants in the atropine group (- 5.8 (- 9.54, - 2.15), P = 0.002). Subjectively, more patients in the atropine group found their pillow to have less saliva the following morning and found their sleep to be better.

CONCLUSIONS

Sublingual atropine drops significantly reduces nocturnal unstimulated clozapine-induced saliva secretion. More research is required to compare the effect of sublingual atropine with other anticholinergic medications and different dosage forms.

TRIAL REGISTRATION

ACTRN12618000051246.

Association of salivary alpha-amylase and salivary flow rate with working memory functioning in healthy children

The aim of this study was to examine the association between auditory and visual working memory (WM) performance and salivary alpha-amylase (sAA) and salivary flow rate (SFR) in a sample of 63 children (38 boys). WM was assessed by means of WISC-V subtests: four auditory subtests (Digit Span and Letter-Number Sequencing) and one visual subtest (Picture Span). SAA activity, output, and SFR were measured at baseline (10 min prior to testing), one minute prior to testing, one minute after the end of the auditory WM subtests and one minute after the end of the visual WM subtest. Our statistical analyses showed an association among SAA activity, output and SFR levels and the number of recalled digits in the last attempt score in Letter-Number Sequencing subtest. Specifically, our results showed that working performance in this task was associated with a concurrent decrease in SFR (r(63) = -0.423, p < .05). This salivary measure was the best predictor of this specific index of working memory performance (β = -0.423, p < .05). These results show that the changes in SFR, which represents changes in parasympathetic tone, could be employed in future studies as a noninvasive marker of working memory performance in child studies.

Effects and Mechanisms of Tastants on the Gustatory-Salivary Reflex in Human Minor Salivary Glands

The effects and mechanisms of tastes on labial minor salivary gland (LMSG) secretion were investigated in 59 healthy individuals. Stimulation with each of the five basic tastes (i.e., sweet, salty, sour, bitter, and umami) onto the tongue induced LMSG secretion in a dose-dependent manner. Umami and sour tastes evoked greater secretion than did the other tastes. A synergistic effect of umami on LMSG secretion was recognized: a much greater increase in secretion was observed by a mixed solution of monosodium glutamate and inosine 5′-monophosphate than by each separate stimulation. Blood flow (BF) in the nearby labial mucosa also increased following stimulation by each taste except bitter. The BF change and LMSG secretion in each participant showed a significant positive correlation with all tastes, including bitter. Administration of cevimeline hydrochloride hydrate to the labial mucosa evoked a significant increase in both LMSG secretion and BF, while adrenaline, atropine, and pirenzepine decreased LMSG secretion and BF. The change in LMSG secretion and BF induced by each autonomic agent was significantly correlated in each participant. These results indicate that basic tastes can induce the gustatory-salivary reflex in human LMSGs and that parasympathetic regulation is involved in this mechanism.

Preparing an Adjuvanted Thermoresponsive Gel Formulation for Sublingual Vaccination

Thermoresponsive gels have unique physicochemical properties that may enable more effective mucosal delivery of active compounds. The thermoresponsive gel (TRG) formulation developed by our group for sublingual delivery maintains fluid-like liquid properties at 2 °C-8 °C and forms a gel at the physiological temperature (~37 °C) within a few seconds. Here, we describe the preparation of a thermoresponsive gel vaccine formulation. Our preclinical studies with various antigens suggest that the mucoadhesive, adjuvanted TRG formulation enabled increased contact of the vaccine antigen with the mucosa, resulting in increased mucosal response(s) with a potential for antigen dose reduction.

In vivo interactions between procyanidins and human saliva proteins: effect of repeated exposures to procyanidins solution

The general accepted mechanism for astringency arises from the interaction between tannins and salivary proteins (SP) resulting in (in)soluble aggregates. By HPLC analysis, it was observed that repeated sips of procyanidins (PC) solution practically depleted aPRPs (∼14%) and statherin (∼2%), and significantly reduced the amount of gPRPs. On the other hand, bPRPs were not significantly affected. In the analysis performed after the last exposure to PC solution, it was seen a significant recovering of the chromatographic peaks corresponding especially to aPRPs (∼74%) and statherin (∼80%). In vitro interaction between SP and PC results in the decrease of the chromatographic peaks of aPRPs and statherin, suggesting that these proteins were involved in the formation of a significant quantity of insoluble complexes. In general, the results suggest that the different families of SP can be involved in different stages of the development of astringency sensation.