Chemical analysis of parotid saliva and lacrimal fluid in psoriatics

The Effect of Biological Treatment on Stress Parameters Determined in Saliva in Patients with Severe Psoriasis

Background and objectives: In psoriatic patients, stress is the most common aggravating factor. Despite the use of quality-of-life assessment questionnaires, diagnosing stress in psoriatic patients is not a flawless procedure. This study aimed to assess the usefulness of potential stress biomarkers in saliva for monitoring the treatment of psoriasis. Materials and methods: A total of 104 adult patients with severe psoriasis were included and randomly treated via biological treatment or symptomatic therapy: 84 received biological treatment, with 20 formed a control group receiving symptomatic therapy. The administered biological treatment was adalimumab, whilst in controls calcipotriol/betamethasone dipropionate topical gel and emollients were used. Patients were monitored monthly with a dermatological examination and the dispensing of a biological drug. During each of the four visits, the severity of the disease was assessed (PASI, BSA, and DLQI), and a sample of the patient’s saliva was taken. In all the participants, the saliva concentrations of immunoglobulin A (sIgA), α-amylase (sAA), and chromogranin A (CgA) were measured. Results: The majority of patients in both the study and control groups achieved clinical improvement, though favoring the group receiving biological treatment. The concentration of sIgA in the saliva was constantly increasing in the study group during subsequent visits (Fr = 27.26; p < 0.001). Meanwhile, there were no statistically significant changes in the control group during the same follow-up period (Fr = 6.66; p = 0.084). Levels of sAA underwent statistically significant changes in both groups (Fr = 58.02; p < 0.001—study group and Fr = 13.74; p = 0.003—control group). In the study group, a steady, statistically significant increase in sAA was observed from the first to the third visit. In the study group, a downward trend in CgA concentration was observed. In the control group, no significant differences in the level of CgA were obtained. Conclusions: sIgA, sAA, and CgA are potential markers of the severity of psoriasis and the associated stress reaction. Based on the presented observations, only sIgA and CgA seem to be valuable biomarkers for monitoring the effectiveness of the systemic treatment of psoriasis.

Biomarkers in Oral Fluids as Diagnostic Tool for Psoriasis

Psoriasis is a prevalent worldwide chronic immuno-inflammatory skin disease with various variants and atypical cases. The use of biomarkers for the diagnosis of psoriasis can favor timely treatment and thus improve the quality of life of those affected. In general, the search for biomarkers in oral fluids is recommended as it is a non-invasive and fast technique. This narrative review aimed to identify biomarkers in gingival crevicular fluid (GCF) and saliva to diagnose psoriasis. To achieve this goal, we selected the available literature using the following MESH terms: “psoriasis”, “saliva” and “gingival crevicular fluid”. The studies analyzed for this review cover original research articles available in English. We found three full articles available for psoriasis biomarkers in GCF and ten articles available for psoriasis biomarkers in saliva. Studies showed that in the saliva of healthy individuals and those with psoriasis, there were differences in the levels of inflammatory cytokines, immunoglobulin A, and antioxidant biomarkers. In GCF, individuals with psoriasis showed higher levels of S100A8, IL-18 and sE-selectin in comparison to healthy individuals, independent of periodontal status. Despite these findings, more studies are required to determine an adequate panel of biomarkers to use in saliva or GCF for psoriasis.

Effects of non-surgical periodontal therapy on inflammatory markers of psoriasis: A randomized controlled trial

AIM

The purpose of this randomized controlled clinical study was to evaluate the effect of non-surgical mechanical periodontal therapy on the inflammatory status and severity of psoriasis in subjects with psoriasis.

MATERIAL AND METHODS

The study population consisted of 92 periodontitis patients with psoriasis vulgaris suffering from an untreated periodontal disease. Two randomized groups were formed from these patients: immediate periodontal therapy (test group, n = 46) and delayed periodontal therapy (control group, n = 46). Periodontal clinical measures, on salivary interleukin 2, interleukin 6 and secretory immunoglobulin A levels and the Psoriasis Area and Severity Index (PASI) scores were evaluated at baseline and on the 8th week in control and test groups.

RESULTS

Eight weeks after completion of non-surgical periodontal therapy (test group) or initial examination (control group), a significant decrease was observed in interleukin 2, interleukin 6 level and in PASI score, whereas a significant increase was observed in secretory immunoglobulin A levels in the test group (p < .05).

CONCLUSION

Within the limits of this study, the results suggest that effective periodontal therapy improves the psoriasis condition in patients afflicted by both diseases.

Saliva as a Future Field in Psoriasis Research

Psoriasis is a skin inflammatory disease characterized by an increased body of comorbidities, including parodontopathy. Despite the visibility of skin lesions, prognostic biomarkers, related to disease monitoring and therapeutic effectiveness, are still missing. Although several markers have been studied, none of them has been identified as an independent prognostic factor. This concise review aims to summarize the current knowledge and results in saliva research applied to psoriasis. Combination of different markers could improve the prognostic prediction in patients with psoriasis. Future studies are needed to implement research on salivary biomarkers and their prognostic/therapeutic effects in the management of patients with psoriasis.

cAMP and cGMP in human parotid saliva: relationships to taste and smell dysfunction, gender, and age

Among the chemical moieties present in human parotid saliva, some, such as gustin or carbonic anhydrase VI, have been useful to distinguish patients with taste and smell dysfunction from normal subjects. To continue these studies we compared levels of salivary cAMP and cGMP in patients with taste and smell dysfunction with those in normal subjects. We were also interested in exploring physiological characteristics of salivary cAMP and cGMP including changes with gender and age because previous studies had not clearly defined these issues. To perform these studies parotid saliva was collected from 61 normal volunteers and 253 patients with taste and smell dysfunction. cAMP and cGMP were measured by a spectrophotometric 96 plate ELISA technique; parotid salivary protein and flow rate were also measured. Both cAMP and cGMP were found in saliva of normal subjects and patients in the detection range of the assay used. In patients mean concentrations of both cAMP and cGMP were lower than in normal subjects; for cAMP levels were lower among both men and women patients. cAMP was 7 to 10 times higher than cGMP in both normal subjects and patients. Concentrations of cAMP were consistently higher in normal women than in normal men. cAMP levels were generally lower and cGMP levels were generally higher than in previously reported studies. There was a complex pattern of change for both cAMP and cGMP with age with concentrations increasing to about age 50, then decreasing, then increasing again at age >70 years.

Number of remaining teeth and rehabilitation with removable dentures in psoriatics

The aim of this investigation was to study associations between the state of dentition and socio-medical aspects in psoriatics. It was found that the number of remaining teeth in subjects under 65 years of age was higher in psoriatics with skin symptoms (P-group) than in psoriatics with skin and joint symptoms (PA-group) (P less than 0.01), this rate being higher than that found among the general population in Finland. In younger subjects, women in the P-group wore removable dentures more frequently than did women in the PA-group (P less than 0.05), whereas among older subjects men in the PA-group wore removable dentures more frequently than did men in the P-group (P less than 0.001). In the log-linear model that was applied, more advanced age, lower level of education and infrequent dental visits were associated with a low number of remaining teeth in both the P-group and the PA-group. A poor general state of health in the P-group and a high number of teeth, indicating that there is an association between severity of general disease and dental health status.

Relationships between human parotid saliva lysozyme lactoferrin, salivary peroxidase and secretory immunoglobulin A in a large sample population

Saliva antimicrobial proteins may interact in a common system for host defence. This study applied multivariate analysis as a means of describing inter-person variation in that system. Samples of stimulated parotid saliva were obtained from 198 subjects. Flow rate was determined, and assays run for total protein, lysozyme, lactoferrin, salivary peroxidase and secretory IgA. Correlation and principal components analysis were used to define the relationships between proteins; cluster analysis was used to identify persons with similar protein concentration profiles. All proteins were significantly correlated at p less than 0.002 (r = 0.20-0.52). Principal components analysis identified a major axis of common variation, defined by lysozyme and salivary peroxidase, and a second axis, defined by secretory IgA. Lactoferrin was associated with both axes. Seven major groupings were obtained by cluster analysis; these were significantly different at p less than 0.001. Such groupings may prove useful in comparing the antimicrobial properties of saliva samples.

Sialochemistry in mucosal lesions of the tongue: electrolytes and total protein

A total of 39 patients with tongue diseases and 17 controls were subjected to chemical analysis of saliva to determine whether tongue lesions are correlated with the composition of the saliva. The salivary flow rate, total protein, phosphate and electrolyte content (Na, K, Ca) were measured in unstimulated and stimulated saliva. The results indicate that disturbed salivary secretion could be revealed in patients with filiform atrophy and those with hairy tongue. The hormonal imbalance might be a factor in the etiology of filiform atrophy and geographic tongue. No significant difference between the sialochemistry of patients with fissured tongue and controls was found.

Salivary IgA, lysozyme and beta 2-microglobulin in periodontal disease

The concentrations of IgA, lysozyme and beta 2-microglobulin (beta 2-m) were quantitated in wax-stimulated mixed saliva from 28 patients with severe periodontitis and from 28 healthy controls. The mutual correlations between IgA, lysozyme and beta 2-m were determined. In patients with periodontitis decreased lysozyme concentrations were detected when compared with controls (P less than 0.05). The correlation between IgA and beta 2-m concentrations was highly significant in both groups studied (P less than 0.0001, and P less than 0.002), whereas beta 2-m and lysozyme concentrations were positively correlated in patients but not in controls. In addition, a significant correlation between IgA and lysozyme was found only in periodontal patients (P less than 0.001).