An analysis of parotid salivary gland function with desipramine and age in female NIA Fischer 344 rats

A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI

BACKGROUND

Medication-induced salivary gland dysfunction (MISGD), xerostomia (sensation of oral dryness), and subjective sialorrhea cause significant morbidity and impair quality of life. However, no evidence-based lists of the medications that cause these disorders exist.

OBJECTIVE

Our objective was to compile a list of medications affecting salivary gland function and inducing xerostomia or subjective sialorrhea.

DATA SOURCES

Electronic databases were searched for relevant articles published until June 2013. Of 3867 screened records, 269 had an acceptable degree of relevance, quality of methodology, and strength of evidence. We found 56 chemical substances with a higher level of evidence and 50 with a moderate level of evidence of causing the above-mentioned disorders. At the first level of the Anatomical Therapeutic Chemical (ATC) classification system, 9 of 14 anatomical groups were represented, mainly the alimentary, cardiovascular, genitourinary, nervous, and respiratory systems. Management strategies include substitution or discontinuation of medications whenever possible, oral or systemic therapy with sialogogues, administration of saliva substitutes, and use of electro-stimulating devices.

LIMITATIONS

While xerostomia was a commonly reported outcome, objectively measured salivary flow rate was rarely reported. Moreover, xerostomia was mostly assessed as an adverse effect rather than the primary outcome of medication use. This study may not include some medications that could cause xerostomia when administered in conjunction with others or for which xerostomia as an adverse reaction has not been reported in the literature or was not detected in our search.

CONCLUSIONS

We compiled a comprehensive list of medications with documented effects on salivary gland function or symptoms that may assist practitioners in assessing patients who complain of dry mouth while taking medications. The list may also prove useful in helping practitioners anticipate adverse effects and consider alternative medications.

Analysis of age-related changes in the functional morphologies of salivary glands in mice

BACKGROUND AND OBJECTIVES

Salivary glands in the elderly commonly exhibit salivary dysfunction resulting dry mouth, poor oral hygiene, and dental caries. However, in vivo changes of salivary glands during aging have not been well documented in the literature. This study was undertaken to determine age-related morphometric and functional changes of salivary glands using an aging mouse model.

METHODS

Male C57BL/6 mice were divided into three groups, group A (10 weeks old; n=10), group B (30 weeks old; n=10), and group C (90 weeks old; n=10). Body weights, salivary gland weights, salivary flow rates, and salivary lag times were measured and compared. Histomorphometric examinations and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays were performed. In addition, changes in salivary uptake and excretion were observed by single-photon emission computed tomography (SPECT).

RESULTS

Body and gland weights increased with age. Gland weight was significantly higher in group B than in groups A and C. Salivary lag time was significantly greater in group C than in groups A and B, and salivary flow rate was significantly greater in group B than in groups A and C. Histologic evaluations exhibited acinar cell atrophy, cytoplasmic vacuolization, lymphocyte infiltration, small mucin component and more periductal fibrosis in salivary glands of group C. TUNEL assays revealed that apoptotic salivary epithelial cells were significantly more numerous in group C than in groups A and B. (99m)Tc-pertechnetate excretion rate was significantly lower in group C than in groups A and B in SPECT.

CONCLUSION

Various morphometric and histopathological changes were observed in the salivary glands of aging mouse as well as relevant functional alterations, such as, decreased saliva production and excretion. Increased number of apoptotic salivary epithelial cells may contribute to the observed functional deterioration.

Evening salivary alpha-amylase, major depressive disorder, and antidepressant use in the Netherlands Study of Depression and Anxiety (NESDA)

Salivary alpha-amylase (sAA) may be a suitable index for sympathetic activity and dysregulation of the autonomic nervous system. The relationship between antidepressants and depression with sAA levels was studied, since antidepressants were previously shown to have a profound impact on heart rate variability as an ANS indicator. Data are from 1692 participants of the Netherlands Study of Depression and Anxiety (NESDA) who were recruited from the community, general practice, and specialized mental health care. Differences in evening sAA levels were examined between patient groups (i.e., 752 current major depressive disorder [MDD], 611 remitted MDD, and 329 healthy controls) and between 46 tricyclic antidepressant (TCA) users, 307 selective serotonin reuptake inhibitor (SSRI) users, 97 users of another antidepressant, and 1242 non-users. Each participant sampled twice at 22.00h and 23.00h. In multivariable analysis, there was a trend over the three groups with increasing sAA levels from controls to remitted MDD to current MDD that approached significance. Furthermore, in comparison to non-users of antidepressants, TCA rather than SSRI users showed higher sAA levels, that persisted after multivariable adjustment. The present study shows that higher evening sAA levels in depressed patients, indicative of an increased sympathetic activity, may be induced by TCAs.

Clinical Performance of a Salivary Amylase Activity Monitor During Hemodialysis Treatment

The hemodialysis procedure is thought to be a physical stressor in the majority of hemodialyzed patients. Previous studies suggest that elevated salivary amylase level may correlate with increased plasma norepinephrine level under psychological and physical stress conditions. In this study, we investigated biological stress reactivity during hemodialysis treatment using salivary amylase activity as a biomarker. Seven patients (male/female = 5/2, age: 67.7+/-5.9 years) who had been receiving regular 4 h hemodialysis were recruited. Salivary amylase activity was measured using a portable analyzer every hour during the hemodialysis session. Salivary amylase activity was shown to be relatively stable and constant throughout hemodialysis, whereas there were significant changes in systolic blood pressure and pulse rate associated with blood volume reduction. Our results show that hemodialysis treatment per se dose not affect salivary amylase activity.