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Park HK, Kim HG, Yang DY, Choi WS, Paick SH, Chung H, Yang SK. Effect of combined solifenacin and aclatonium in preventing dry mouth in patients with overactive bladder. Low Urin Tract Symptoms 2019; 11:56-60. [DOI: 10.1111/luts.12194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/22/2017] [Accepted: 07/09/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Hyoung Keun Park
- Department of Urology; Konkuk University School of Medicine; Seoul Korea
| | - Hyeong Gon Kim
- Department of Urology; Konkuk University School of Medicine; Seoul Korea
| | - Dae Yul Yang
- Department of Urology; Hallym University Kangdong Sacred Heart Hospital; Seoul Korea
| | - Woo Suk Choi
- Department of Urology; Konkuk University School of Medicine; Seoul Korea
| | - Sung Hyun Paick
- Department of Urology; Konkuk University School of Medicine; Seoul Korea
| | - Hong Chung
- Department of Urology; Konkuk University School of Medicine; Seoul Korea
| | - Sang-Kuk Yang
- Department of Urology; Konkuk University School of Medicine; Seoul Korea
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Wang Z, Li W, Hong X, Su JZ, Hua H, Peng X, Lv L, Yu GY. Minor salivary glands function is decreased in hyposalivation-related diseases. Arch Oral Biol 2016; 69:63-70. [PMID: 27243418 DOI: 10.1016/j.archoralbio.2016.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 05/13/2016] [Accepted: 05/13/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this cross-sectional study was to investigate the relationship between minor salivary gland (MSG) flow rates and oral dryness degrees in patients with xerostomia induced by primary Sjögren's syndrome (pSS), IgG4-related sialadenitis (IgG4-RS), radiation therapy-induced dry mouth (RTDM), or Steven-Johnson syndrome (SJS). DESIGN 160 patients with pSS, IgG4-RS, RTDM, or SJS and their age- and sex-matched healthy control subjects were enrolled. The whole saliva flow rates and MSG flow rates were measured in four locations, including the upper labial, lower labial, buccal, and palatal mucosae. The degree of oral dryness was assessed in patient groups using the summated xerostomia inventory (SXI). RESULTS The flow rates of whole saliva and most MSGs in patient groups were significantly lower than the flow rates in healthy control groups (P<0.05). The mean relative percentage of decrease in saliva flow rates was smaller in MSGs than in whole saliva in patient groups (P<0.05), indicating that these disorders have less impact on MSGs. Among the four MSG locations (the upper labial, lower labial, buccal, and palatal), buccal glands showed the highest flow rates in patient groups (P<0.05). SXI scores were significantly higher in pSS and RTDM patients than in IgG4-RS and SJS patients (P<0.05). The degree of xerostomia varied among different patient groups (P<0.05) and there was no clear correlation between MSG flow rates and SXI scores (P>0.05). CONCLUSIONS MSG function is significantly reduced in pSS, RTDM, IgG4-RS, and SJS patients, but this reduction is more pronounced in the major salivary glands.
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Affiliation(s)
- Zhen Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081, Beijing, PR China
| | - Wei Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081, Beijing, PR China
| | - Xia Hong
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081, Beijing, PR China
| | - Jia-Zeng Su
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081, Beijing, PR China
| | - Hong Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, 100081, Beijing, PR China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081, Beijing, PR China
| | - Lan Lv
- Department of Ophthalmology, Affiliated Beijing Tong Ren Hospital, Capital University of Medical Science, 100005, Beijing, PR China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081, Beijing, PR China.
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Villa A, Wolff A, Narayana N, Dawes C, Aframian DJ, Lynge Pedersen AM, Vissink A, Aliko A, Sia YW, Joshi RK, McGowan R, Jensen SB, Kerr AR, Ekström J, Proctor G. World Workshop on Oral Medicine VI: a systematic review of medication-induced salivary gland dysfunction. Oral Dis 2016; 22:365-82. [PMID: 26602059 DOI: 10.1111/odi.12402] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/11/2015] [Accepted: 11/14/2015] [Indexed: 12/11/2022]
Abstract
The aim of this paper was to perform a systematic review of the pathogenesis of medication-induced salivary gland dysfunction (MISGD). Review of the identified papers was based on the standards regarding the methodology for systematic reviews set forth by the World Workshop on Oral Medicine IV and the PRISMA statement. Eligible papers were assessed for both the degree and strength of relevance to the pathogenesis of MISGD as well as on the appropriateness of the study design and sample size. A total of 99 papers were retained for the final analysis. MISGD in human studies was generally reported as xerostomia (the sensation of oral dryness) without measurements of salivary secretion rate. Medications may act on the central nervous system (CNS) and/or at the neuroglandular junction on muscarinic, α-and β-adrenergic receptors and certain peptidergic receptors. The types of medications that were most commonly implicated for inducing salivary gland dysfunction were those acting on the nervous, cardiovascular, genitourinary, musculoskeletal, respiratory, and alimentary systems. Although many medications may affect the salivary flow rate and composition, most of the studies considered only xerostomia. Thus, further human studies are necessary to improve our understanding of the association between MISGD and the underlying pathophysiology.
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Affiliation(s)
- A Villa
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - A Wolff
- Tel-Aviv Sourasky Medical Center and Saliwell Ltd., Harutzim, Israel
| | - N Narayana
- Department of Oral Biology, UNMC College of Dentistry, Lincoln, NE, USA
| | - C Dawes
- Department of Oral Biology, University of Manitoba, Winnipeg, MB, Canada
| | | | - A M Lynge Pedersen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A Vissink
- University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - A Aliko
- Faculty of Dental Medicine, University of Medicine, Tirana, Albania.,Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Y W Sia
- McGill University, Montreal, QC, Canada
| | - R K Joshi
- DAPMRV Dental College, Bangalore, India
| | - R McGowan
- New York University College of Dentistry, New York, NY, USA
| | - S B Jensen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A R Kerr
- New York University College of Dentistry, New York, NY, USA
| | - J Ekström
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - G Proctor
- Division of Mucosal & Salivary Biology, Dental Institute, King's College London, London, UK
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Beneficial effect of donepezil on obstructive sleep apnea: A double-blind, placebo-controlled clinical trial. Sleep Med 2012; 13:290-6. [DOI: 10.1016/j.sleep.2011.09.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 09/21/2011] [Accepted: 09/26/2011] [Indexed: 11/22/2022]
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A comparison of salivary substitutes versus a natural sialogogue (citric acid) in patients complaining of dry mouth as an adverse drug reaction: a clinical, randomized controlled study. ACTA ACUST UNITED AC 2011; 112:e15-20. [DOI: 10.1016/j.tripleo.2011.01.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Revised: 01/22/2011] [Accepted: 01/27/2011] [Indexed: 11/18/2022]
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Abstract
In this article, the literature on minor salivary gland secretion rates, composition, and function is reviewed. Measurements of the minor salivary gland secretion rates and composition are complicated, and the secretions display large biological variability. Despite this, some characteristics of these secretions have been found repeatedly in independent investigations. Minor gland saliva varies between different oral sites. Buccal saliva flow is higher than labial saliva flow, which in turn is usually higher than the palatal gland secretion rate. It is generally agreed that minor gland saliva is important for the whole saliva composition, and especially for the secretory immunoglobulin A and mucins. The secretion from these glands seems also important for subjective feelings of dry mouth and general wellbeing. Further research is essential for understanding the role of these secretions for oral, as well as for general, health.
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Affiliation(s)
- Lars Eliasson
- Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
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Khosravani N, Birkhed D, Ekström J. The cholinesterase inhibitor physostigmine for the local treatment of dry mouth: a randomized study. Eur J Oral Sci 2009; 117:209-17. [PMID: 19583746 DOI: 10.1111/j.1600-0722.2009.00632.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Application of physostigmine to the oromucosal surface with the aim of stimulating underlying mucin-producing glands while reducing cholinergic systemic effects might be a strategy for treating dry mouth. Subjects suffering from dry mouth and with hyposalivation participated in a crossover, double-blind, randomized study. A gel containing physostigmine (0.9, 1.8, 3.6, and 7.2 mg) or placebo was applied to the inside of the lips and distributed with the tongue. The feeling of dryness was assessed using a visual analogue scale (VAS) (where a score of 100 = extremely dry) and systemic effects were registered. Based on assessments of efficacy and safety, the dose of 1.8 mg of physostigmine was selected for use in the second part of the study to make objective measurements of saliva volumes. Physostigmine (1.8 mg) produced long-lasting (120 min) relief (evident as a score reduction of 25 on the VAS) in the feeling of dryness. Judging from AUC values related to baseline over 180 min, the improvement for both mouth and lips in response to physostigmine was six times greater than that to placebo. At higher doses of physostigmine, gastrointestinal discomfort predominantly occurred. The volume of saliva collected in response to physostigmine was five times higher over 180 min than that collected in response to placebo. Physostigmine, applied locally, therefore appears to be a promising modality for dry-mouth treatment.
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Affiliation(s)
- Nina Khosravani
- Section of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Kolahi J, Mansourian M. Autotransplantation of cryopreserved minor salivary glands: a new approach for management of radiation-induced xerostomia. Med Hypotheses 2009; 74:29-30. [PMID: 19729251 DOI: 10.1016/j.mehy.2009.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 08/12/2009] [Indexed: 11/25/2022]
Abstract
To date, it still is impossible to successfully prevent radiation-induced xerostomia. Therefore, further research, particularly regarding treatment, is urgently warranted. Lower labial mucosa with its submucosal minor salivary glands (MSGs) of approximately 2.5 x 3 cm can be prepared by means of a surgical knife or Ellman Surgitron high-frequency/low-temperature radiosurgical device. Also we can consider area of the palatine fovea to find and remove MSGs. We can find locations containing more MSGs via scintigraphy techniques and positron emission tomography. Removing of MSGs can be done 1-2 weeks before start of radiotherapy. Subsequently the MSGs containing complex graft should be cryopreserved via liquid nitrogen for long-term storage. Autotransplantation surgery will be carried out 2-3 months after radiotherapy. The frozen tissue could be thawed rapidly in a 37 degrees C water bath for 2-3 min. Host site should be as far as possible to the radiation zone and has a good blood supply. Hyperbaric oxygen therapy (30 treatment sessions before and 10 sessions after re-implantation) is strongly recommended. An aggressive short or medium-term antibiotic treatment will necessary to avoid infection. Immunosuppressive treatment will not require. The main criticism with this hypothesis is viability and usefulness of MSGs containing graft, after being frozen and subsequently thawed.
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Affiliation(s)
- Jafar Kolahi
- Torabinejad Research Center, Isfahan University of Medical Sciences, No 10, Sayt 180, Shahin Shahr, Isfahan Co 83188-65161, Iran.
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Moraes W, Poyares D, Sukys-Claudino L, Guilleminault C, Tufik S. Donepezil improves obstructive sleep apnea in Alzheimer disease: a double-blind, placebo-controlled study. Chest 2008; 133:677-83. [PMID: 18198262 DOI: 10.1378/chest.07-1446] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND There is an association between Alzheimer disease and sleep-disordered breathing. Donepezil is the drug most frequently used to treat cognitive symptoms in Alzheimer disease. This study evaluates the effects of donepezil on obstructive sleep apnea in patients with Alzheimer disease. METHODS Randomized, double-blind, placebo-controlled design. Twenty-three patients with mild-to-moderate Alzheimer disease and apnea-hypopnea index (AHI) > 5/h were allocated to two groups: donepezil treated (n = 11) and placebo treated (n = 12). Polysomnography and cognitive evaluation using Alzheimer disease assessment scale-cognitive (ADAS-cog) subscale were performed at baseline and after 3 months. Cognitive and sleep data were analyzed using analysis of variance. RESULTS AHI and oxygen saturation improved significantly after donepezil treatment compared to baseline and placebo (p < 0.05). Rapid eye movement (REM) sleep duration increased after donepezil treatment (p < 0.05). ADAS-cog scores improved after donepezil treatment, although they did not correlate with REM sleep increase and sleep apnea improvement (p < 0.01). CONCLUSIONS Donepezil treatment improved AHI and oxygen saturation in patients with Alzheimer disease. Treatment also increased REM sleep duration and reduced ADAS-cog scores. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00480870.
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Affiliation(s)
- Walter Moraes
- Psychobiology Department, Universidade Federal de São Paulo, São Paulo, Brazil.
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Khosravani N, Ekström J, Birkhed D. Intraoral stimulation of salivary secretion with the cholinesterase inhibitor physostigmine as a mouth spray: A pilot study in healthy volunteers. Arch Oral Biol 2007; 52:1097-101. [PMID: 17658455 DOI: 10.1016/j.archoralbio.2007.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Revised: 05/24/2007] [Accepted: 06/08/2007] [Indexed: 11/23/2022]
Abstract
Dry mouth produces a deterioration in oral health and impairs quality of life. There is a need for a novel approach to the pharmacological treatment of dry mouth. With a view to enhancing the cholinergic drive on minor salivary glands, whilst at the same time minimising adverse systemic effects, the cholinesterase inhibitor physostigmine was therefore sprayed, in a fixed volume, onto the oral mucosa of seven healthy subjects. Three concentrations (0.5%, 1% and 2%) were tested. The mean salivary output over time (0-105 min) was higher than that of placebo (p<0.05), as the area under the curve increased by 61%, 91% and 66% at physostigmine 0.5%, 1% and 2%, respectively. Two subjects experienced nausea at the highest physostigmine concentration, thus reflecting systemic effects. Heart rate, blood pressure and respiration were unaffected by the physostigmine treatment.
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Affiliation(s)
- Nina Khosravani
- Department of Pharmacology, Institute of Neuroscience and Physiology, Box 431, Sahlgrenska Academy at Göteborg University, SE-413 90 Göteborg, Sweden
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Khosravani N, Ekman R, Ekström J. Acetylcholine synthesis, muscarinic receptor subtypes, neuropeptides and secretion of ferret salivary glands with special reference to the zygomatic gland. Arch Oral Biol 2007; 52:417-26. [PMID: 17123459 DOI: 10.1016/j.archoralbio.2006.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Revised: 10/11/2006] [Accepted: 10/16/2006] [Indexed: 11/15/2022]
Abstract
Studies on salivary secretion are usually focused on parotid and submandibular glands. However, the film of mucin, that protects the oral structures and is responsible for the feeling of oral comfort, is produced by the submucosal glands. The submucosal zygomatic and molar glands are particularly large in carnivores such as the ferret. Comparisons between the mucous sublingual, zygomatic and molar glands, serous parotid and sero-mucous submandibular glands showed the acetylcholine synthesis, in terms of concentration, to be three to four times higher in the mucous glands than in the parotid and submandibular glands. Bromoacetylcholine inhibited 95-99% of the synthesis of acetylcholine in the incubates of the five types of glands, showing the acetylcholine synthesis to depend on the activity of choline acetyltransferase. The high acetylcholine synthesis in the zygomatic gland was of nervous origin, since cutting the buccal nerve, aiming at parasympathetic denervation, and allowing time for nerve degeneration, reduced the acetylcholine synthesising capacity of the gland by 95%. A similar reduction (96%) in the parotid gland followed upon the avulsion of the parasympathetic auriculo-temporal nerve. Zygomatic saliva was very viscous. The salivary flow rate in response to electrical stimulation (20 Hz) of the buccal nerve (zygomatic gland), expressed per gland weight, was one-third of that to stimulation of the auriculo-temporal nerve (parotid gland) or the chorda-lingual nerve (submandibular gland). As previously shown for the parotid and submandibular gland, a certain fraction (25%) of the parasympathetic secretory response of the zygomatic gland depended on non-adrenergic, non-cholinergic transmission mechanisms, probably involving substance P and vasoactive intestinal peptide and possibly calcitonin gene-related peptide. Particularly, high concentrations of vasoactive intestinal peptide were found in the sublingual and molar glands, and of substance P in the submandibular, zygomatic and molar glands; notably, the concentration of calcitonin gene-related peptide of the sublingual gland was not detectable. All five muscarinic receptor subtypes were detected in the five glands. The receptor protein profile, as judged by immunoblotting and semi-quantitative estimations, was about the same in the glands: high level of M3, low level of M2 and levels roughly in the same range of M1, M4 and M5. Compared to the parotid and submandibular glands, the M5 receptor level was particularly low in the mucin-secreting glands. The present study points out both similarities and dissimilarities between the five types of glands investigated. The zygomatic gland, in particular, appears to be a suitable model for future studies aiming at causing relief of dry mouth by local pharmacological treatment.
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Affiliation(s)
- Nina Khosravani
- Section of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Göteborg University, Medicinaregatan 15 D, P.O. Box 431, 405 30 Göteborg, Sweden
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Hedner J, Kraiczi H, Peker Y, Murphy P. Reduction of sleep-disordered breathing after physostigmine. Am J Respir Crit Care Med 2003; 168:1246-51. [PMID: 12958052 DOI: 10.1164/rccm.200211-1344oc] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The cholinesterase inhibitor physostigmine (PHYS) was investigated in a double-blind, placebo-controlled, randomized, crossover trial of 10 male patients with moderate to severe obstructive sleep apnea. PHYS (0.12 microg/minute/kg, 7-hour infusion) reduced mean apnea/hypopnea index (AHI) by 13.6 (95% confidence interval [CI], 2.2-25.1) corresponding to 21.4% (95% CI, -5.5 to 47.9) and increased minimum SaO2 by 8.7% (95% CI, -0.3 to 17.7) corresponding to 23.2% (95% CI, 4.8-41.3). During the last third of the night, coinciding with predicted plasma concentration steady state, non-REM sleep AHI decreased by 19.2 (95% CI, 0.1-38.3) or 14.9% (95% CI, -43.6 to 77.7) and REM AHI by 33.8 (95% CI, 13.7-54.0) or 67.5% (95% CI, 49.7-85.3). Mean total sleep time was reduced by 74 minutes (95% CI, 33.9-114.9), but patients with the least pronounced sleep shortening had the largest reduction of AHI (r = 0.73, p < 0.02). The nocturnal decline in heart rate was reduced by PHYS. Moreover, resting (early-night placebo heart rate) was positively correlated with proportional reduction of REM apnea index (r = 0.69, p < 0.02). Body mass index was negatively correlated with reduction of REM AHI (r = 0.77, p < 0.02). This, predominantly REM-related, reduction of obstructive sleep apnea after PHYS may provide a new treatment option if the effects are maintained in long-term studies.
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Affiliation(s)
- Jan Hedner
- Sleep Laboratory, Department of Pulmonary Medicine and Allergology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
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Ekström J, Helander HF. Secretion from submucosal salivary glands of the ferret in response to a cholinesterase inhibitor applied onto the oral mucosa. Eur J Oral Sci 2002; 110:230-6. [PMID: 12120709 DOI: 10.1034/j.1600-0447.2002.201249.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Parasympathomimetics or cholinesterase inhibitors taken orally may relieve dry-mouth symptoms, but this route of administration is often associated with adverse systemic reactions. In the present study, an animal model was worked out aimed at stimulating the submucosal glands and avoiding systemic effects. In the anesthetized ferret, saliva from the parotid, sublingual and submandibular glands was prevented from reaching the mouth. Vehicle or physostigmine was applied topically for 10 min on the buccal and labial mucosa on one side, while the other side served as a control. Fluid from each side was collected every 5 min Mean basal secretion was 0.17 mg 5 min(-1). The response to physostigmine 0.1% did not exceed that of the vehicle. At higher concentrations the responses lasted 80-120 min. Peak secretion was nine (0.25% physostigmine), 13 (0.5% physostigmine) and 40 (1% physostigmine) times higher than baseline. At 1% physostigmine, the secretion from the control side was elevated, and a small flow from the duct-cannulated parotid gland occurred, indicating systemic effects. Arterial blood pressure was well maintained. Additional observations on the duct-cannulated zygomatic gland showed that secretion from this gland increased already within the 10-min period of application of physostigmine to the overlying mucosa. The distance between the mucosa and the zygomatic gland was only about 1 mm. Physostigmine-induced secretion was abolished by atropine. Local gland stimulation may be an attractive alternative for the treatment of dry mouth.
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Affiliation(s)
- Jörgen Ekström
- Department of Pharmacology, Institute of Physiology and Pharmacology, Göteborg, Sweden.
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