Anatomical stability of human fungiform papillae and relationship with oral perception measured by salivary response and intensity rating

Relative size of fungiform papillae in patients with neurofibromatosis Type 1

OBJECTIVE

To explore possible manifestations of neurofibromatosis on the tongue, especially, enlarged papillae fungiformes. According to the literature, enlarged fungiform papillae of the tongue are a very common oral finding in patients with Neurofibromatosis Type 1 (NF1).

MATERIALS AND METHODS

Firstly, photos of 18 NF1 patients' tongues, taken at different times were compared to rule of possible fluctuating papillae size. Secondly, 60 photos of 60 patients with NF1 were age/sex matched, blinded and compared to 60 photos of 60 healthy patients. Three independent medical doctors rated the photos in regard of the fungiform papillae as smaller/same/larger at two different times. The inter- and intraindividual results were compared. Thirdly, fungiform papillae of 11 NF1 patients were quantitatively measured using the Denver protocol.

RESULTS

The fungiform papillae showed a stable size. The comparison of the healthy individuals to the NF1 patients suggests that the larger papillae are significantly more frequent in NF1 patients than in age- and gender-matched non-NF1 individuals. The agreement between two ratings of each of the 3 raters at different time points was two moderate and one substantial, the agreement among raters was only fair, since the Fleiss' Kappa value of all 6 ratings was 0.38.

CONCLUSION

Although this study confirms that the evaluation of the size of the fungiform papillae by visual inspection only is very subjective, the fungiform papillae in NF1 patients do seem to be enlarged at a statistically significant level. Nonetheless the statistical difference is not distinctive enough to establish this as a diagnostic tool in diagnosing NF1.

CLINICAL RELEVANCE

Facilitating the diagnosis of NF1 is an important factor in finding the correct treatment for these patients. A clinical inspection of the tongue is a simple and non-invasive procedure. This paper addresses the question if an inspection of the tongue, especially the fungiform papillae is a reliable indicator for the diagnosis of NF1.

Tongue papillae density and fat taster status- a cardinal role on sweet and bitter taste perception among Indian population

Obesity is a complex nutritional disorder that may be influenced by calorie intake and eating behaviours. Aside from many studies, the influence of papillae count on obesity is still debated. Despite the multiple variables connected to weight gain and altered taste perception, determining the association between papillae count and taste sensitivity to fat, sweet and bitter tastes, in particular, has recently become a focus of attention. This study aimed to rule out the relationship between the number of papillae on different areas of the tongue and taste sensitivity in people (n = 150) among the various groups depending on their body mass index (BMI) and fat taste sensitivity. The general labelled magnitude scale (gLMS) was used for the taste sensitivity analysis, and participants were asked to rate the intensity of each concentration of the different tastants. Using a digital camera to obtain a picture of the tongue, the density of the papillae on the tongue was counted manually by three different operators. The study reveals that the total papillae density and BMI had a direct negative correlation (r = -0.43), with papillae density (PD) decreasing as BMI increased. Concurrently, persons with higher BMIs had lower papillae distributions (32.38 ± 1.85 PD/cm²) and significantly lower perceptions of the intensity of fat taste. Further examining papillae density in the anterior front part of the tongue, the front-right section, showed significantly higher papillae distribution (74.04 ± 2.11 PD/cm²) than the front-left section. When considering the sensitivity in the tip of the tongue, middle tongue, and whole mouth, high-sensitivity individuals for fat are more sensitive to both sweet and bitter tastes. Overall, the results of this study demonstrated a strong relationship between taste sensitivity in the Indian population, BMI, and tongue papillae density in various regions of the tongue.

Holistic approach to effects of foods, human physiology, and psychology on food intake and appetite (satiation & satiety)

Appetite (satiation and satiety) is an essential element for the control of eating behavior, and as a consequence human nutrition, body weight, and chronic disease risk. A better understanding of appetite mechanisms is necessary to modulate eating behavior and food intake, and also provide a practical approach for weight management. Although many researchers have investigated the relationships between satiation/satiety and specific factors including human physiology, psychology, and food characteristics, limited information on the interactions between factors or comparisons between the relative importance of factors in contributing to satiation/satiety have been reported. This article reviews progress and gaps in understanding individual attributes contributing to perceived satiation/satiety, the advantages of considering multiple factors together in appetite experiments, as well as the applications of nondestructive sensing in evaluating human factors contributing to relative appetite perception. The approaches proposed position characterization of appetite (satiation and satiety) for personalized and precision nutrition in relation to human status and healthy diets. In particular, it is recommended that future studies of appetite perception recognize the inter-dependence of food type and intake, appetite (satiation and satiety), and individual status.

Microscopic Anatomy of the Upper Aerodigestive Tract in Harbour Seals (Phoca vitulina): Functional Adaptations to Swallowing

Abandoned harbour seal pups (Phoca vitulina) are frequently recovered by rehabilitation centres and often require intensive nursing, gavage feeding and swallowing rehabilitation prior to anticipated release. Seal upper aerodigestive tract (UAT) histology descriptions relevant to deglutition are limited, impacting advances in rehabilitation practice. Therefore, we examined the histological characteristics of the harbour seal UAT to understand species-specific functional anatomy and characterize adaptations. To this end, we conducted gross dissections, compiled measurements and reviewed histologic features of the UAT structures of 14 pre-weaned harbour seal pups that died due to natural causes or were humanely euthanized. Representative samples for histologic evaluation included the tongue, salivary glands, epiglottis, and varying levels of the trachea and esophagus. Histologically, there was a prominent muscularis in the tongue with fewer lingual papillae types compared to humans. Abundant submucosal glands were observed in lateral and pharyngeal parts of the tongue and rostral parts of the esophagus. When compared to other mammalian species, there was a disproportionate increase in the amount of striated muscle throughout the length of the esophageal muscularis externa. This may indicate a lesser degree of autonomic control over the esophageal phase of swallowing in harbour seals. Our study represents the first detailed UAT histological descriptions for neonatal harbour seals. Collectively, these findings support specific anatomic and biomechanic adaptations relevant to suckling, prehension and deglutition. This work will inform rehabilitation practices and guide future studies on swallowing physiology in harbour seals with potential applications to other pinniped and otariid species in rehabilitation settings. This article is protected by copyright. All rights reserved.

COVID-19 Induced Taste Dysfunction and Recovery: Association with Smell Dysfunction and Oral Health Behaviour

Background and Objectives: Disruption to taste and smell are common symptoms of COVID-19 infection. The current literature overlooks taste symptoms and tends to focus on the sense of smell. Persisting cases (>28 days) of taste dysfunction are increasingly recognised as a major future healthcare challenge. This study focuses on the severity and recovery of COVID-19 induced taste loss and association with olfactory symptoms, lifestyle and oral health factors. Materials and Methods: This study was a cross-sectional survey comparing 182 rapid taste recovery participants (≤28 days) with 47 participants with prolonged taste recovery >28 days. Analyses of taste loss in association with smell loss, age, sex, illness severity, diet, BMI, vitamin-D supplementation, antidepressants, alcohol use, smoking, brushing frequency, flossing, missing teeth, appliances and number of dental restorations were conducted. Differences in the severity of the loss of sour, sweet, salt, bitter and umami tastes were explored. Results: Both the severity and the duration of taste and smell loss were closely correlated (p < 0.001). Salt taste was significantly less affected than all other taste qualities (p < 0.001). Persisting taste loss was associated with older age (mean ± 95% CI = 31.73 ± 1.23 years vs. 36.66 ± 3.59 years, p < 0.001) and reduced likelihood of using floss (odds ratio ± 95% CI = 2.22 (1.15−4.25), p = 0.047). Conclusions: Smell and taste loss in COVID-19 are closely related, although a minority of individuals can experience taste or smell dysfunction in the absence of the other. The taste of salt may be less severely affected than other taste qualities and future work exploring this finding objectively is indicated. The association of flossing with rapid taste recovery adds to the growing evidence of a link between good periodontal health and favourable COVID-19 outcomes.

Predicting Satiety from the Analysis of Human Saliva Using Mid-Infrared Spectroscopy Combined with Chemometrics

The aim of this study was to evaluate the ability of mid-infrared (MIR) spectroscopy combined with chemometrics to analyze unstimulated saliva as a method to predict satiety in healthy participants. This study also evaluated features in saliva that were related to individual perceptions of human–food interactions. The coefficient of determination (R²) and standard error in cross validation (SECV) for the prediction of satiety in all saliva samples were 0.62 and 225.7 satiety area under the curve (AUC), respectively. A correlation between saliva and satiety was found, however, the quantitative prediction of satiety using unstimulated saliva was not robust. Differences in the MIR spectra of saliva between low and high satiety groups, were observed in the following frequency ratios: 1542/2060 cm⁻¹ (total protein), 1637/3097 cm⁻¹ (α-amino acids), and 1637/616 (chlorides) cm⁻¹. In addition, good to excellent models were obtained for the prediction of satiety groups defined as low or high satiety participants (R² 0.92 and SECV 0.10), demonstrating that this method could be used to identify low or high satiety perception types and to select participants for appetite studies. Although quantitative PLS calibration models were not achieved, a qualitative model for the prediction of low and high satiety perception types was obtained using PLS-DA. Furthermore, this study showed that it might be possible to evaluate human/food interactions using MIR spectroscopy as a rapid and cost-effective tool.

In situ oral lubrication and smoothness sensory perception influenced by tongue surface roughness

BACKGROUND

The human tongue is important in the oral processing of food and in sensory perception. Tongue topography could influence delicate differences in sensory perception. It is hypothesized that tongue surface roughness could alter oral lubrication status and affect perception of smoothness. Fifteen participants with varying levels of tongue surface roughness were recruited and tested. Participants' in situ oral lubrication status without and after consumption of fluid food (milk with varying fat content and maltodextrin solutions with different shear viscosities) was measured. Participants' smoothness sensory scores were also recorded.

RESULTS

The in situ friction coefficient (0.299-1.505) was significantly positively correlated with tongue-surface roughness (54.6-140.0 μm) in all types of test fluid samples across participants. Oral lubrication was significantly decreased when participants consumed the test fluid samples compared with no liquid food consumption, for all test fluid sample types (P < 0.05). No significant differences in in situ friction coefficient were found after participants consumed different test fluid samples, and this was mainly attributed to the limited quantities of fluid residuals in the oral cavity after expectoration. Participants whose tongue surface roughness differed did not exhibit significant differences in smoothness perception with different test fluid samples.

CONCLUSION

Tongue surface roughness has a strong impact on in situ oral lubrication, and fluid food intake reduces in situ oral lubrication significantly. Saliva film and tongue surface roughness might play greater roles in oral lubrication and smoothness sensory perception if fluid is expectorated after consumption. The association between oral physiology and texture perception still needs further elucidation. © 2021 Society of Chemical Industry.

Sweet Taste Is Complex: Signaling Cascades and Circuits Involved in Sweet Sensation

Sweetness is the preferred taste of humans and many animals, likely because sugars are a primary source of energy. In many mammals, sweet compounds are sensed in the tongue by the gustatory organ, the taste buds. Here, a group of taste bud cells expresses a canonical sweet taste receptor, whose activation induces Ca²⁺ rise, cell depolarization and ATP release to communicate with afferent gustatory nerves. The discovery of the sweet taste receptor, 20 years ago, was a milestone in the understanding of sweet signal transduction and is described here from a historical perspective. Our review briefly summarizes the major findings of the canonical sweet taste pathway, and then focuses on molecular details, about the related downstream signaling, that are still elusive or have been neglected. In this context, we discuss evidence supporting the existence of an alternative pathway, independent of the sweet taste receptor, to sense sugars and its proposed role in glucose homeostasis. Further, given that sweet taste receptor expression has been reported in many other organs, the physiological role of these extraoral receptors is addressed. Finally, and along these lines, we expand on the multiple direct and indirect effects of sugars on the brain. In summary, the review tries to stimulate a comprehensive understanding of how sweet compounds signal to the brain upon taste bud cells activation, and how this gustatory process is integrated with gastro-intestinal sugar sensing to create a hedonic and metabolic representation of sugars, which finally drives our behavior. Understanding of this is indeed a crucial step in developing new strategies to prevent obesity and associated diseases.

Effects of beverage carbonation on lubrication mechanisms and mouthfeel

The perception of carbonation is an important factor in beverage consumption which must be understood in order to develop healthier products. Herein, we study the effects of carbonated water on oral lubrication mechanisms involved in beverage mouthfeel and hence taste perception. Friction was measured in a compliant PDMS-glass contact simulating the tongue-palate interface (under representative speeds and loads), while fluorescence microscopy was used to visualise both the flow of liquid and oral mucosal pellicle coverage. When carbonated water is entrained into the contact, CO₂ cavities form at the inlet, which limit flow and thus reduce the hydrodynamic pressure. Under mixed lubrication conditions, when the fluid film thickness is comparable to the surface roughness, this pressure reduction results in significant increases in friction (>300% greater than under non-carbonated water conditions). Carbonated water is also shown to be more effective than non-carbonated water at debonding the highly lubricious, oral mucosal pellicle, which again results in a significant increase in friction. Both these transient mechanisms of starvation and salivary pellicle removal will modulate the flow of tastants to taste buds and are suggested to be important in the experience of taste and refreshment. For example this may be one reason why flat colas taste sweeter.

Intraoral Microbial Metabolism and Association with Host Taste Perception

Metabolomics has been identified as a means of functionally assessing the net biological activity of a particular microbial community. Considering the oral microbiome, such an approach remains largely underused. While the current knowledge of the oral microbiome is constantly expanding, there are several deficits in knowledge particularly relating to their interactions with their host. This work uses nuclear magnetic resonance spectroscopy to investigate metabolic differences between oral microbial metabolism of endogenous (i.e., salivary protein) and exogenous (i.e., dietary carbohydrates) substrates. It also investigated whether microbial generation of different metabolites may be associated with host taste perception. This work found that in the absence of exogenous substrate, oral bacteria readily catabolize salivary protein and generate metabolic profiles similar to those seen in vivo. Important metabolites such as acetate, butyrate, and propionate are generated at relatively high concentrations. Higher concentrations of metabolites were generated by tongue biofilm compared to planktonic salivary bacteria. Thus, as has been postulated, metabolite production in proximity to taste receptors could reach relatively high concentrations. In the presence of 0.25 M exogenous sucrose, increased catabolism was observed with increased concentrations of a range of metabolites relating to glycolysis (lactate, pyruvate, succinate). Additional pyruvate-derived molecules such as acetoin and alanine were also increased. Furthermore, there was evidence that individual taste sensitivity to sucrose was related to differences in the metabolic fate of sucrose in the mouth. High-sensitivity perceivers appeared more inclined toward continual citric acid cycle activity postsucrose, whereas low-sensitivity perceivers had a more efficient conversion of pyruvate to lactate. This work collectively indicates that the oral microbiome exists in a complex balance with the host, with fluctuating metabolic activity depending on nutrient availability. There is preliminary evidence of an association between host behavior (sweet taste perception) and oral catabolism of sugar.

Endogenous salivary citrate is associated with enhanced rheological properties following oral capsaicin stimulation

NEW FINDINGS

What is the central question of this study? What are the relationships between physical properties of saliva, protein composition and metabolite composition? What is the main finding and its importance? Salivary citrate, one of the major endogenous metabolites in saliva, increased upon capsaicin stimulation and was associated with improved physical properties measured by extensional rheology. This suggests salivary gland citrate transporters might be a valuable area of future study.

ABSTRACT

Saliva displays viscoelastic properties which enable coating, lubrication and protection of the oral mucosa and hard tissues. Individuals lacking saliva or perceiving oral dryness can manage their symptoms using artificial saliva preparations, but these often fail to mimic the sensation and functionality of natural saliva. It is widely acknowledged that mucins (MUC7 and MUC5B) confer saliva's rheological properties, but artificial saliva containing purified mucins is still often an inadequate substitute. This work aimed to explore salivary components that influence salivary extensional rheology to better understand how natural saliva could be replicated. Saliva was stimulated via control and capsaicin solutions in healthy volunteers. Extensional rheology was analysed using a CaBER-1 (capillary breakup) extensional rheometer. Protein composition, including mucins, was measured by gel-electrophoresis band densitometry and metabolites were measured by 1 H nuclear magnetic resonance spectroscopy. Capsaicin stimulation significantly increased capillary breakup time, extensional viscosity and the abundance of most major salivary proteins. Stimulation also increased salivary citrate and choline concentrations. Significant correlations were found between capillary breakup time and amylase (r = 0.67, P < 0.05), statherin (ρ = 0.66, P < 0.05) and citrate (ρ = 0.81, P < 0.01). The relationship between citrate and salivary rheology was subsequently investigated in vitro. These results suggest that citrate and non-mucin proteins are stronger predictors of salivary rheology than the more often studied mucin glycoproteins. Potential mechanisms are discussed and future work in this area could help formulate more effective saliva substitutes, more closely resembling natural saliva.