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Miyamoto ST, Serrano ÉV, Gianórdoli APE, Altoé LB, Noronha BD, Dos Santos PHA, Pedrini APT, da Silva NRS, Favarato LF, Alochio LV, Tomé WA, Lackner A, Valim V. Brazilian version of the "Primary Sjögren's Syndrome - Quality of Life questionnaire (PSS-QoL)": translation, cross-cultural adaptation and validation. Adv Rheumatol 2024; 64:60. [PMID: 39160602 DOI: 10.1186/s42358-024-00395-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/22/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND The Primary Sjögren's Syndrome Quality of Life questionnaire (PSS-QoL) is the first specific instrument to assess health-related quality of life (HRQoL) in Sjögren's disease (SjD). The aim is to translate and cross-culturally adapt the PSS-QoL into Brazilian Portuguese and to evaluate its psychometric properties. METHODS The original English version was translated into Brazilian Portuguese by two native Brazilians who were proficient in the English language. The retranslation was conducted by two native Americans proficient in Brazilian Portuguese. A committee undertook an analysis of the translated and retranslated versions, resulting in the generation of the first Brazilian version, which was submitted to the cross-cultural adaptation phase. In this phase, 50 participants with SjD responded to the instrument in Stages I and II, resulting in the generation of the second and final Brazilian version. To assess the psychometric properties, demographic and clinical data were collected from 75 patients. The HRQoL questionnaires (final Brazilian version of the PSS-QoL, Short Form-36 Health Survey (SF-36) and EuroQoL-5 dimension (EQ-5D)) were completed. Construct validity was analyzed using the Pearson or Spearman correlation coefficient. Reliability was analyzed using Cronbach's alpha and the intraclass correlation coefficient (ICC). RESULTS Eight questions and one response item were revised due to an incomprehension rate of greater than 15% among the participants in the cross-cultural adaptation phase. The final Brazilian version of the PSS-QoL was validated, revealing a high correlation between the total score and functional capacity (r= -0.713, p < 0.001), and vitality (r= -0.770, p < 0. 001) and mental health (r= -0.742, p < 0.001) domains of the SF-36 and a moderate correlation with the other domains of the SF-36 and a moderate correlation with the EQ-5D-tto (r= -0.573, p < 0.001), and EQ-5D-VAS (r= -0.559, p < 0.001). The intraobserver (ICC = 0.939; Cronbach's alpha = 0.964) and interobserver (ICC = 0.965; Cronbach's alpha = 0.964) reliability of the total score showed very high consistency. CONCLUSION The Brazilian version of the PSS-QoL has been demonstrated to be a valid and reproducible instrument for the assessment of HRQoL in patients with SjD.
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Affiliation(s)
- Samira Tatiyama Miyamoto
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29040-090, Brazil.
| | - Érica Vieira Serrano
- Hospital Universitário Cassiano Antônio Moraes (Hucam), Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brazil
| | - Ana Paula Espíndula Gianórdoli
- Hospital Universitário Cassiano Antônio Moraes (Hucam), Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brazil
| | - Lara Betini Altoé
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29040-090, Brazil
| | - Bianca Domingos Noronha
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29040-090, Brazil
| | - Pedro Henrique Alves Dos Santos
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29040-090, Brazil
| | - Ana Paula Truhlar Pedrini
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29040-090, Brazil
| | - Nicole Reis Souza da Silva
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29040-090, Brazil
| | - Letícia Fonseca Favarato
- Hospital Universitário Cassiano Antônio Moraes (Hucam), Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brazil
| | - Luíza Vallory Alochio
- Hospital Universitário Cassiano Antônio Moraes (Hucam), Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brazil
| | - Weider Andrade Tomé
- Hospital Universitário Cassiano Antônio Moraes (Hucam), Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brazil
| | - Angelika Lackner
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Valéria Valim
- Hospital Universitário Cassiano Antônio Moraes (Hucam), Programa de Pós-graduação em Saúde Coletiva (PPGSC), Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brazil
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Schertel Cassiano L, Leite FRM, Alves-Costa S, Costa SA, Nascimento GG. Oral conditions are associated with salt taste disability among American adults. Oral Dis 2024. [PMID: 38566452 DOI: 10.1111/odi.14926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/30/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
AIM To explore the association between oral conditions and their interaction with salt taste disability among American adults. METHODS Data from the 2013-2014 NHANES cycle were used (n = 2373). The exposures were periodontitis, defined by the 2017 EFP-AAP classification, dental caries, missing teeth, and edentulism, as per the DMF-T index, and xerostomia. The outcome was salt taste disability, objectively assessed. Covariates included sex, age, educational level, poverty index, obesity, diabetes, smoking, alcohol consumption, and medications related to mouth dryness. Weighted multivariable logistic regression modeling was used to evaluate the relationship between oral conditions and their interaction and salt taste disability. RESULTS Participants who reported xerostomia were more likely to have salt taste disability (OR 2.42; 95%CI 1.44-4.07), especially those older than 60 years (OR 3.63; 95%CI 1.72-7.63). Among participants aged 40-59, xerostomia increased the chance of salt taste disability; however, the confidence interval included the null value. The interactions between xerostomia and edentulism increased the chance of salt taste disability. CONCLUSION Oral conditions seem to influence the ability to taste salt. Dental professionals may help identify individuals with taste alterations and raise their awareness of the risk of systemic diseases that require the reduction of salt intake.
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Affiliation(s)
| | - Fábio R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Silas Alves-Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Brazil
| | | | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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3
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Shintani T, Naito M, Obayashi N, Ando T, Kawaguchi H, Yanamoto S, Kajiya M, Sugita M. Resting Saliva Volume as a Risk Factor for Hypogeusia: A Retrospective Study. Physiol Behav 2023; 267:114224. [PMID: 37148986 DOI: 10.1016/j.physbeh.2023.114224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES The causes of hypogeusia include zinc deficiency, systemic illness, and consumption of drugs. Notably, patients with oral cavity diseases such as oral candidiasis and salivary gland hypofunction may present with risk factors that remain unreported. Hence, this study aimed to investigate the relationship between age, sex, smoking status, serum zinc concentration, oral candidiasis, saliva volume, and taste function in patients with hypogeusia. SUBJECTS AND METHODS Overall, 335 participants who complained of taste abnormalities underwent a taste test. Based on the recognition threshold value, the participants were classified as normal individuals (recognition threshold of 1 and 2) and patients with hypogeusia (recognition threshold of ≥3). The clinical characteristics, including resting saliva volume (RSV) and stimulated saliva volume (SSV), were compared, and a multivariate logistic regression analysis focusing on RSV was performed. RESULTS Patients with hypogeusia had a lower RSV than normal individuals for all tastes, but not for SSV. Based on the results of regression analysis, RSV was identified as an independent predictor of hypogeusia for salty and bitter tastes. Moreover, the proportion of patients with decreased RSV increased as the number of taste qualities exceeding the reference recognition threshold increased. Furthermore, a decrease in RSV was associated with an increase in the recognition threshold for salty and bitter tastes. CONCLUSIONS Based on the results of the present study, moisturizing the oral cavity may be useful against hypogeusia.
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Affiliation(s)
- Tomoaki Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nami Obayashi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshinori Ando
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroyuki Kawaguchi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Souichi Yanamoto
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima, Hiroshima University, Japan
| | - Mikihito Kajiya
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Makoto Sugita
- Department of Physiology and Oral Physiology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
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Al-Ezzi MY, Khan KS, Tappuni AR. Smell Dysfunction in Patients with Primary Sjögren’s Syndrome: Impact on Quality of Life. J Clin Med 2023; 12:jcm12072724. [PMID: 37048807 PMCID: PMC10095094 DOI: 10.3390/jcm12072724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Objectives: Patients with primary Sjögren’s syndrome (pSS) often report smell and taste disturbances. However, the correlation between smell impairment and mucosal dryness is not well understood. The objectives of this study were to investigate the following: (1) the prevalence of smell hypofunction in patients with SS; (2) the impact of smell hypofunction on their quality of life (QoL); (3) whether the patients’ smell is correlated with xerostomia; and (4) whether the patients’ smell is affected by taste hypofunction, disease duration, age, smoking or self-reported neuropathy. Methodology: An ethically approved cross-sectional study was conducted on 65 female patients with SS and 62 sex-matched healthy controls. Their smell was assessed using the University of Pennsylvania Smell Identification Test. Their taste acuity was assessed using the Taste Strips Test. A visual analogue scale was used for the self-assessment of smell and taste functions. Xerostomia was assessed by the salivary flow rate, clinical oral dryness score and the Xerostomia Inventory. The patients’ QoL and mental health well-being were assessed using validated questionnaires. Results: In the SS group, the patients’ smell function was impaired in 27/65 patients compared with the controls (15/62, p < 0.05), and it did not correlate with the severity of xerostomia, taste acuity (r = 0.05, p = 0.6) or self-reported nasal dryness (r = −0.02, p = 0.7). In the patients’ group, smell hypofunction was not correlated with disease duration (β = 0.1, 95% CI = −0.07–0.1) or smoking (β = −0.02, 95% CI = −8–7). Age was not correlated with the smell function in the patients’ group (β = −0.1, p = 0.5) but was correlated significantly with smell in the healthy participants’ group (β = −0.3, p = 0.02). Neuropathy affected 81.2% of the patients’ group. Their QoL and mental health well-being were not affected by smell hypofunction. Conclusion: Smell hypofunction appears to be a clinical manifestation in patients with SS, but it does not seem to be associated with the severity of mucosal dryness or with taste disturbance.
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Affiliation(s)
- Minan Y. Al-Ezzi
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
- College of Medicine and Dentistry, Ulster University, Birmingham B4 6BN, UK
| | - Khalid S. Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
| | - Anwar R. Tappuni
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
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Autoimmunity, COVID-19 Omicron Variant, and Olfactory Dysfunction: A Literature Review. Diagnostics (Basel) 2023; 13:diagnostics13040641. [PMID: 36832129 PMCID: PMC9955947 DOI: 10.3390/diagnostics13040641] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Smelling is a critical sense utilized daily. Consequently, smelling impairment or anosmia may lead to a reduction in life quality. Systemic diseases and particular autoimmune conditions can impair olfactory function; among others are Systemic Lupus Erythematosus, Sjögren Syndrome, and Rheumatoid Arthritis. Interactions between the olfactory process and the immune systems cause this phenomenon. Alongside autoimmune conditions, in the recent COVID-19 pandemic, anosmia was also described as a prevalent infection symptom. Nevertheless, the occurrence of anosmia is significantly less common in Omicron-infected patients. Several theories have been proposed to explain this phenomenon. One possibility is that the Omicron variant preferentially enters host cells via endocytosis, rather than plasma cell membrane fusion. This endosomal pathway is less dependent on the activation of Transmembrane serine protease 2 (TMPRSS2), expressed at the olfactory epithelium. As a result, the Omicron variant may have reduced efficiency in penetrating the olfactory epithelium, leading to a lower prevalence of anosmia. Furthermore, olfactory changes are known to be associated with inflammatory conditions. The Omicron variant elicits a less robust autoimmune and inflammatory response, believed to reduce the probability of anosmia. This review elaborates on the commonalities and differences in autoimmune and COVID-19 omicron-associated anosmia.
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Foguem C, Seror R, Gosset M. Chemosensory dysfunction in primary Sjögren's syndrome: a topical review. Clin Rheumatol 2023; 42:1-14. [PMID: 36063255 PMCID: PMC9443648 DOI: 10.1007/s10067-022-06359-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 01/11/2023]
Abstract
Primary Sjögren's syndrome is an autoimmune exocrinopathy related to lymphocytic infiltration of the exocrine glandular epithelia (such as salivary, lacrimal, nasal, and sebaceous glands or vaginal mucosa) with systemic manifestations of an immuno-inflammatory nature, and not associated with any other systemic disease. It is characterized by severe dryness (Sicca syndrome), particularly in mouth and eyes, with potential strong impact on quality of life and could increase the risk of depression in Sjögren's patient. To date, the impairment of taste and olfactory functions related to Sjögren syndrome remains poorly assessed; so is the trigeminal functions which remain sparsely studied in patients with Sjögren disease. However, other factors can also modify chemosensory functions (olfactory or gustatory sensations and trigeminal nerves), in particular the reduction of the masticatory coefficient or halitosis, due to oral saliva flow decrease, and poor dental condition, which are often present in Sjögren patients. Of the 12 articles evaluated after a 22-year literature search of this review, chemosensory disorders (including taste, smell, and trigeminal impairments) are described and evaluated in pSS patients, with mainly poorer performance compared to healthy controls. Diagnostic and therapeutic (including rehabilitation) approaches of chemosensory disorders in pSS are discussed in this review. Clinician should be more attentive to taste as well as olfacto-trigeminal disorders in primary Sjögren's disease, if possible at the earlier stage, in order to take the best care of Sjögren's patients. This review also highlights some lack in knowledge on pSS chemosensory disorders that should provide new research perspectives. Key Points •Chemosensory functions (including taste, smell, and trigeminal functions) are altered in patients with primary Sjögren's syndrome (pSS) due to dryness of the mouth and the nose. •The trigeminal nerve which interacts with olfactory and gustatory nerves contributes to olfactory and taste perception but remains little studied to date. •Chemosensory function should be considered in the daily clinical assessment of patients with pSS. •Chemosensory function treatment is not standardized yet, however symptomatic treatment of Sjögren syndrome-associated dryness transiently would improve taste and smell, and olfactory or gustatory rehabilitation in pSS patients would be useful.
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Affiliation(s)
- C Foguem
- Auban Moët-Centre Hospitalier d'Epernay, Adresse:137, Rue de l'Hôpital, 51200, Epernay, France.
| | - R Seror
- Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud (AP-HP), Le Kremlin-Bicêtre, France
| | - M Gosset
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, 94200, Ivry/seine, France
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies URP2496, Université de Paris, 92120, Montrouge, France
- Laboratoire d'Excellence, INFLAMEX, Paris, France
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Zhao X, Liu G, Yu X, Yang X, Gao W, Zhao Z, Ma T, Ma J. Ablation of AQP5 gene in mice leads to olfactory dysfunction caused by hyposecretion of Bowman's gland. Chem Senses 2023; 48:bjad030. [PMID: 37586060 DOI: 10.1093/chemse/bjad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Indexed: 08/18/2023] Open
Abstract
Smell detection depends on nasal airflow, which can make absorption of odors to the olfactory epithelium by diffusion through the mucus layer. The odors then act on the chemo-sensitive epithelium of olfactory sensory neurons (OSNs). Therefore, any pathological changes in the olfactory area, for instance, dry nose caused by Sjögren's Syndrome (SS) may interfere with olfactory function. SS is an autoimmune disease in which aquaporin (AQP) 5 autoantibodies have been detected in the serum. However, the expression of AQP5 in olfactory mucosa and its function in olfaction is still unknown. Based on the study of the expression characteristics of AQP5 protein in the nasal mucosa, the olfaction dysfunction in AQP5 knockout (KO) mice was found by olfactory behavior analysis, which was accompanied by reduced secretion volume of Bowman's gland by using in vitro secretion measure system, and the change of acid mucin in nasal mucus layer was identified. By excluding the possibility that olfactory disturbance was caused by changes in OSNs, the result indicated that AQP5 contributes to olfactory functions by regulating the volume and composition of OE mucus layer, which is the medium for the dissolution of odor molecules. Our results indicate that AQP5 can affect the olfactory functions by regulating the water supply of BGs and the mucus layer upper the OE that can explain the olfactory loss in the patients of SS, and AQP5 KO mice might be used as an ideal model to study the olfactory dysfunction.
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Affiliation(s)
- Xinnan Zhao
- Department of Anatomy, College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
| | - Gang Liu
- Department of Anatomy, College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
| | - Xin Yu
- The High School Attached to Northeast Normal University, Changchun, Jilin, China
| | - Xiaohan Yang
- Department of Anatomy, College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
- Department of Morphology, College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
| | - Wenting Gao
- Institute of Genome Engineered Animal Models for Human Disease, National Center of Genetically Engineered Animal Models, College of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, China
| | - Zinan Zhao
- Department of Biotechnology, College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
| | - Tonghui Ma
- National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, Liaoning, China
- School of Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jianmei Ma
- Department of Anatomy, College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
- National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, Liaoning, China
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Dyball S, Reynolds JA, Herrick AL, Haque S, Chinoy H, Bruce E, Naz S, Parker B, Bruce IN. Determinants of health-related quality of life across the spectrum of connective tissue diseases using latent profile analysis: Results from the LEAP cohort. Rheumatology (Oxford) 2022:6935805. [PMID: 36534822 PMCID: PMC10393437 DOI: 10.1093/rheumatology/keac680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Poor health-related quality of life (HR-QoL) is well recognised in patients with connective tissue diseases (CTD). We hypothesised that subgroups of patients across the spectrum of CTD experience different HR-QoL patterns, and aimed to determine patient-level characteristics associated with these different subgroups. METHODS Using the eight continuous domains of the Medical Outcomes Study Short-Form 36 (SF-36) questionnaire we performed data-driven clustering to derive latent profiles (LP) of patients with distinct HR-QoL patterns. Multivariable ordinal logistic regression was used to determine patient-level characteristics associated with each HR-QoL subgroup identified. RESULTS 309 CTD patients completed the SF-36 questionnaire. The most impaired SF-36 domains in each disease group were vitality, general health and bodily pain. The physical component of the SF-36 was consistently more impaired compared with the mental component, with similar scores across disease groups.Three latent profiles were identified with poor (n = 89; 29%), average (n = 190; 61.4%) and excellent (n = 30; 9.7%) HR-QoL. LP were not associated with diagnostic grouping or autoantibody profiles. Black background (OR 0.22 [95% CI 0.08-0.63]), Indo-Asian background (0.39 [0.19-0.78]), concomitant fibromyalgia (0.40 [0.20-0.78]), sicca symptoms (0.56 [0.32-0.98]) and multi-morbidity (Charlson Comorbidity Index, 0.81 [0.67-0.97]) were associated with the 'poor' HR-QoL LP. CONCLUSION Distinct HR-QoL subgroups exist that are not primarily driven by the specific diagnosis or autoantibody profiles. We identified a number of key demographic and clinical factors associated with poor HR-QoL. These factors need to be addressed across the whole CTD spectrum as part of a holistic management approach aimed at improving overall patient outcomes.
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Affiliation(s)
- Sarah Dyball
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, UK.,The Kellgren Centre for Rheumatology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - John A Reynolds
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Rheumatology Department, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Ariane L Herrick
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK.,Department of Rheumatology, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Sahena Haque
- Department of Rheumatology, Manchester University Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Hector Chinoy
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, UK.,National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK.,Department of Rheumatology, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Ellen Bruce
- The Kellgren Centre for Rheumatology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Sophia Naz
- Department of Rheumatology, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Ben Parker
- The Kellgren Centre for Rheumatology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.,National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Ian N Bruce
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, UK.,The Kellgren Centre for Rheumatology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.,National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK
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9
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Červený K, Janoušková K, Vaněčková K, Zavázalová Š, Funda D, Astl J, Holy R. Olfactory Evaluation in Clinical Medical Practice. J Clin Med 2022; 11:jcm11226628. [PMID: 36431104 PMCID: PMC9698169 DOI: 10.3390/jcm11226628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/27/2022] [Accepted: 11/04/2022] [Indexed: 11/10/2022] Open
Abstract
The subjective and demanding nature of olfactory testing means that it is often neglected in clinic despite loss of smell leading to significant limitations in everyday life. The list of diseases associated with loss of olfaction far exceeds the field of otorhinolaryngology and can also be seen in neurodegenerative disorders. Knowledge of possible clinical testing is essential to determine a proper differential diagnosis for the loss of olfactory sense. Causes of olfactory impairment can be divided into either failure in transferring odour to the organ of perception or damage to the olfactory pathway structure itself. Examination should therefore include methods evaluating cross-sectional area and patency of the nasal cavity as well as subjective or objective assessment of olfactory function. In this report we summarize several articles, studies, and our own experiences to provide a comprehensive review of their current clinical usage including their benefits, limitations, and possible outcomes. We also discuss the mechanism of olfaction step by step to provide a full understanding of the possible errors depending on the localization in the pathway and the methods designed for their detection. We discuss the correlation of the microbiome in nasal polyposis and chronic rhinitis with olfactory impairment using objective olfactometry. The topic of objective olfactometry and the examination of olfactory event-related potentials (OERP) is commented upon in detail.
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Affiliation(s)
- Květoslav Červený
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, First Faculty of Medicine, Charles University, 15006 Prague, Czech Republic
- Institute of Anatomy, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Karla Janoušková
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Kristýna Vaněčková
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Šárka Zavázalová
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - David Funda
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the CAS, v. v. i., 14220 Prague, Czech Republic
| | - Jaromír Astl
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Richard Holy
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
- Correspondence:
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10
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Błochowiak K. Smell and Taste Function and Their Disturbances in Sjögren's Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12472. [PMID: 36231772 PMCID: PMC9564460 DOI: 10.3390/ijerph191912472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Chemosensory disorders are a possible disturbance in Sjögren's syndrome (SS). The aim of the study is to comprehensively present chemosensory disorders in SS and to indicate their possible causes. The possible causes of taste and smell disorders in SS are changes in the structure of exocrine glands and their dysfunction, damage to receptors and weakening of their ability to regenerate, and neurological changes in the form of peripheral neuropathy and impaired cognitive function. Other postulated causes of chemosensory disorders are autoimmune mechanisms, adverse effects of drugs used in SS, and primary potentially SS-triggering viral infections. They are multifactorial and may occur independently of each other. The time of their onset and correlation with other disease symptoms may facilitate the determination of their primary cause in each patient. Awareness of chemosensory disorders in SS may help to ease their progress and eliminate other factors responsible for their more severe manifestation. In the prevention and treatment of chemosensory disorders in SS, the most important thing is to alleviate xerostomia and dryness in the nasal cavity and their effects in the form of chronic local inflammations, counteract receptor atrophy, and an implementation of appropriate neurological diagnosis and treatment.
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Affiliation(s)
- Katarzyna Błochowiak
- Department of Oral Surgery and Periodontology, Poznan University of Medical Sciences, 61-812 Poznan, Poland
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11
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Analysis of the dental care queries in the "Mouth-Nose" discussion forum of the French association of patients with Gougerot-Sjögren's syndromes and dryness. BMC Oral Health 2022; 22:418. [PMID: 36131279 PMCID: PMC9494845 DOI: 10.1186/s12903-022-02450-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Primary Sjögren Syndrome is a rare autoimmune systemic disease characterized by impaired secretory functions of the exocrine gland. One of the main clinical features is dry mouth and subsequent oral diseases, which are also found in patients with Sicca. This leads to a marked deterioration in the quality of life and the patient’s search for information and solutions. Many patients turn to patients’ associations that offer moments of sharing to their members, especially through online discussion forums. Today, these forums represent quality material for a sociological or biomedical analysis of patients' concerns, as close as possible to their daily lives. Our objective is to analyze the concerns of patients with SS or Sicca regarding their dry mouth especially dental care. Methods In this cross-sectional observation study, a quantitative analysis of the Mouth-Nose online forum discussion of the French Association of Patients with Gougerot-Sjögren’s Syndromes and Dryness have been performed. After reading and re-reading, initial request themes, topics, and subtopics were established and coding was performed. Then, the 885 threads were classified depending the initial request, pragma-linguistic indices and the main topic discussed in the thread. After identifying the threads dealing with dental care, we looked at which types of care were most discussed and classified the discussions according to whether or not the patient was satisfied with their care at the dentist. Results The majority of the initial requests are posts for experiences sharing and/or advice. The topic of “dental care” is one of the main concerns of the forum users. Among the threads that concern dental care, requests to share experience with implants are in the majority. Finally, the majority of the posts on dental care relate to care in private dental practice, deals with dental implants and prevention and resulted mainly in patient satisfaction. Conclusions Analysis of the forum reveals importance of patient concerns about prevention, and care costs due to implant treatment, which add to disease burden. Most of messages relate favorable experiences with their dentists, which is in line with the approach of sharing experiences and support characteristic of a forum.
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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Thomas DC, Chablani D, Parekh S, Pichammal RC, Shanmugasundaram K, Pitchumani PK. Dysgeusia: A review in the context of COVID-19. J Am Dent Assoc 2021; 153:251-264. [PMID: 34799014 PMCID: PMC8595926 DOI: 10.1016/j.adaj.2021.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/07/2021] [Accepted: 08/20/2021] [Indexed: 12/19/2022]
Abstract
Background Taste disorders in general, and dysgeusia in particular, are relatively common disorders that may be a sign of a more complex acute or chronic medical condition. During the COVID-19 pandemic, taste disorders have found their way into the realm of general as well as specialty dentistry, with significance in screening for patients who potentially may have the virus. Types of Studies Reviewed The authors searched electronic databases (PubMed, Embase, Web of Science, Google Scholar) for studies focused on dysgeusia, ageusia, and other taste disorders and their relationship to local and systemic causes. Results The authors found pertinent literature explaining the normal physiology of taste sensation, proposals for suggested new tastes, presence of gustatory receptors in remote tissues of the body, and etiology and pathophysiology of taste disorders, in addition to the valuable knowledge gained about gustatory disorders in the context of COVID-19. Along with olfactory disorders, taste disorders are one of the earliest suggestive symptoms of COVID-19 infection. Conclusions Gustatory disorders are the result of local or systemic etiology or both. Newer taste sensations, such as calcium and fat tastes, have been discovered, as well as taste receptors that are remote from the oropharyngeal area. Literature published during the COVID-19 pandemic to date reinforces the significance of early detection of potential patients with COVID-19 by means of screening for recent-onset taste disorders. Practical Implications Timely screening and identification of potential gustatory disorders are paramount for the dental care practitioner to aid in the early diagnosis of COVID-19 and other serious systemic disorders.
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Topan YE, Bozkurt B, Yılmaz S, Elsürer Ç, Gorcuyeva S, Bozkurt MK. Olfactory dysfunction in primary Sjogren's syndrome and its correlation with dry eye. ACTA OTORHINOLARYNGOLOGICA ITALICA 2021; 41:443-449. [PMID: 34734580 PMCID: PMC8569659 DOI: 10.14639/0392-100x-n1344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/04/2021] [Indexed: 12/11/2022]
Abstract
Objective To evaluate the olfactory function in primary Sjögren’s syndrome (pSS) patients and investigate its correlation with dry eye parameters. Methods Thirty-eight pSS patients (49.47 ± 10.06 years) and 20 healthy volunteers (47.40 ± 8.92 years) were enrolled in the study. All participants underwent ENT and eye examinations including a modified Connecticut Chemosensory Clinical Research Center (CCCRC) test, tear break-up time (TBUT), ocular surface staining (OSS) and Schirmer test. The parameters were compared between the two groups using Student-t test, and Pearson test was used to evaluate the correlations. Results Mean Schirmer and TBUT values were 2.39 ± 1.48 mm/5 min and 3.66 ± 1.5 sec in pSS and 18.30 ± 6.16 mm/5 min and 14.60 ± 3.64 sec in healthy subjects (p < 0.001, both). There was a significant decrease in mean odour threshold, odour identification, CCCRC and VAS scores in the pSS group (p < 0.001). Dry eye parameters showed moderate correlations with CCCRC parameters (r = 0.4-0.6, p < 0.001) and olfaction VAS score (r = 0.4-0.75, p < 0.05). Conclusions There is a mild clinical impairment in smell sense in patients with pSS which seems to be correlated with dry eye parameters. Therefore, smell complaints should be queried in pSS patients suffering from severe dry eye.
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Affiliation(s)
- Yunus E Topan
- Selcuk University School of Medicine, Otolaryngology Dept., Konya, Turkey
| | - Banu Bozkurt
- Selcuk University School of Medicine, Ophthalmology Dept., Konya, Turkey
| | - Sema Yılmaz
- Selcuk University School of Medicine, Rheumatology Dept., Konya, Turkey
| | - Çağdaş Elsürer
- Selcuk University School of Medicine, Otolaryngology Dept., Konya, Turkey
| | - Sona Gorcuyeva
- Selcuk University School of Medicine, Ophthalmology Dept., Konya, Turkey
| | - Mete K Bozkurt
- Selcuk University School of Medicine, Otolaryngology Dept., Konya, Turkey
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15
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Care need and dry mouth as risk indicators for impaired taste and smell. Sci Rep 2021; 11:20419. [PMID: 34650210 PMCID: PMC8516854 DOI: 10.1038/s41598-021-99978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/05/2021] [Indexed: 12/04/2022] Open
Abstract
To identify whether reduced saliva secretion or xerostomia symptoms are risk indicators for impaired taste and smell, depending on age and care needs. This cross-sectional study evaluated taste and smell in patients categorized into different age groups (<65> years) and different care need, with and without dry mouth. Of the 185 patients included, 119 were classified as “dry mouth” and 66 as “without dry mouth”. Overall, 103 (55.7%) were female and 37 (20%) needed care. There was no difference between “dry mouth” and “without dry mouth” regarding identification of odors or tastes, but a difference in the number of correctly identified odors and tastes in favor of “without care need” patients (p < 0.05). The ability to identify smells and tastes was negatively influenced by age, number of medications, and number of comorbidities, but subjective dry mouth had no impact. According to our results, subjective dry mouth is not a risk factor for an impaired ability to recognize smells and tastes. However, care need representing age, the number of medications taken, and the number of chronic comorbidities is a risk indicator.
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16
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Olfactory impairment in patients with primary Sjogren's syndrome and its correlation with organ involvement and immunological abnormalities. Arthritis Res Ther 2021; 23:250. [PMID: 34587995 PMCID: PMC8480095 DOI: 10.1186/s13075-021-02624-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/12/2021] [Indexed: 12/02/2022] Open
Abstract
Objective Patients with autoimmune diseases often present with olfactory impairment. The aim of the study was to assess the olfactory functions of patients with primary Sjögren’s syndrome and to correlate these findings with their disease activity. Methods Fifty-two patients with primary SS and 52 sex- and age-matched healthy control subjects were included. All of them underwent clinical and laboratory examination. Olfactory functions were evaluated using olfactory function assessment by computerized testing including the three stages of smell: threshold, identification, and memory of the different odors. Results All the olfactory scores (olfactory threshold, identification, and memory) in patients with pSS were significantly decreased than the control group (all P < 0.01). Patients had higher proportion of anosmia (13.5% vs 0%) and hyposmia (19.2% vs 11.5%) than controls (χ2 = 10.526, P < 0.01). Multivariable regression analysis revealed that ESSDAI and the symptoms of dryness, fatigue, and limb pain had negative influence on olfactory function (adjusted R2 = 0.381, 0.387, 0.513, and 0.614, respectively). ESSPRI showed significantly negative association with olfactory threshold, identification, memory, and total scores. Olfactory identification and memory scores were decreased in pSS patients with thyroid dysfunction or hypocomplementemia (P < 0.05). Smell threshold scores were decreased in pSS patients with anti-SSA antibody or anti-nuclear antibody compared with those without those autoantibodies (P < 0.01). Conclusion Our findings indicate that olfactory functions are impaired in pSS patients. There was a close correlation between olfactory dysfunction and disease severity and immunological abnormalities. Immune and systemic inflammation dysregulation might play a role in the mechanism of this defect. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02624-6.
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Cao N, Shi H, Chen C, Xie L, Wang Z, Zheng L, Yu C. Characterization of comprehensive dynamic epigenetic changes during human primary Sjögren's syndrome progression. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1044. [PMID: 34422956 PMCID: PMC8339825 DOI: 10.21037/atm-21-1754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/24/2021] [Indexed: 11/06/2022]
Abstract
Background Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by reduced exocrine gland (principally the salivary and lacrimal glands) activity caused by chronic lymphocytic infiltration. Although pSS has been closely associated with an increased risk of mucosa-associated lymphoid tissue (MALT) lymphoma, the dynamic epigenetic changes in the gland cells that accompany the pathogenesis are not entirely understood. Methods In this study, we harvested tissue samples from the labial gland with (LG_pSS) or without pSS (LG_NC) before MALT development, as well as the parotid gland with tumor tissues (PG_MALT) and paracancerous tissues (PG_NC) of two pSS patients with MALT lymphoma, and conducted RNA-seq and ChIP-seq for tri-methylated histone 3 lysine 4, 9, 27, 36, and 79 (H3K4/9/27/36/79me3). Results Transcriptome landscapes indicated two outcomes of pSS progression with or without MALT lymphoma represented by distinct populations of differentially expressed genes and their functions. Furthermore, the epigenetic atlas of genome-wide H3K4/9/27/36/79me3 was in different stages for various samples, indicating that the variance of H3K4me3 was the earliest event, followed by selective alterations of H3K9/27/36/79me3. These four epigenetic modifications determine the final outcome of pSS progression. Conclusions Our results not only advance the understanding of the dynamics of pSS progression and highlight the importance of epigenetic alterations in regulating transcription during this pathological process, but also identify potential therapeutic targets for pSS treatment and lymphoma intervention.
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Affiliation(s)
- Ningning Cao
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Huan Shi
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chan Chen
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lisong Xie
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhijun Wang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lingyan Zheng
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chuangqi Yu
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Rhinological manifestations of Sjögren's syndrome: a cohort-matched, prospective, cross-sectional, observational study. The Journal of Laryngology & Otology 2021; 135:932-936. [PMID: 34420533 DOI: 10.1017/s0022215121002255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the prevalence of abnormal rhinological findings in a Sjögren's syndrome population. METHODS A cohort-matched, prospective, cross-sectional, observational study was conducted. Sixty-seven subjects (30 patients and 37 controls) were enrolled. Rhinological assessment including smell threshold was evaluated using a standardised, validated clinical test as part of a larger study. RESULTS Smell thresholds were -4.4 and -5.4 in the Sjögren's syndrome and control groups, respectively (p = 0.001). Hyposmia (threshold values of less than -4.5) was demonstrated in the Sjögren's syndrome group (47 per cent). Smell was negatively correlated with age (p = 0.040). Nasal septal perforation was noted in 3 Sjögren's syndrome patients (10 per cent) and nasal mucosal dryness in 10 patients (33 per cent), but none of the control group were affected. CONCLUSION Hyposmia in Sjögren's syndrome was demonstrated using the Smell Threshold Test. Nasal septal perforation and nasal mucosa dryness were also noted in patients with Sjögren's syndrome. A diagnosis of Sjögren's syndrome should be considered and investigated in smell deprivation and/or nasal septal perforation patients.
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McCoy SS, Bartels CM, Saldanha IJ, Bunya VY, Akpek EK, Makara MA, Baer AN. National Sjögren's Foundation Survey: Burden of Oral and Systemic Involvement on Quality of Life. J Rheumatol 2021; 48:1029-1036. [PMID: 32934136 PMCID: PMC7956920 DOI: 10.3899/jrheum.200733] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To define the association between oral and systemic manifestations of Sjögren syndrome (SS) and quality of life (QOL). METHODS We analyzed a cross-sectional survey conducted by the Sjögren's Foundation in 2016, with 2961 eligible responses. We defined oral symptom and sign exposures as parotid gland swelling, dry mouth, mouth ulcers/sores, oral candidiasis, trouble speaking, choking or dysphagia, sialolithiasis or gland infection, and dental caries. Systemic exposures included interstitial lung disease, purpura/petechiae/cryoglobulinemia, vasculitis, neuropathy, leukopenia, interstitial nephritis, renal tubular acidosis, autoimmune hepatitis, primary biliary cholangitis, or lymphoma. Outcomes included SS-specific QOL questions generated by SS experts and patients. RESULTS Using multivariable regression models adjusted for age, sex, race, and employment, we observed that mouth ulcers or sores, trouble speaking, and dysphagia were associated with poor quality of life. The following oral aspects had the greatest effect on the following QOL areas: (1) mouth ulcers/sores on the challenge and burden of living with SS (OR 4.26, 95% CI 2.89-6.28); (2) trouble speaking on memory and concentration (OR 4.24, 95% CI 3.28-5.48); and (3) dysphagia on functional interference (OR 4.25, 95% CI 3.13-5.79). In contrast, systemic manifestations were associated with QOL to a lesser extent or not at all. CONCLUSION Oral manifestations of SS, particularly mouth ulcers or sores, trouble speaking, and dysphagia, were strongly associated with worse QOL. Further study and targeted treatment of these oral manifestations provides the opportunity to improve quality of life in patients with SS.
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Affiliation(s)
- Sara S McCoy
- S.S. McCoy, MD, MS, C.M. Bartels, MD, MS, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;
| | - Christie M Bartels
- S.S. McCoy, MD, MS, C.M. Bartels, MD, MS, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ian J Saldanha
- I.J. Saldanha, MBBS, MPH, PhD, Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice and Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
| | - Vatinee Y Bunya
- V.Y. Bunya, MD, MSCE, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Esen K Akpek
- E.K. Akpek, MD, Department of Ophthalmology, Johns Hopkins University School of Medicine
| | | | - Alan N Baer
- A.N. Baer, MD, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Dias LH, Miyamoto ST, Giovelli RA, de Magalhães CIM, Valim V. Pain and fatigue are predictors of quality of life in primary Sjögren's syndrome. Adv Rheumatol 2021; 61:28. [PMID: 34051867 DOI: 10.1186/s42358-021-00181-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/27/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Few studies have evaluated the relation of quality of life (QoL) with symptoms and disease activity in primary Sjögren's syndrome (pSS). There is also scant information on the predictors of QoL in this population. The aim of this study was to assess QoL in patients with pSS and to investigate their possible predictors. METHODS In a cross-sectional study, 77 patients with pSS were evaluated using the following questionnaires: Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-Fatigue), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), Short Form-36 Health Survey (SF-36) and World Health Organization Quality of Life Assessment (WHOQOL-BREF). Seventy-seven healthy controls responded to the SF-36 and WHOQOL-BREF. The Mann-Whitney test, t-test, Pearson and Spearman correlation, and multiple regression analysis were used in the statistical analysis. RESULTS Patients with pSS and healthy controls were matched by gender and age. The mean scores for the ESSDAI, ESSPRI and FACIT-Fatigue were 3.34 ± 4.61, 6.58 ± 2.29 and 26.17 ± 11.02, respectively. Patients had a lower employment rate (36.4% versus 62.3%, p < 0.01) and higher work disability (10.4% versus 1.3%, p < 0.01). SF-36 and WHOQOL-BREF values were lower in patients with pSS (p < 0.001), except in the WHOQOL-BREF environment domain. Pain (ESSPRI), fatigue (FACIT-Fatigue), antinuclear antibody (ANA), anti-Ro-SSA and economic class (Brazilian Economic Classification Criteria - CCEB) were independent predictors of QoL. CONCLUSIONS The main predictors of poor QoL in patients with pSS were pain and fatigue, and these symptoms had an impact regardless of disease activity, age, schooling, marital status, work disability and fibromyalgia.
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Affiliation(s)
- Laiza Hombre Dias
- Department of Clinical Medicine, Cassiano Antonio Moraes University Hospital / EBSERH, Federal University of Espírito Santo (Ufes), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29075-910, Brazil.,Brazilian Society of Rheumatology, São Paulo, Brazil
| | - Samira Tatiyama Miyamoto
- Department of Integrated Health Education, Federal University of Espírito Santo (Ufes), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29075-910, Brazil
| | - Raquel Altoé Giovelli
- Brazilian Society of Rheumatology, São Paulo, Brazil.,Department of Clinical Medicine, School of Sciences of Santa Casa de Misericórdia de Vitória (Emescam), Av. Nossa Senhora da Penha 2190, Vitória, ES, 29045-925, Brazil
| | | | - Valeria Valim
- Department of Clinical Medicine, Cassiano Antonio Moraes University Hospital / EBSERH, Federal University of Espírito Santo (Ufes), Av. Marechal Campos, 1468, Maruípe, Vitória, ES, CEP: 29075-910, Brazil. .,Brazilian Society of Rheumatology, São Paulo, Brazil. .,Brazilian Sjögren Syndrome Commission, São Paulo, Brazil.
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21
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Takehara S, Hirani V, Wright FAC, Naganathan V, Blyth FM, Le Couteur DG, Waite LM, Seibel MJ, Handelsman DJ, Cumming RG. Appetite, oral health and weight loss in community-dwelling older men: an observational study from the Concord Health and Ageing in Men Project (CHAMP). BMC Geriatr 2021; 21:255. [PMID: 33863274 PMCID: PMC8052725 DOI: 10.1186/s12877-021-02169-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Unintended weight loss and the reduction in appetite are common phenomenon among older people. Reduced appetite has been linked to medication related reductions in saliva production, reduced taste ability and poor oral health. Poor appetite can result in reduced nutrient intake ensuing weight loss. It is possible that poor appetite is a mediating step on the causal pathway between oral health and weight loss. This study investigates whether poor oral health and loss of appetite are related to weight loss. Methods This is an observational study where data were obtained from the Concord Health and Ageing in Men Project (CHAMP). Information on socio-demographics, appetite and health related behavior was collected by self-completed questionnaire. Intraoral assessment was conducted by calibrated oral health therapists. Height and weight were measured by trained staff. Regression analysis investigated associations between oral health and appetite as risk factors for weight loss. Results Participants included 542 community dwelling older males. 99 older men (18.3%) experienced 5% or more weight loss over 3 years. Men who lost weight from baseline had lower BMI and lower body weight, had higher prevalence of frailty and depression, reported poorer appetite, and had fewer teeth (13.8 ± 9.5) than those who did not lose weight (16.3 ± 9.3). Before adjustment, the prevalence ratio (PR) for weight loss was 1.76 (95% Confidence Interval (CI), 1.19–2.59) for participants with 0–19 natural teeth present compared to those with 20 or more teeth. When adding appetite and other variables to the model, the PR for number of teeth and weight loss was unchanged: 1.78 (95% CI, 1.06–3.00). The mediation analysis showed that the indirect effect of appetite on the association between number of natural teeth on weight loss was not found to be significant. Conclusion This study found that number of natural teeth present and appetite are independently related to weight change among elderly men in Australia. Tooth loss can increase the risk of swallowing difficulty leading to change in food preference, avoidance of foods and a decrease in energy intake. Our study showed the importance of oral health interventions to encourage maintenance of 20 or more natural teeth in older people.
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Affiliation(s)
- Sachiko Takehara
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia. .,Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - F A Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Fiona M Blyth
- Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,ANZAC Research Institute, The University of Sydney, Concord Hospital, Sydney, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, The University of Sydney, Concord Hospital, Sydney, NSW, Australia
| | - Robert G Cumming
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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22
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Eren E, Balcı K, Gerçik Ö, Kabadayı G, Akar S. Does Nasal Secretion Decrease in Sjögren Syndrome and Does This Affect Nasal Function? Laryngoscope 2020; 131:370-373. [PMID: 32780886 DOI: 10.1002/lary.29022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/08/2020] [Accepted: 07/24/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Sjögren syndrome is a systemic inflammatory disease causing gland dysfunction. Few (and contradictory) reports on the mucosal effects of Sjögren syndrome have appeared. Here, we objectively demonstrate nasal dryness in Sjögren syndrome patients and explore the effect of such dryness on olfaction. METHODS Thirty-four consecutive patients with primary Sjögren syndrome were enrolled in this cross-sectional study. The control group consisted of 21 age- and sex-matched volunteers. Medical histories and nasal findings were recorded. The Connecticut Chemosensory Clinical Research Center test was used to evaluate olfactory function. All subjects underwent mucucociliary clearance analysis (the saccharin test and peak nasal inspiratory flowmetry). The intranasal Schirmer test was used to evaluate the nasal cavity. RESULTS The nasal Schirmer test scores were 8.4 mm (right) and 8 mm (left) (P = .041, P = .016, respectively, compared to controls). The Chi-squared test revealed significant differences (compared to controls) in nasal dryness (P = .001), postnasal drip (P = .04), and smell (a decrease) (P = .005). Neither olfactory function nor mucociliary clearance differed between the groups. We noted a trend toward a positive correlation between olfactory function and the nasal Schirmer score but statistical significance was not attained. CONCLUSION The intranasal Schirmer test objectively showed that Sjögren syndrome patients exhibited nasal cavity dryness; this is useful in terms of follow-up. This did not affect olfactory function. LEVEL OF EVIDENCE 4 Laryngoscope, 131:370-373, 2021.
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Affiliation(s)
- Erdem Eren
- Department of Otolaryngology-Head & Neck Surgery, Izmir Atatürk Research and Education Hospital, İzmir, Turkey
| | - Koray Balcı
- Department of Otolaryngology-Head & Neck Surgery, Izmir Atatürk Research and Education Hospital, İzmir, Turkey
| | - Önay Gerçik
- Department of Rheumatology, Izmir Katip Çelebi University Atatürk Research and Education Hospital, İzmir, Turkey
| | - Gökhan Kabadayı
- Department of Rheumatology, Izmir Katip Çelebi University Atatürk Research and Education Hospital, İzmir, Turkey
| | - Servet Akar
- Department of Rheumatology, Izmir Katip Çelebi University Atatürk Research and Education Hospital, İzmir, Turkey
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23
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Šijan Gobeljić M, Milić V, Pejnović N, Damjanov N. Chemosensory dysfunction, Oral disorders and Oral health-related quality of life in patients with primary Sjögren's syndrome: comparative cross-sectional study. BMC Oral Health 2020; 20:187. [PMID: 32620111 PMCID: PMC7333297 DOI: 10.1186/s12903-020-01169-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/19/2020] [Indexed: 11/11/2022] Open
Abstract
Background The aim of this study was to evaluate chemosensory function and oral disorders in patients with primary Sjögren’s syndrome (pSS) and to compare these findings with those of age- and gender-matched healthy controls. Methods This comparative cross-sectional study included 58 patients with primary Sjögren’s syndrome (pSS) and 55 age- and gender-matched healthy controls. Olfactory and gustatory function, burning sensations in the tongue (BST) and halitosis were assessed. Oral health-related quality of life (OHRQoL) was evaluated using the short-form Oral Health Impact Profile (OHIP-14). Results Patients with pSS had significantly lower self-reported visual analogue scale (VAS) smell score (8.6 ± 2.2 vs. 9.6 ± 0.7, p = 0.016) and VAS taste score (8.5 ± 2.1 vs. 9.5 ± 0.7, p = 0.014) than healthy controls. A greater proportion of patients with pSS had anosmia (3.8% vs. 0.0%) or hyposmia (36.5% vs. 13.2%) and ageusia for basic tastes: sweetness (34.0% vs. 7.5%), sourness (10.6% vs. 0.0), saltiness (10.0% vs. 5.7%) or bitterness (19.1% vs. 1.9%) as evaluated using Sniffin Sticks test and taste stripts, respectively. A higher proportion of pSS patients complained of dysgeusia (52.6% vs. 9.4%, p < 0.0001) and BST (45.6% vs. 0.0%, p < 0.0001), while similar number of patients with pSS and controls reported halitosis (31.6% vs. 28.3%, p = 0.434). The mean OHIP-14 score was significantly higher in patients with pSS (6.8 ± 7.0 vs. 2.3 ± 8.5, p < 0.001) indicating patients’ poorer OHRQoL compared with controls. Conclusions The majority of patients with pSS had impaired chemosensory function and indicators of oral health in comparison with the age- and gender-matched healthy controls. Further studies of oral hygiene habits and dietary intake of these patients are needed to ensure better management of oral health problems in patients with pSS.
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Affiliation(s)
| | - Vera Milić
- Institute of Rheumatology, Resavska 69, Belgrade, 11000, Serbia.,University of Belgrade Medical School, Institute of Rheumatology, Belgrade, Serbia
| | - Nada Pejnović
- Institute of Rheumatology, Resavska 69, Belgrade, 11000, Serbia.
| | - Nemanja Damjanov
- Institute of Rheumatology, Resavska 69, Belgrade, 11000, Serbia.,University of Belgrade Medical School, Institute of Rheumatology, Belgrade, Serbia
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24
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Walliczek-Dworschak U, Wendler J, Khan T, Aringer M, Hähner A, Hummel T. Chemosensory function is decreased in rheumatoid arthritis. Eur Arch Otorhinolaryngol 2020; 277:1675-1680. [PMID: 32128609 DOI: 10.1007/s00405-020-05874-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Research indicates that rheumatic disorders are accompanied by decreased chemosensory function. The present study aimed to specifically evaluate this issue in patients with rheumatoid arthritis (RA). METHODS 212 RA patients (43 men, 169 women, mean age 59 ± 13.3 years), and 30 healthy controls (10 men, 20 women, mean age 40 ± 15.3 years), were included in this study. Chemosensory measurements consisted of olfactory testing using the "Sniffin' Sticks" test battery (with odor thresholds, odor discrimination and odor identification; OT, OD, OI) and gustatory testing on a suprathreshold and a quasi-threshold level using "taste sprays" and "taste strips", respectively. In addition, inflammatory markers (erythrocyte sedimentation rate, C-reactive protein) and RA autoantibodies (anti-cyclic citrullinated peptides, RA factors) were evaluated. RESULTS Olfactory measurements showed 4% of the RA patients functionally anosmic and 40% hyposmic. RA patients scored significantly lower in suprathreshold olfactory tests (OD, OI) compared to controls (OI: 12.5 ± 2.5 vs. 14.1 ± 1.3; OD: 11.3 ± 2.7 vs. 12.9 ± 1.7). In addition, RA patient had decreased taste function compared to healthy individuals (10.4 ± 2.6 vs. 11.7 ± 1.7). Chemosensory function did not correlate with parameters related to the severity of disease. CONCLUSION Chemosensory function (taste, OD and OI) appears to be decreased in RA patients. In contrast, OT was not affected. Changes in chemosensory function seem to be independent of disease parameters such as duration of disease or disease activity.
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Affiliation(s)
- Ute Walliczek-Dworschak
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. .,Klinik für Hals-Nasen und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg, Standort Marburg, Germany.
| | - Jörg Wendler
- Outpatient Clinic for Rheumatological Disorders, Erlangen, Germany
| | - Tran Khan
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.,Outpatient Clinic for Rheumatological Disorders, Erlangen, Germany.,Division of Rheumatology, Department of Medicine III, TU, Dresden, Germany
| | - Martin Aringer
- Division of Rheumatology, Department of Medicine III, TU, Dresden, Germany
| | - Antje Hähner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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25
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Al‐Ezzi M, Khan K, Tappuni AR. Is the taste acuity affected by oral dryness in primary Sjögren’s syndrome patients? Oral Dis 2020; 26:688-695. [DOI: 10.1111/odi.13259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Minan Al‐Ezzi
- Barts and the London School of Medicine and Dentistry Queen Mary University of London London UK
| | - Khalid Khan
- Barts and the London School of Medicine and Dentistry Queen Mary University of London London UK
| | - Anwar R. Tappuni
- Barts and the London School of Medicine and Dentistry Queen Mary University of London London UK
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26
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Bainbridge KE, Byrd-Clark D, Leopold D. Factors Associated With Phantom Odor Perception Among US Adults: Findings From the National Health and Nutrition Examination Survey. JAMA Otolaryngol Head Neck Surg 2019; 144:807-814. [PMID: 30128498 DOI: 10.1001/jamaoto.2018.1446] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Phantom odor perception can be a debilitating condition. Factors associated with phantom odor perception have not been reported using population-based epidemiologic data. Objective To estimate the prevalence of phantom odor perception among US adults 40 years and older and identify factors associated with this condition. Design, Setting, and Participants In this cross-sectional study with complex sampling design, 7417 adults 40 years and older made up a nationally representative sample from data collected in 2011 through 2014 as part of the National Health and Nutrition Examination Survey. Exposures Sociodemographic characteristics, cigarette and alcohol use, head injury, persistent dry mouth, smell function, and general health status. Main Outcomes and Measures Phantom odor perception ascertained as report of unpleasant, bad, or burning odor when no actual odor exists. Results Of the 7417 participants in the study, 52.8% (3862) were women, the mean (SD) age was 58 (12) years, and the prevalence of phantom odor perception occurred in 534 participants, which was 6.5% of the population (95% CI, 5.7%-7.5%). Phantom odor prevalence varied considerably by age and sex. Women 60 years and older reported phantom odors less commonly (7.5% [n = 935] and 5.5% [n = 937] among women aged 60-69 years and 70 years and older, respectively) than younger women (9.6% [n = 1028] and 10.1% [n = 962] among those aged 40-49 years and 50-59 years, respectively). The prevalence among men varied from 2.5% (n = 846) among men 70 years and older to 5.3% (n = 913) among men 60 to 69 years old. Phantom odor perception was 60% (n = 1602) to 65% (n = 2521) more likely among those with an income-to-poverty ratio of less than 3 compared with those in the highest income-to-poverty ratio group (odds ratio [OR], 1.65; 95% CI, 1.06-2.56; and OR, 1.60; 95% CI, 1.01-2.54 for income-to-poverty ratio <1.5 and 1.5-2.9, respectively). Health conditions associated with phantom odor perception included persistent dry mouth (OR, 3.03; 95% CI, 2.17-4.24) and history of head injury (OR, 1.74; 95% CI, 1.20-2.51). Conclusions and Relevance An age-related decline in the prevalence of phantom odor perception is observed in women but not in men. Only 11% (n = 64) of people who report phantom odor perception have discussed a taste or smell problem with a clinician. Associations of phantom odor perception with poorer health and persistent dry mouth point to medication use as a potential explanation. Prevention of serious head injuries could have the added benefit of reducing phantom odor perception.
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Affiliation(s)
- Kathleen E Bainbridge
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland
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27
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Vivino FB, Bunya VY, Massaro-Giordano G, Johr CR, Giattino SL, Schorpion A, Shafer B, Peck A, Sivils K, Rasmussen A, Chiorini JA, He J, Ambrus JL. Sjogren's syndrome: An update on disease pathogenesis, clinical manifestations and treatment. Clin Immunol 2019; 203:81-121. [PMID: 31022578 DOI: 10.1016/j.clim.2019.04.009] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Frederick B Vivino
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Vatinee Y Bunya
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Giacomina Massaro-Giordano
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Chadwick R Johr
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Stephanie L Giattino
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Annemarie Schorpion
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Brian Shafer
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Ammon Peck
- Department of Infectious Diseases and Immunology, University of Florida College of Veterinary Medicine, PO Box 100125, Gainesville, FL 32610, USA.
| | - Kathy Sivils
- Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, 825 NE 13th Street, OK 73104, USA.
| | - Astrid Rasmussen
- Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, 825 NE 13th Street, OK 73104, USA.
| | - John A Chiorini
- NIH, Adeno-Associated Virus Biology Section, National Institute of Dental and Craniofacial Research, Building 10, Room 1n113, 10 Center DR Msc 1190, Bethesda, MD 20892-1190, USA.
| | - Jing He
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - Julian L Ambrus
- Division of Allergy, Immunology and Rheumatology, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA.
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28
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Miyamoto ST, Valim V, Fisher BA. Health-related quality of life and costs in Sjögren's syndrome. Rheumatology (Oxford) 2019; 60:2588-2601. [PMID: 30770918 DOI: 10.1093/rheumatology/key370] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/13/2018] [Indexed: 02/06/2023] Open
Abstract
Health-related quality of life (HRQoL) has an increasing role in medical decision-making. This review of the literature aims to provide an overview on HRQoL, costs, and work disability in SS, a disease characterized by focal lymphocytic infiltration of exocrine glands with no therapeutics of proven immunomodulatory potential. HRQoL is markedly reduced in SS in multiple studies across many countries when compared with HRQoL in healthy controls. The reduction in HRQoL is similar to that observed in other chronic diseases such as RA, SLE, FM and, interestingly, non-SS sicca syndrome. Impaired HRQoL in SS has been found to be associated with fatigue, pain/articular involvement, ocular and oral involvement, pruritus, sexual dysfunction, impaired sleep, pulmonary manifestations, psychological dysfunction and impaired physical function. Until now, no therapeutic has been shown to improve HRQoL in an adequately powered double-blind, placebo-controlled randomized controlled trial. Although primary SS does not, in general, impair life expectancy and is often inappropriately considered a benign 'nuisanvce' disease for those patients without systemic manifestations, the associated costs and work disability are striking. This, together with the significant reduction in HRQoL, strongly argues for the development of new therapeutic approaches to manage this neglected disease.
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Affiliation(s)
- Samira T Miyamoto
- Department of Integrated Education in Health, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Valéria Valim
- Department of Medical Clinic, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Benjamin A Fisher
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.,Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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29
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Distorted Taste and Impaired Oral Health in Patients with Sicca Complaints. Nutrients 2019; 11:nu11020264. [PMID: 30682880 PMCID: PMC6412562 DOI: 10.3390/nu11020264] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 01/25/2023] Open
Abstract
Senses of smell and taste, saliva flow, and dental status are considered as important factors for the maintenance of a good nutritional status. Salivary secretory rates, chemosensory function, burning mouth sensation, halitosis and dental status were investigated in 58 patients with primary Sjögren’s syndrome (pSS), 22 non-Sjögren’s syndrome sicca (non-SS) patients, and 57 age-matched healthy controls. A significantly greater proportion of patients with pSS and non-SS had ageusia, dysgeusia, burning mouth sensation, and halitosis compared to controls. Patients with pSS had significantly lower olfactory and gustatory scores, and significantly higher caries experience compared to controls. Patients with pSS and non-SS patients had significantly lower unstimulated and stimulated whole saliva secretory rates compared to controls. The findings indicated that several different aspects of oral health were compromised in both, patients with pSS and non-SS, and this may affect their food intake and, hence, their nutritional status. Although non-SS patients do not fulfill Sjögren’s syndrome classification criteria, they have similar or, in some cases, even worse oral complaints than the patients with pSS. Further studies are needed to investigate food preferences, dietary intake, and nutritional status in these two patient groups in relation to their health condition.
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30
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Abstract
Alterations in the ability to smell or taste are of considerable consequence, impacting quality of life, safety, nutrition, and dietary activities. These primary senses are influenced by a wide range of systemic diseases and disorders that commonly involve the entire body. These include viral, bacterial, fungal, protozoal, cestode, and nematode infections that can spread throughout the gastric, lymphatic, neural, or circulatory systems as well as classic autoimmune disorders, collagen diseases, diabetes, and hypertension, and others. Although a considerable literature has evolved in which the function of both taste and smell has been assessed in a number of such disorders, quantitative chemosensory testing is still relatively rare with many disorders not receiving empirical assessment. Incongruent findings are not uncommon. This chapter reviews what is known about the influences of a wide spectrum of systemic diseases and disorders on the abilities to taste and smell.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Oral Disorders in Sjögren’s Syndrome. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.2478/sjecr-2018-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Sjogren’s syndrome (SS) is a complex, chronic, systemic, autoimmune disease that mainly affects the exocrine glands, especially the salivary and lacrimal glands, leading to the dryness of the mouth and eyes, along with fatigue, joint and muscle pain. The prevalence of SS is estimated to be between 0.05% and 1% in European population. Diagnosis of SS is based on the revised criteria of the American-European consensus group (AECG). Sjogren’s syndrome can be subclassified into primary disease (primary Sjogren syndrome, pSS) and a secondary disease (secondary Sjogren syndrome, sSS) when present with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis. The decrease in salivary flow and qualitative alterations in saliva could explain many of the oral manifestations frequently present in patients with SS. Low salivary flow may affect chewing, swallowing, speech and sleeping in pSS patients. Oral manifestations include dental erosion, dental caries, mucosal infection, ulcers and oral candidiasis. Recent studies reveal that pSS patients experience impaired olfactory and gustatory functions and have higher occurrence of oral complications such as dysgeusia, burning sensation in the tongue (BST) and halitosis. The exocrine manifestations and systemic involvement in SS significantly impact the patient’s perception of oral healthrelated quality of life (OHRQoL).
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Bombini MF, Peres FA, Lapa AT, Sinicato NA, Quental BR, Pincelli ÁDSM, Amaral TN, Gomes CC, Del Rio AP, Marques-Neto JF, Costallat LTL, Fernandes PT, Cendes F, Rittner L, Appenzeller S. Olfactory function in systemic lupus erythematosus and systemic sclerosis. A longitudinal study and review of the literature. Autoimmun Rev 2018; 17:405-412. [PMID: 29444467 DOI: 10.1016/j.autrev.2018.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND/PURPOSE To evaluate olfactory function in systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and healthy controls over a 2-year period, and to determine the association of olfactory dysfunction with age, disease activity, disease damage, treatment, anxiety and depression symptoms and limbic structures volumes. METHODS Consecutive SLE and SSc patients were enrolled in this study. Clinical, laboratory disease activity and damage were assessed according to diseases specific guidelines. Olfactory functions were evaluated using the Sniffin' Sticks test (TDI). Volumetric magnetic resonance imaging (MRI) was obtained in a 3T Phillips scanner. Amygdalae and hippocampi volumes were analyzed using FreeSurfer® software. RESULTS We included 143 SLE, 57 SSc and 166 healthy volunteers. Olfactory dysfunction was observed in 78 (54.5%) SLE, 35 (59.3%) SSc patients and in 24 (14.45%) controls (p<0.001) at study entry. SLE and SSc patients had significantly lower mean in all three phases (TDI) of the olfactory assessment when compared with healthy volunteers. In SLE, the presence of olfactory dysfunction was associated with older age, disease activity, higher anxiety and depression symptoms score, smaller left hippocampus volume, smaller left and right amygdalae volume and the presence of anti-ribosomal P (anti-P) antibodies. In SSc the presence of olfactory impairment was associated with older age, disease activity, smaller left and right hippocampi volumes and smaller right amygdala volume. Olfactory function was repeated after a 2-year period in 90 SLE, 35 SSc and 62 controls and was stable in all three groups. CONCLUSION Both SLE and SSc patients with longstanding disease had significant reduction in all stages of TDI that maintained stable over a 2-year period. Olfactory dysfunction was associated with age, inflammation and hippocampi and amygdalae volumes. In SLE, additional association with anti-P, anxiety and depression symptoms was observed.
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Affiliation(s)
- Mariana Freschi Bombini
- Physiopathology Graduate Program, School of Medical Sciences, University of Campinas, Brazil; Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Fernando Augusto Peres
- Medicine Graduate Program, School of Medical Sciences, University of Campinas, Brazil; Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Aline Tamires Lapa
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Child and Adolescent Health Graduate Program, School of Medical Sciences, University of Campinas, Brazil
| | - Nailú Angélica Sinicato
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Child and Adolescent Health Graduate Program, School of Medical Sciences, University of Campinas, Brazil
| | - Beatriz Ricato Quental
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Ágatha de Souza Melo Pincelli
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Tiago Nardi Amaral
- Medicine Graduate Program, School of Medical Sciences, University of Campinas, Brazil; Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil
| | | | - Ana Paula Del Rio
- Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil
| | | | - Lilian T L Costallat
- Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil
| | | | - Fernando Cendes
- Medical Imaging Computing Laboratory, School of Electrical and Computer Engineering, University of Campinas, Brazil
| | - Leticia Rittner
- Department of Neurology, School of Medical Sciences, University of Campinas, Brazil
| | - Simone Appenzeller
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil.
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Hammitt KM, Naegeli AN, van den Broek RWM, Birt JA. Patient burden of Sjögren's: a comprehensive literature review revealing the range and heterogeneity of measures used in assessments of severity. RMD Open 2017; 3:e000443. [PMID: 28955493 PMCID: PMC5604724 DOI: 10.1136/rmdopen-2017-000443] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/20/2017] [Accepted: 08/11/2017] [Indexed: 12/11/2022] Open
Abstract
CONTEXT The severity of Sjögren's syndrome has been evaluated using a wide variety of clinical measures and patient-reported outcomes (PROs). This may contribute to the lack of clarity concerning the burden of Sjögren's from the patient perspective. OBJECTIVE To perform a comprehensive peer-reviewed literature analysis of the patient aspects of Sjögren's, focusing on PROs, to investigate the complexity underlying the evaluation of the syndrome and to elucidate the discordance between the different measures. METHODS We searched Embase for articles published between January 2005 and September 2015. Research articles, clinical and diagnostic reviews, and validation studies with a focus on patient aspects of Sjögren's were selected as the primary information source. RESULTS 157 articles met the eligibility criteria. A wide variety of assessment measures used to evaluate glandular, extraglandular and functional domains were observed. Many different, non-validated Visual Analogue Scales, with a wide range of anchor words, were used in the quantification of Sjögren's disease burden, impeding comparisons between studies. Relatively few clinical trials of drug therapies used validated scales: European League Against Rheumatism Sjögren's Syndrome Patient Reported Index was used most often for symptom assessment and 36 Item Short Form Survey for quality of life (QoL). CONCLUSION A wide range and diversity of measures are used to evaluate the patient burden of Sjögren's; most are not validated for use in this disease. PRO endpoints, validated specifically in Sjögren's, that demonstrate improvement are needed. These measures should focus on QoL aspects important to patients and will most likely involve gauging change in function rather than patient-reported symptoms.
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Affiliation(s)
| | - April N Naegeli
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA
| | | | - Julie A Birt
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA
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Rusthen S, Young A, Herlofson BB, Aqrawi LA, Rykke M, Hove LH, Palm Ø, Jensen JL, Singh PB. Oral disorders, saliva secretion, and oral health-related quality of life in patients with primary Sjögren's syndrome. Eur J Oral Sci 2017. [PMID: 28643390 DOI: 10.1111/eos.12358] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chemosensory function, burning sensations in the tongue (BST), halitosis, saliva secretion, and oral health-related quality of life (OHRQoL) were investigated in patients with primary Sjögren's syndrome (pSS). In 31 patients with pSS and 33 controls, olfactory and gustatory functions were evaluated. Self-reported complaints of dysgeusia, BST, and halitosis were recorded. Saliva secretion rates were measured and OHRQoL was assessed using the short-form Oral Health Impact Profile (OHIP-14). Patients had significantly lower olfactory (8.8 ± 3.5 vs. 10.7 ± 1.2) and gustatory (18.9 ± 7.1 vs. 25.4 ± 4.3) scores than controls, and significantly more patients complained of dysgeusia (58.1% vs. 0%), BST (54.8% vs. 6.1%), and halitosis (41.9% vs. 0%). A significantly greater proportion of patients with pSS had ageusia (19% vs. 0%), hypogeusia (32% vs. 12%), anosmia (13% vs. 0%), or hyposmia (29% vs. 9%). Significantly lower saliva secretion rates (ml min-1 ) were observed in patients with pSS for stimulated (0.62 ± 0.40 vs. 1.57 ± 0.71) and unstimulated (0.08 ± 0.07 vs. 0.29 ± 0.17) saliva. The mean OHIP-14 score was significantly higher in patients with pSS (16.2 ± 10.8 vs. 2.7 ± 3.1) and was positively correlated with dysgeusia, BST, and halitosis. In conclusion, patients with pSS reported higher occurrence of dysgeusia, BST, and halitosis, and demonstrated relatively impaired chemosensory and salivary functions. The patients' poorer OHRQoL was associated with dysgeusia, BST, and halitosis.
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Affiliation(s)
- Shermin Rusthen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Alix Young
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Bente B Herlofson
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Lara A Aqrawi
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Morten Rykke
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Lene H Hove
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Øyvind Palm
- Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Janicke L Jensen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Preet B Singh
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Zhang Q, Wang X, Chen H, Shen B. Sjögren's syndrome is associated with negatively variable impacts on domains of health-related quality of life: evidence from Short Form 36 questionnaire and a meta-analysis. Patient Prefer Adherence 2017; 11:905-911. [PMID: 28546741 PMCID: PMC5436777 DOI: 10.2147/ppa.s132751] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The purpose of this article was to systematically review the literature to identify the impact of primary Sjögren's syndrome (pSS) on specific health-related quality of life (HRQoL) domains. METHODS A meta-analysis was performed, and the related articles were searched in Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine, and Web of Science databases and in reference lists of articles and systematic reviews. Score of the Short Form 36 (SF-36) questionnaire was used as the outcome measurement, and mean differences (MD) with 95% confidence intervals (CIs) were calculated. RESULTS Seven studies were included, comprising 521 patients with pSS and 9,916 healthy controls. The SF-36 questionnaire score of each domain (physical function, role physical [RP] function, emotional role function, vitality, mental health, social function, body pain, general health, physical component scale, mental component scale) was lower in patients with pSS than in healthy controls, especially the score in the dimension of RP function. CONCLUSION This meta-analysis showed that patients had lower pSS score in each dimension of the SF-36, mostly in the RP function. This demonstrated that targeted interventions should be carried out to improve the HRQoL of pSS patients.
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Affiliation(s)
- Qiuxiang Zhang
- Department of Nursing, The Second Affiliated Hospital of Nantong University
- School of Nursing, Nantong University
| | - Xulin Wang
- Department of Epidemiology and Medical Statistics, Nantong University, Nantong, Jiangsu, People’s Republic of China
| | - Haoyang Chen
- Department of Nursing, The Second Affiliated Hospital of Nantong University
- School of Nursing, Nantong University
| | - Biyu Shen
- Department of Nursing, The Second Affiliated Hospital of Nantong University
- Correspondence: Biyu Shen, Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, People’s Republic of China, Tel/fax +86 513 8506 1318, Email
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36
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Hamburger J. Orofacial manifestations in patients with inflammatory rheumatic diseases. Best Pract Res Clin Rheumatol 2016; 30:826-850. [PMID: 27964791 DOI: 10.1016/j.berh.2016.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/19/2016] [Indexed: 11/16/2022]
Abstract
The main orofacial manifestation of the inflammatory rheumatic diseases is that of Sjögren's syndrome. In addition, there is a constellation of orofacial manifestations of the inflammatory rheumatic diseases, many of which are extra-articular with some constituting presenting signs of the underlying rheumatic disease. This review will discuss the orofacial manifestations in a variety of connective tissue diseases and will also allude to the oral adverse drug reactions that may occur as a consequence of therapy.
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Affiliation(s)
- John Hamburger
- Birmingham Behçet's Syndrome Centre of Excellence, Sheldon Block, Birmingham and Midland Eye Centre, City Hospital, Dudley Road, Birmingham, B18 7QH, UK.
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37
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Al-Ezzi MY, Pathak N, Tappuni AR, Khan KS. Primary Sjögren’s syndrome impact on smell, taste, sexuality and quality of life in female patients: A systematic review and meta-analysis. Mod Rheumatol 2016; 27:623-629. [DOI: 10.1080/14397595.2016.1249538] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Minan Y. Al-Ezzi
- Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Neha Pathak
- Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Anwar R. Tappuni
- Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Khalid S. Khan
- Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK
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38
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Hoffman HJ, Rawal S, Li CM, Duffy VB. New chemosensory component in the U.S. National Health and Nutrition Examination Survey (NHANES): first-year results for measured olfactory dysfunction. Rev Endocr Metab Disord 2016; 17:221-40. [PMID: 27287364 PMCID: PMC5033684 DOI: 10.1007/s11154-016-9364-1] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The U.S. NHANES included chemosensory assessments in the 2011-2014 protocol. We provide an overview of this protocol and 2012 olfactory exam findings. Of the 1818 NHANES participants aged ≥40 years, 1281 (70.5 %) completed the exam; non-participation mostly was due to time constraints. Health technicians administered an 8-item, forced-choice, odor identification task scored as normosmic (6-8 odors identified correctly) versus olfactory dysfunction, including hyposmic (4-5 correct) and anosmic/severe hyposmic (0-3 correct). Interviewers recorded self-reported smell alterations (during past year, since age 25, phantosmia), histories of sinonasal problems, xerostomia, dental extractions, head or facial trauma, and chemosensory-related treatment and changes in quality of life. Olfactory dysfunction was found in 12.4 % (13.3 million adults; 55 % males/45 % females) including 3.2 % anosmic/severe hyposmic (3.4 million; 74 % males/26 % females). Selected age-specific prevalences were 4.2 % (40-49 years), 12.7 % (60-69 years), and 39.4 % (80+ years). Among adults ≥70 years, misidentification rates for warning odors were 20.3 % for smoke and 31.3 % for natural gas. The highest sensitivity (correctly identifying dysfunction) and specificity (correctly identifying normosmia) of self-reported olfactory alteration was among anosmics/severe hyposmics (54.4 % and 78.1 %, respectively). In age- and sex-adjusted logistic regression analysis, risk factors of olfactory dysfunction were racial/ethnic minority, income-to-poverty ratio ≤ 1.1, education <high school, and heavy drinking. Moderate-to-vigorous physical activity reduced risk of impairment. Olfactory dysfunction is prevalent, particularly among older adults. Inexpensive, brief odor identification tests coupled with questions (smell problems past year, since age 25, phantosmia) could screen for marked dysfunction. Healthcare providers should be prepared to offer education on non-olfactory avoidance of hazardous events.
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Affiliation(s)
- Howard J Hoffman
- Epidemiology and Statistics Program, Division of Scientific Programs, National Institute on Deafness and other Communication Disorders (NIDCD) at the National Institutes of Health (NIH), Bethesda, MD, USA
| | - Shristi Rawal
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Rockville, MD, USA
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269, USA
| | - Chuan-Ming Li
- Epidemiology and Statistics Program, Division of Scientific Programs, National Institute on Deafness and other Communication Disorders (NIDCD) at the National Institutes of Health (NIH), Bethesda, MD, USA
| | - Valerie B Duffy
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269, USA.
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Rojas-Alcayaga G, Herrera Ronda A, Espinoza Santander I, Bustos Reydet C, Ríos Erazo M, Wurmann P, Sabugo F, Geenen R. Illness Experiences in Women with Oral Dryness as a Result of Sjögren's Syndrome: The Patient Point of View. Musculoskeletal Care 2016; 14:233-242. [PMID: 27061842 DOI: 10.1002/msc.1134] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sjögren's syndrome and the associated dryness can have multiple consequences. The aim of the present qualitative study was to give an in-depth account of the life experiences of women with primary Sjögren's syndrome (pSS) and health-related behaviours, and to summarize these experiences in an integrated model. METHODS Twelve women diagnosed with pSS who regularly attended the Hospital of the University of Chile participated in detailed interviews. The data were analysed using qualitative methods based on the principles of grounded theory. RESULTS Selective coding identified three categories: illness experience, social interaction and psychological response. An integrated model was developed connecting these dynamic aspects and suggesting how they could lead to a life cycle crisis in cases of maladjustment. We found that problem-solving strategies, reconstruction of identity, acceptance and a social support may prevent this life cycle crisis. DISCUSSION Xerostomia and other consequences of pSS can have a profound influence on daily life. However, the severity of the consequences depends on individual experiences with the illness, social influences and the psychological responses of the patient. Physicians, dentists and other healthcare professionals can help the patient by listening to their problems and exploring solutions based on a psychological approach.
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Affiliation(s)
- Gonzalo Rojas-Alcayaga
- Department of Oral Pathology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Behavioral Science Area, Institute for Research in Dental Science, Universidad de Chile, Santiago, Chile
| | - Andrea Herrera Ronda
- Behavioral Science Area, Institute for Research in Dental Science, Universidad de Chile, Santiago, Chile
| | | | - Claudia Bustos Reydet
- Behavioral Science Area, Institute for Research in Dental Science, Universidad de Chile, Santiago, Chile
| | - Matías Ríos Erazo
- Behavioral Science Area, Institute for Research in Dental Science, Universidad de Chile, Santiago, Chile
| | - Pamela Wurmann
- Rheumatology Section, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Francisca Sabugo
- Rheumatology Section, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
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Kami YN, Sumi M, Takagi Y, Sasaki M, Uetani M, Nakamura T. Arterial Spin Labeling Imaging for the Parotid Glands of Patients with Sjögren's Syndrome. PLoS One 2016; 11:e0150680. [PMID: 26959680 PMCID: PMC4784920 DOI: 10.1371/journal.pone.0150680] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/16/2016] [Indexed: 11/18/2022] Open
Abstract
Sjögren's syndrome (SS) is characterized by hypofunction of the salivary and lacrimal glands. The salivary function is largely dependent upon the blood supply in the glands. However, the diseased states of the gland perfusion are not well understood. The arterial spin labeling (ASL) technique allows noninvasive quantitative assessment of tissue perfusion without the need for contrast agent. Here, we prospectively compared the perfusion properties of the parotid glands between patients with SS and those with healthy glands using ASL MR imaging. We analyzed salivary blood flow (SBF) kinetics of 22 healthy parotid glands from 11 volunteers and 28 parotid glands from 14 SS patients using 3T pseudo-continuous ASL imaging. SBF was determined in resting state (base SBF) and at 3 sequential segments after gustatory stimulation. SBF kinetic profiles were characterized by base SBF level, increment ratio at the SBF peak, and the differences in segments where the peak appeared (SBF types). Base SBFs of the SS glands were significantly higher than those of healthy glands (59.2 ± 22.8 vs. 46.3 ± 9.0 mL/min/100 g, p = 0.01). SBF kinetic profiles of the SS glands also exhibited significantly later SBF peaks (p < 0.001) and higher SBF increment ratios (74 ± 49% vs. 47 ± 39%, p = 0.04) than the healthy glands. The best SBF criterion (= 51.2 mL/min/100 mg) differentiated between control subjects and SS patients with 71% sensitivity and 82% specificity. Taken together, these results showed that the SS parotid glands were mostly hyperemic and the SS gland responses to gustatory stimulation were stronger and more prolonged than those of the healthy glands. The ASL may be a promising technique for assessing the diseased salivary gland vascularization of SS patients.
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Affiliation(s)
- Yukiko N. Kami
- Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan
| | - Misa Sumi
- Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan
| | - Yukinori Takagi
- Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan
| | - Miho Sasaki
- Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiology, Nagasaki University Graduate School of Biosciences, Nagasaki, Japan
| | - Takashi Nakamura
- Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan
- * E-mail:
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Heiser C, Hofauer B, Scherer E, Schukraft J, Knopf A. Liposomal treatment of xerostomia, odor, and taste abnormalities in patients with head and neck cancer. Head Neck 2015; 38 Suppl 1:E1232-7. [PMID: 26315309 DOI: 10.1002/hed.24198] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/04/2015] [Accepted: 07/07/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Smell and taste disorders, sicca symptoms, can be detected in patients with head and neck cancer. The purpose of this study was to assess the utility of local liposomal application in the treatment of patients with head and neck cancers. METHODS Ninety-eight patients with head and neck cancer were included in this study. The groups were defined as: group 1 = only surgery; group 2 = surgery + adjuvant radiochemotherapy; and group 3 = primarily radiochemotherapy. All patients had finished cancer treatment and received liposomal sprays for the nose and mouth for 2 months (LipoNasal, LipoSaliva; Optima Pharmaceutical GmbH, Germany) and suffered from taste and smell disorders. We performed tests with "Sniffin' Sticks," "Taste Strips," and a xerostomia questionnaire before and after treatment. RESULTS After application of liposomes, patients demonstrated a statistically significant increase in smell and taste, and reduced xerostomia. CONCLUSION Our results demonstrate that using nonpharmaceutical liposomal sprays improve smell, taste, and symptoms of xerostomia in patients with head and neck cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1232-E1237, 2016.
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Affiliation(s)
- Clemens Heiser
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany
| | - Benedikt Hofauer
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany
| | - Elias Scherer
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany
| | - Johannes Schukraft
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany
| | - Andreas Knopf
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany
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Shoji N, Kaneta N, Satoh-Kuriwada S, Tsuchiya M, Hashimoto N, Uneyama H, Kawai M, Sasano T. Expression of umami-taste-related genes in the tongue: a pilot study for genetic taste diagnosis. Oral Dis 2015; 21:801-6. [PMID: 25990784 DOI: 10.1111/odi.12350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/01/2015] [Accepted: 05/08/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Expression of taste-related genes in the tongue was analysed to develop a technique for genetic diagnosis of umami taste disorders. MATERIALS AND METHODS Tissue samples were collected from healthy volunteers by scraping the foliate papillae of the tongue. Immunocytochemistry staining of gustducin, a taste-cell-specific G protein, and gene expression analysis by real-time polymerase chain reaction of β-actin, gustducin (GNAT3) and umami receptors (T1R1, T1R3 and mGluR1) were performed. Changes in umami receptor expression following application of umami substances onto the tongue were analysed. RESULTS Gustducin-positive cells were observed in the samples, indicating the presence of taste cells. Gene expression of β-actin, GNAT3, T1R1 and T1R3 was detected in all seven samples tested, while that of mGluR1 was detected in four samples. Sequence analysis by NCBI Blast showed that each polymerase chain reaction product had a 99% rate of identification of its target sequence. Stimulation of the tongue with monosodium glutamate significantly upregulated the gene expression levels of T1R1 and T1R3, indicating that this method can detect alterations in umami-related gene expression. CONCLUSION Evaluation of the expression of the umami receptor genes, T1R1 and T1R3, in the tongue may be clinically useful for objective genetic diagnosis of umami taste disorders.
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Affiliation(s)
- N Shoji
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - N Kaneta
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - S Satoh-Kuriwada
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - M Tsuchiya
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Tohoku Fukushi University, Sendai, Japan
| | - N Hashimoto
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Uneyama
- Institute for Innovation, Ajinomoto Company Inc., Kawasaki, Tokyo, Japan
| | - M Kawai
- Institute for Innovation, Ajinomoto Company Inc., Kawasaki, Tokyo, Japan
| | - T Sasano
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Iaccarino L, Shoenfeld N, Rampudda M, Zen M, Gatto M, Ghirardello A, Bassi N, Punzi L, Shoenfeld Y, Doria A. The olfactory function is impaired in patients with idiopathic inflammatory myopathies. Immunol Res 2014; 60:247-52. [DOI: 10.1007/s12026-014-8581-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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44
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Su N, Poon R, Grushka M. Does Sjogren’s syndrome affect odor identification abilities? Eur Arch Otorhinolaryngol 2014; 272:773-4. [DOI: 10.1007/s00405-014-3208-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 07/24/2014] [Indexed: 11/29/2022]
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Perricone C, Shoenfeld N, Agmon-Levin N, de Carolis C, Perricone R, Shoenfeld Y. Smell and autoimmunity: a comprehensive review. Clin Rev Allergy Immunol 2014; 45:87-96. [PMID: 23233263 DOI: 10.1007/s12016-012-8343-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The sense of smell is an ancient sensory modality vital for sampling and perceiving the chemical composition of surrounding environments. Olfaction involves a pathway of biochemical and electrophysiological processes, which allows the conversion of molecular information into sensations. Disturbances in the olfactory function have been investigated mainly in neurological/neurodegenerative disorders such as Alzheimer's and Parkinson's diseases; impaired sense of smell has been associated with depressed mood. Only recently, smell capability was tested in other diseases, particularly autoimmune diseases. Shoenfeld and colleagues opened this chapter showing that patients affected with systemic lupus erythematosus (SLE) have disturbances in their olfactory functions and revealed its association with neuropsychiatric manifestations of the disease. This evidence was confirmed in experimental models and replicated in other SLE populations. The connection between autoimmunity and the sense of smell was lately emphasized by studies on patients with Sjögren's syndrome and in patients with other autoimmune/immune-mediated diseases, such as polydermatomyositis, recurrent spontaneous abortion, and hereditary angioedema. Genetic susceptibility and hormonal and environmental factors may play a role in these conditions. Olfactory receptor gene clusters are located in proximity to key locus of susceptibility for autoimmune diseases such as the major histocompatibility complex, suggesting not only a physic linkage, but a functional association. Nonetheless, gender- and hormone-mediated effects are fundamental in the development of autoimmune diseases. The different connections between smell and autoimmunity, genes and hormones may suggest that this is another tessera of a mosaic which is waiting the answer of Oedipus.
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Affiliation(s)
- Carlo Perricone
- Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
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Cho HJ, Yoo JJ, Yun CY, Kang EH, Lee HJ, Hyon JY, Song YW, Lee YJ. The EULAR Sjogren's syndrome patient reported index as an independent determinant of health-related quality of life in primary Sjogren's syndrome patients: in comparison with non-Sjogren's sicca patients. Rheumatology (Oxford) 2013; 52:2208-17. [DOI: 10.1093/rheumatology/ket270] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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47
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Solemdal K, Sandvik L, Willumsen T, Mowe M. Taste ability in hospitalised older people compared with healthy, age-matched controls. Gerodontology 2012; 31:42-8. [DOI: 10.1111/ger.12001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2012] [Indexed: 01/09/2023]
Affiliation(s)
| | - Leiv Sandvik
- The Faculty of Dentistry; University of Oslo; Oslo Norway
| | | | - Morten Mowe
- The Faculty of Medicine; University of Oslo; Oslo Norway
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The impact of oral health on taste ability in acutely hospitalized elderly. PLoS One 2012; 7:e36557. [PMID: 22570725 PMCID: PMC3343000 DOI: 10.1371/journal.pone.0036557] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 04/06/2012] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate to what extent various oral health variables are associated with taste ability in acutely hospitalized elderly. Background Impaired taste may contribute to weight loss in elderly. Many frail elderly have poor oral health characterized by caries, poor oral hygiene, and dry mouth. However, the possible influence of such factors on taste ability in acutely hospitalized elderly has not been investigated. Materials and Methods The study was cross-sectional. A total of 174 (55 men) acutely hospitalized elderly, coming from their own homes and with adequate cognitive function, were included. Dental status, decayed teeth, oral bacteria, oral hygiene, dry mouth and tongue changes were recorded. Growth of oral bacteria was assessed with CRT® Bacteria Kit. Taste ability was evaluated with 16 taste strips impregnated with sweet, sour, salty and bitter taste solutions in 4 concentrations each. Correct identification was given score 1, and maximum total taste score was 16. Results Mean age was 84 yrs. (range 70–103 yrs.). Total taste score was significantly and markedly reduced in patients with decayed teeth, poor oral hygiene, high growth of oral bacteria and dry mouth. Sweet and salty taste were particularly impaired in patients with dry mouth. Sour taste was impaired in patients with high growth of oral bacteria. Conclusion This study shows that taste ability was reduced in acutely hospitalized elderly with caries activity, high growth of oral bacteria, poor oral hygiene, and dry mouth. Our findings indicate that good oral health is important for adequate gustatory function. Maintaining proper oral hygiene in hospitalized elderly should therefore get high priority among hospital staff.
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Primary Sjögren’s syndrome in Moroccan patients: characteristics, fatigue and quality of life. Rheumatol Int 2011; 32:2637-43. [DOI: 10.1007/s00296-011-2009-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 07/10/2011] [Indexed: 10/18/2022]
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50
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Perricone C, Agmon-Levin N, Shoenfeld N, de Carolis C, Guarino MD, Gigliucci G, Milana I, Novelli L, Valesini G, Perricone R, Shoenfeld Y. Evidence of impaired sense of smell in hereditary angioedema. Allergy 2011; 66:149-54. [PMID: 20649895 DOI: 10.1111/j.1398-9995.2010.02453.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hereditary angioedema (HAE) is an autosomal-dominant disorder resulting from C1-inhibitor (C1INH) deficiency. Smell impairments were found in patients affected with systemic lupus erythematosus, that, similarly to HAE, is characterized by the activation of the classical complement pathway with C4 consumption. In this study, we aimed at evaluating the sense of smell in patients with HAE. METHODS Thirty patients with HAE and 30 healthy age- and sex-matched controls were evaluated for olfactory functions using the 3-stages Sniffin'-Sticks kit (threshold, discrimination, and identification [TDI]). TDI scores were analyzed according to complement levels (C1INH, C3, C4 and CH50), Beck depression inventory (BDI-II) and danazol treatment. RESULTS A significant decrease in olfactory function was observed in patients affected with HAE compared with controls in total TDI score (P < 0.001), and in the discrimination (P < 0.001) and identification scores (P = 0.012). Anosmia was present only in patients with HAE (3.3%) who also exhibited more frequently hyposmia (53.3%vs 3.3%, P < 0.0001). Complement levels were reduced in patients with HAE. C4 serum levels showed positive correlation with total TDI score (P < 0.001), and with discrimination (P = 0.002) and identification (P = 0.011) scores. CH50 complement levels showed positive correlation with total TDI score (P < 0.001), and with threshold (P = 0.002) and discrimination (P = 0.011) scores. Sex, age, danazol treatment, BDI-II scores were not different between the patients and controls and did not influence TDI scores significantly. CONCLUSION Evidence for an impaired sense of smell was found in patients with HAE. The reduction in olfactory function in these cases seems to correlate with complement C4 and CH50 levels. Immune and genetic mechanisms might play a role in this defect.
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Affiliation(s)
- C Perricone
- Reumatologia, Dipartimento di Clinica e Terapia Medica, Sapienza Università di Roma, Rome, Italy.
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