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Walther LM, von Känel R, Zuccarella-Hackl C, Wirtz PH. Hyperreactivity of Salivary Alpha-Amylase to Acute Psychosocial Stress and Norepinephrine Infusion in Essential Hypertension. Biomedicines 2022; 10:1762. [PMID: 35885066 PMCID: PMC9312828 DOI: 10.3390/biomedicines10071762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
It is unknown whether the observed general physiological hyperreactivity to acute psychosocial stress in essential hypertension also extends to salivary alpha-amylase (sAA), a surrogate sympathetic nervous system marker. Here, we investigated sAA reactivity to acute psychosocial stress in essential hypertensive males (HT) as compared to normotensive controls (NT). To shed light on underlying mechanisms, we moreover tested for sAA reactivity following a standardized norepinephrine (NE) infusion. We hypothesized that both acute psychosocial stress and an NE infusion of similar duration would lead to greater sAA reactivity in HT than in NT. In the stress study, we examined sAA reactivity to 15 min of acute psychosocial stress induced by the Trier Social Stress Test (TSST) in 19 HT and 23 NT up to 40 min after stress. In the infusion study, 20 HT and 22 NT received a standardized NE infusion (5 μg/mL/min) over 15 min mimicking NE release in reaction to acute psychosocial stress. HT exhibited greater sAA reactivity to the TSST as compared to NT (p = 0.049, ηp2 = 0.08, f = 0.29). In reaction to the standardized NE infusion, HT showed higher sAA reactivity as compared to NT (p = 0.033, ηp2 = 1.00, f = 0.33). Our findings suggest stress-induced sAA hyperreactivity in essential hypertension that seems to be at least in part mediated by a higher reactivity to a standardized amount of NE in HT. With respect to clinical implications, sAA stress reactivity may serve as a noninvasive marker indicative of early cardiovascular risk.
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Affiliation(s)
- Lisa-Marie Walther
- Biological Work and Health Psychology, Department of Psychology, University of Konstanz, 78464 Konstanz, Germany;
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, 78464 Konstanz, Germany
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (C.Z.-H.)
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (C.Z.-H.)
| | - Petra H. Wirtz
- Biological Work and Health Psychology, Department of Psychology, University of Konstanz, 78464 Konstanz, Germany;
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, 78464 Konstanz, Germany
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Surin W, Chatiketu P, Hutachok N, Srichairatanakool S, Chatupos V. Pain intensity and salivary α‐amylase activity in patients following mandibular third molar surgery. Clin Exp Dent Res 2022; 8:1082-1091. [PMID: 35801257 PMCID: PMC9562728 DOI: 10.1002/cre2.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Objective We aimed to compare the levels of pain and salivary α‐amylase (SAA) in patients before and after mandibular third molar surgery. Materials and Methods Patients were divided into asymptomatic and symptomatic groups and were then identified by the analgesic drug taken throughout the 2‐week study. The visual analog scale (VAS) was employed to evaluate the severity of pain experienced by a given subject before treatment, when the anesthetic wore off, in the morning, and at night for a period of 1 week. Saliva was collected from the mouth floor of the subjects and the levels of SAA activity were measured at indicated times. Results The levels of postoperative pain were higher than those of pretreatment pain (p < 0.05), but were not necessarily different between the two groups. The pain levels were positively correlated with SAA activities in both groups (p < 0.05). There was no difference between the number of analgesics taken by the two groups and the postoperative complications observed during the study. A significant correlation was observed between the VAS pain scale and SAA activities. Conclusion SAA would be a simple effective biomarker for the objective assessment of pain intensity in patients who have undergone mandibular third molar surgery.
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Affiliation(s)
- Wanvipa Surin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chiang Mai University Chiang Mai Thailand
| | - Piyanart Chatiketu
- Department of Family and Community Dentistry, Faculty of Dentistry Chiang Mai University Chiang Mai Thailand
| | - Nuntouchaporn Hutachok
- Department of Biochemistry, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | | | - Vuttinun Chatupos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chiang Mai University Chiang Mai Thailand
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Andrianome S, Yahia-Cherif L, Selmaoui B. Effect of short exposure to radiofrequency electromagnetic fields on saliva biomarkers: a study on the electrohypersensitive individuals. Int J Radiat Biol 2019; 95:788-792. [DOI: 10.1080/09553002.2019.1569776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Soafara Andrianome
- Department of Experimental Toxicology, Institut National de l’Environnement Industriel et des Risques, (INERIS), Verneuil-en-Halatte, France
- Laboratoire PériTox UMR-I 01, UFR de Médecine, Université de Picardie Jules Verne, Amiens, France
| | - Lydia Yahia-Cherif
- Centre de Recherche de l’Institut du Cerveau et de la Moelle Epinière (CRICM) et Centre de Neuroimagerie de Recherche (CENIR), Paris, France
| | - Brahim Selmaoui
- Department of Experimental Toxicology, Institut National de l’Environnement Industriel et des Risques, (INERIS), Verneuil-en-Halatte, France
- Laboratoire PériTox UMR-I 01, UFR de Médecine, Université de Picardie Jules Verne, Amiens, France
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Hu KF, Chou YH, Wen YH, Hsieh KP, Tsai JH, Yang P, Yang YH, Lin CHR. Antipsychotic medications and dental caries in newly diagnosed schizophrenia: A nationwide cohort study. Psychiatry Res 2016; 245:45-50. [PMID: 27526316 DOI: 10.1016/j.psychres.2016.07.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/05/2016] [Accepted: 07/24/2016] [Indexed: 10/21/2022]
Abstract
We investigated the association between antipsychotic medications and the risk of dental caries in patients with schizophrenia. We enroled a nationwide cohort of patients with newly diagnosed schizophrenia within 1 year of dental caries development. Exposure to antipsychotics and other medications was categorised according to their type and duration, and the association between exposure and dental caries was assessed through logistic regressions. Of the 3610 patients with newly diagnosed schizophrenia, 2149 (59.5%) exhibited an incidence of treated dental caries. Logistic regression analysis identified a younger age, female sex, high income, a 2-year history of dental caries, and exposure to first-generation antipsychotics, and antihypertensives as independent risk factors for treated dental caries in patients with schizophrenia. Hyposalivation, the adverse effect of first-generation antipsychotics and antihypertensives, was associated with an increased risk of treated dental caries. However, hypersalivation from first-generation antipsychotics for dental caries was associated with a protective factor. These findings suggest that clinicians should pay attention to the aforementioned risk factors for dental caries in patients with schizophrenia, particularly while prescribing first-generation antipsychotics and antihypertensives to such patients.
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Affiliation(s)
- Kai-Fang Hu
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Hsiang Chou
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsia Wen
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Pin Hsieh
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- Department of Psychiatry and Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical College, Kaohsiung Medical University, No.100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
| | - Pinchen Yang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsin Yang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
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Balakumar P, Kavitha M, Nanditha S. Cardiovascular drugs-induced oral toxicities: A murky area to be revisited and illuminated. Pharmacol Res 2015; 102:81-9. [DOI: 10.1016/j.phrs.2015.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/22/2015] [Accepted: 09/08/2015] [Indexed: 12/20/2022]
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Grossmann SDMC, Oliveira CDNAD, Souto GR, Góes C, Mesquita RA. Oral lichenoid lesion: A review of the literature. World J Stomatol 2015; 4:103-107. [DOI: 10.5321/wjs.v4.i2.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/26/2015] [Accepted: 02/12/2015] [Indexed: 02/06/2023] Open
Abstract
The oral lichenoid lesion (OLL) is response that occurs on the oral mucosa. The OLL include allergic response to the dental materials, drugs, and on graft-vs-host disease (GVHD). OLL to dental material happen when restorative materials, most commonly amalgam, are in direct contact with the mucosa in sensitized individuals. Medications that produce OLL are oral hypoglycemic agents, angiotensin-converting enzyme inhibitors, and nonsteroidal anti-inflammatory agents. GVHD is a complication in bone marrow transplantation and OLL is a common lesion observed in this disease especially in chronic GVHD. The clinical and histological aspects of OLL are similar to oral lichen planus and turn it difficult to make a differential diagnosis. The purpose of this paper is review about OLL related to the dental materials, drug use and GVHD.
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Djukić LJ, Roganović J, Brajović MD, Bokonjić D, Stojić D. The effects of anti-hypertensives and type 2 diabetes on salivary flow and total antioxidant capacity. Oral Dis 2015; 21:619-25. [PMID: 25689395 DOI: 10.1111/odi.12325] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/04/2015] [Accepted: 02/08/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The present cross-sectional study aimed to determine the effect of first-line anti-hypertensive drugs (enalapril, metoprolol, and combinations of enalapril with metoprolol and/or hydrochlorothiazide) on salivary gland function and salivary total antioxidant capacity (TAC) in hypertensive patients with/without diabetes mellitus (DM) type 2. MATERIALS AND METHODS Salivary gland function was measured as xerostomia (interview) and unstimulated whole saliva flow rate (UWSFR) in 447 subjects (387 hypertensive and 60 healthy). Salivary TAC was evaluated by spectrophotometric assay. RESULTS Enalapril is not xerogenic, while metoprolol and drug combinations are. In the presence of DM type 2, all drugs, except metoprolol, had pronounced xerogenic effect. Binary logistic regression analysis found enalapril to be significantly associated with decreased risk of xerogenic effect development, while DM type 2 with increased risk. In the presence of enalapril in hypertensive patients with/without DM type 2 salivary TAC was similar to that in healthy subjects, while for metoprolol was reduced. CONCLUSIONS Enalapril is not xerogenic but is antioxidant, which moderately reduces the risk of xerogenic effect development even in the presence of DM type 2. However, metoprolol and drug combinations exhibit xerogenic effect. In DM type 2, xerogenic effect of all drugs was pronounced except of metoprolol.
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Affiliation(s)
- L J Djukić
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - J Roganović
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - M D Brajović
- Department of Cardiology, Zvezdara University Hospital, Belgrade, Serbia
| | - D Bokonjić
- Military Medical Academy, National Poison Control Centre, Belgrade, Serbia
| | - D Stojić
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Kuebler U, von Känel R, Heimgartner N, Zuccarella-Hackl C, Stirnimann G, Ehlert U, Wirtz PH. Norepinephrine infusion with and without alpha-adrenergic blockade by phentolamine increases salivary alpha amylase in healthy men. Psychoneuroendocrinology 2014; 49:290-8. [PMID: 25128931 DOI: 10.1016/j.psyneuen.2014.07.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/23/2014] [Accepted: 07/23/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mental stress reliably induces increases in salivary alpha amylase (sAA), a suggested surrogate marker for sympathetic nervous system (SNS) reactivity. While stress-induced sAA increases correlate with norepinephrine (NE) secretion, a potential mediating role of noradrenergic mechanisms remains unclear. In this study, we investigated for the first time in humans whether a NE-stress-reactivity mimicking NE-infusion with and without alpha-adrenergic blockade by phentolamine would induce changes in sAA. METHODS In a single-blind placebo-controlled within-subjects design, 21 healthy men (29-66 years) took part in three different experimental trials varying in terms of substance infusion with a 1-min first infusion followed by a 15-min second infusion: saline-infusion (trial-1), NE-infusion (5 μg/min) without alpha-adrenergic blockade (trial-2), and with phentolamine-induced non-selective blockade of alpha1- and alpha2-adrenergic receptors (trial-3). Saliva samples were collected immediately before, during, and several times after substance infusion in addition to blood pressure and heart rate readings. RESULTS Experimental trials significantly differed in sAA reactivity to substance-infusion (p=.001) with higher sAA reactivity following NE-infusion with (trial-3; p=.001) and without alpha-adrenergic-blockade (trial-2; p=.004) as compared to placebo-infusion (trial-1); sAA infusion reactivity did not differ between trial-2 and trial-3 (p=.29). Effective phentolamine application was verified by blood pressure and heart rate infusion reactivity. Salivary cortisol was not affected by NE, either with or without alpha-adrenergic-blockade. CONCLUSIONS We found that NE-infusion stimulates sAA secretion, regardless of co-administered non-selective alpha-adrenergic blockade by phentolamine, suggesting that the mechanism underlying stress-induced sAA increases may involve NE.
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Affiliation(s)
- Ulrike Kuebler
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland; Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Nadja Heimgartner
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | | | - Guido Stirnimann
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Petra H Wirtz
- Biological and Health Psychology, University of Bern, Bern, Switzerland.
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Information for physicians and pharmacists about drugs that might cause dry mouth: a study of monographs and published literature. Drugs Aging 2014; 31:55-65. [PMID: 24293180 DOI: 10.1007/s40266-013-0141-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Over three-quarters of the older population take medications that can potentially cause dry mouth. Physicians or pharmacists rarely inform patients about this adverse effect and its potentially severe damage to the teeth, mouth and general health. OBJECTIVES The objectives of this study were to (1) identify warnings in the literature about dry mouth associated with the most frequently prescribed pharmaceutical products in Canada; and (2) consider how this information might be obtained by physicians, pharmacists and patients. METHODS Monographs on the 72 most frequently prescribed medications during 2010 were retrieved from the Compendium of Pharmaceuticals and Specialties (CPS, a standard drug information reference for physicians and pharmacists), the National Library of Medicine's 'DailyMed' database, directly from the manufacturers, and from a systematic search of biomedical journals. RESULTS The CPS provided monographs for 43% of the medications, and requests to manufacturers produced the remaining monographs. Mentions of dry mouth were identified in 61% of the products (43% amongst CPS monographs; an additional 43% amongst manufacturers' monographs; 7% in the DailyMed database and 7% from biomedical journals); five medications had contradictory reports in different monographs. CONCLUSION Nearly two-thirds (61%) of the most commonly prescribed medications can cause dry mouth, yet warnings about this adverse effect and its potentially serious consequences are not readily available to physicians, pharmacists, dentists or patients.
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Johanson CN, Österberg T, Lernfelt B, Ekström J, Birkhed D. Salivary secretion and drug treatment in four 70-year-old Swedish cohorts during a period of 30 years. Gerodontology 2013; 32:202-10. [DOI: 10.1111/ger.12089] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2013] [Indexed: 01/10/2023]
Affiliation(s)
- Cecilia N. Johanson
- Departments of Cariology; Institutes of Odontology and Medicine; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Tor Österberg
- Departments of Cariology; Institutes of Odontology and Medicine; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Department of Internal Medicine; Institutes of Odontology and Medicine; sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Bodil Lernfelt
- Department of Internal Medicine; Institutes of Odontology and Medicine; sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Jörgen Ekström
- Department of Pharmacology; Institutes of Neuroscience and Physiology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Dowen Birkhed
- Departments of Cariology; Institutes of Odontology and Medicine; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Bokor-Bratic M, Cankovic M, Dragnic N. Unstimulated whole salivary flow rate and anxiolytics intake are independently associated with oralCandidainfection in patients with oral lichen planus. Eur J Oral Sci 2013; 121:427-33. [DOI: 10.1111/eos.12073] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Marija Bokor-Bratic
- Dental Clinic; Faculty of Medicine; University of Novi Sad; Novi Sad; Serbia
| | - Milos Cankovic
- Dental Clinic; Faculty of Medicine; University of Novi Sad; Novi Sad; Serbia
| | - Natasa Dragnic
- Institute for Public Health of Vojvodina; Novi Sad; Serbia
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Napeñas JJ, Miles L, Guajardo-Streckfus C, Streckfus CF. Salivary flow rates among women diagnosed with benign and malignant tumors. SPECIAL CARE IN DENTISTRY 2013; 33:102-10. [PMID: 23600980 DOI: 10.1111/scd.12017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to compare salivary flow rates (SWS) among patients diagnosed with benign and varying malignant solid tumors with the comparison group, prior to the initiation of any treatment. An evaluation of the results found that mean baseline SWS flow rates were higher for healthy patients (1.55 ml/min) when compared to patients diagnosed with benign tumors (1.13 ml/min), breast cancer (1.09 ml/min), and reproductive carcinomas (0.94 ml/min). The overall model (F = 7.76; p < .001) and the Dunnett's post hoc analyses were statistically significant at the p < .001 level. Additionally, medications, race, and season of the year had significant effects on mean SWS flow rates. The results suggest that salivary secretion is lower among both benign and malignant tumor subjects prior to the initiation of treatment. Salivary evaluations of subjects prior to treatment may be useful in identifying individuals at risk for oral complications during chemotherapy.
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Affiliation(s)
- Joel J Napeñas
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
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Veen G, Giltay EJ, Vreeburg SA, Licht CM, Cobbaert CM, Zitman FG, Penninx BW. Determinants of salivary evening alpha-amylase in a large sample free of psychopathology. Int J Psychophysiol 2012; 84:33-8. [DOI: 10.1016/j.ijpsycho.2012.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Revised: 12/30/2011] [Accepted: 01/04/2012] [Indexed: 01/09/2023]
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Engert V, Vogel S, Efanov SI, Duchesne A, Corbo V, Ali N, Pruessner JC. Investigation into the cross-correlation of salivary cortisol and alpha-amylase responses to psychological stress. Psychoneuroendocrinology 2011; 36:1294-302. [PMID: 21470780 DOI: 10.1016/j.psyneuen.2011.02.018] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 01/19/2011] [Accepted: 02/25/2011] [Indexed: 10/18/2022]
Abstract
Stress is a multidimensional construct. To accurately represent stress physiology, multiple stress measures across multiple stress-related systems should be assessed. However, associations may be masked given that different systems underlie different time courses. Salivary cortisol and alpha-amylase (sAA) are reliable biological stress markers of the sympathetic nervous system (SNS) and the hypothalamus pituitary adrenal (HPA) axis, respectively. Studies examining the link between sAA and cortisol levels in response to stress have produced inconsistent results. Here, we investigated whether the covariance of stress-induced sAA and cortisol release is dependent on the distinct temporal dynamics of the two stress markers. A total of 50 male participants were exposed to a psychological laboratory stressor with high frequency (2-min interval) saliva sampling in two independent studies. Synchronized time series of sAA and cortisol measures before, during and after stress induction were obtained. Cross-correlation analysis was applied to test for the association of sAA and cortisol levels at various stages relative to the onset of the stressor. Positive and negative cross-correlations between lagged pairs of sAA and cortisol measures were found in both studies. The strongest correlation was found for sAA preceding cortisol release by 13.5 min (r = .27, p < .001). With a smaller effect size cortisol also significantly preceded sAA by 13.5 min (r = -.16, p < .001). We suggest that sAA and cortisol stress responses are reliably associated at various time lags throughout a stressful situation. As a possible connection site between HPA axis and SNS that may underlie sAA-cortisol associations, we discuss CRF neurons of the hypothalamus involved in sympathetic regulation.
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Affiliation(s)
- Veronika Engert
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
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Strahler J, Kirschbaum C, Rohleder N. Association of blood pressure and antihypertensive drugs with diurnal alpha-amylase activity. Int J Psychophysiol 2011; 81:31-7. [DOI: 10.1016/j.ijpsycho.2011.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Revised: 04/07/2011] [Accepted: 04/08/2011] [Indexed: 02/07/2023]
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Saliva profiles in children using heart failure medication: a pilot study. Eur Arch Paediatr Dent 2011; 11:187-91. [PMID: 20840829 DOI: 10.1007/bf03262742] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM To study the saliva profiles in children with severe heart disease taking heart failure medication compared with the saliva from healthy age and gender matched controls. STUDY DESIGN Cross sectional case-control design. METHODS Twenty-four age and gender matched pairs of children, mean age 12.0 years participated. Stimulated saliva was collected in a standardized way before lunchtime and the subjects were asked to refrain from all eating, drinking and tooth brushing 90 mins before sampling. Stimulated salivary secretion rate, buffering capacity, total salivary viable count of bacteria, mutans streptococci and lactobacilli, calcium, chloride, magnesium, potassium, sodium and salivary IgA were determined. RESULTS There were 7 of the 24 children in the cardiac group who had secretions below 0.5 ml/min compared with no child in the control group (p<0.01). Lower [corrected] total viable counts of bacteria (TVC) were detected in the cardiac group 1.4x10⁶ ± 1.2x10⁷ vs. 2.7x10⁶ ± 2.9x10⁷ in the control group (p<0.05). Mutans streptococci (MS) in the cardiac group were 5.2x10⁴ ± 1.5x10⁵ vs. 8.1 x10³ ± 1.3x10⁴ in the control group, (p>0.05) and MS ratio of TVC constituted 0.11±0.35 per cent compared to 0.01±0.02 per cent for the control group (p>0.05). STATISTICS Continuous data were analysed by an analysis of variance (ANOVA) and categorical data by chi-square test. CONCLUSION Reduced salivary secretion could be a caries risk factor in children taking heart failure medication.
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Relationships of beta-blockers and anxiolytics intake and salivary secretion, masticatory performance and taste perception. Arch Oral Biol 2010; 55:164-9. [PMID: 20018274 DOI: 10.1016/j.archoralbio.2009.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 11/16/2009] [Accepted: 11/21/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Assess the influence of salivary flow on physiological parameters of the stomatognathic system in patients who take beta-blockers or anxiolytic medications. DESIGN Sixty patients were divided into three groups based on the following criteria: Group 1, control (n=20; no use of medication); Group 2, use of antihypertensive beta-blockers (n=20); and Group 3, use of benzodiazepine anxiolytics (n=20). Salivary flow was assessed by determining stimulated and non-stimulated flow/minute. The quantification of the sense of taste was determined on a visual analogue scale (VAS) using solutions of 0.9% NaCl (salty), 50% sucrose (sweet), 20% unsweetened coffee (bitter) and 4.2% vinegar (sour). The DMFT index (number of decayed/missing/filled teeth) was determined by a calibrated examination, following the criteria of the World Health Organization (WHO). Masticatory performance was assessed with an Optosil comminution test and Rosim-Ramler equation. RESULTS The results did not reveal a significant correlation between salivary flow and masticatory performance (p>0.05). We observed significant decreased non-stimulated salivary flow for Group 2 (p=0.05) when compared to controls. However, taste perception was not influenced by salivary secretion amongst groups. Furthermore, we observed a significant negative correlation between non-stimulated salivary flow and DMFT in Group 1 (p=0.02; r=-0.52). CONCLUSIONS Patients under beta-blockers therapy presented reduced non-stimulated salivary flow when compared to controls, without influencing the sense of taste or masticatory performance. The use of anxiolytics did not affect salivary flow and taste perception in the studied sample.
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Nater UM, Rohleder N. Salivary alpha-amylase as a non-invasive biomarker for the sympathetic nervous system: current state of research. Psychoneuroendocrinology 2009; 34:486-96. [PMID: 19249160 DOI: 10.1016/j.psyneuen.2009.01.014] [Citation(s) in RCA: 880] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 01/23/2009] [Accepted: 01/27/2009] [Indexed: 12/16/2022]
Abstract
Development of new biomarkers is a constantly evolving field of research endeavor in psychoneuroendocrinology. Salivary biomarkers have received special attention since they are readily accessible and easily obtained. Salivary alpha-amylase (sAA) has been proposed as a sensitive biomarker for stress-related changes in the body that reflect the activity of the sympathetic nervous system (SNS), and a growing body of research is accumulating to support the validity and reliability of this parameter. However, questions remain to be answered before sAA can be accepted as an index of SNS activity. This review describes sAA as an emerging biomarker for stress and provides an overview of the current literature on stress-related alterations in sAA. It critically discusses how sAA might reflect changes in the autonomic nervous system. Finally, current and future fields for the application of sAA measurement are outlined.
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Affiliation(s)
- U M Nater
- University of Zurich, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Zurich, Switzerland.
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Hugo FN, Hilgert JB, Corso S, Padilha DMP, Bozzetti MC, Bandeira DR, Pawlowski J, Gonçalves TR. Association of chronic stress, depression symptoms and cortisol with low saliva flow in a sample of south-Brazilians aged 50 years and older. Gerodontology 2008; 25:18-25. [DOI: 10.1111/j.1741-2358.2007.00188.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
OBJECTIVE The objective of the present study was to compare a new type of symptomatic lichenoid reaction, specifically located on the mucosal side of the lips, and associated with microorganisms, with a matched group presenting with reticular oral lichen planus (OLP) of the buccal mucosa. PATIENTS AND METHODS The mean age for both groups was 66 years with a predominance of women (62%). The lichenoid reaction group (n = 25) presented with a reticular reaction pattern embracing various degrees of erythema. Patients presenting with OLP had similar lesions confined to the buccal mucosa but not on the mucosal side of the lips. RESULTS In both groups, 80% were on any type of medication. However, 56% of the patients with lichenoid reactions medicated with more than three drugs compared with 29% (P < 0.05) in the OLP group. The former group more often used medicaments prescribed for cardiovascular diseases (48%vs 25%). Twenty-two of the patients with lichenoid reactions were treated with chlorhexidine. In 80% of these patients (n = 18), the lesions improved or completely healed, indicating a microbial association. CONCLUSION Lichenoid reactions present on the mucosal side of the lips may be initiated by microbial plaque precipitated on the buccal surfaces of the anterior teeth.
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Affiliation(s)
- K Bäckman
- Clinic of Oral Medicine, Public Dental Health, Göteborg, Sweden
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Atkinson JC, Grisius M, Massey W. Salivary hypofunction and xerostomia: diagnosis and treatment. Dent Clin North Am 2005; 49:309-26. [PMID: 15755407 DOI: 10.1016/j.cden.2004.10.002] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Salivary gland hypofunction and complaints of xerostomia are common in elderly patients, irrespective of their living situation. Medication use is frequently related to dry mouth symptoms and reductions in salivary flow rates. Patients with reduced salivary flow are at increased risk for caries, oral fungal infections, swallowing problems, and diminished or altered taste. Oral health care providers should institute aggressive preventive measures and recommend palliative care for patients with significant reduction in salivary gland function. The systemic agents pilocarpine and cevimeline may help selected patients. Selective use of fluoride-releasing restorative materials and conservative treatment plans are recommended for this patient group.
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Affiliation(s)
- Jane C Atkinson
- Comprehensive Care and Therapeutics, University of Maryland Dental School, 666 West Baltimore Street, 3E-32, Baltimore, MD 21201-1586, USA.
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Nederfors T, Nauntofte B, Twetman S. Effects of furosemide and bendroflumethiazide on saliva flow rate and composition. Arch Oral Biol 2004; 49:507-13. [PMID: 15126132 DOI: 10.1016/j.archoralbio.2004.01.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2004] [Indexed: 11/24/2022]
Abstract
Aim of this study was to evaluate the effect on saliva flow rate and composition and on perceived xerostomia. The study used a Latin square design, all subjects being once daily (at 7.00 a.m.) taking the bendroflumethiazide (2.5 mg), furosemide (40 mg), or placebo, in a randomised order. Each treatment period of 7 days was separated by wash-out periods of 14 days. Unstimulated and paraffin chewing stimulated whole saliva, and 3% citric acid stimulated parotid and submandibular-sublingual secretion were collected twice daily, at 7.30 a.m., with the patients in a fasting condition (morning values), and at 10.30 a.m., about 2 h after intake of a standard breakfast (lunchtime values), on day 0 (baseline), day 1 (acute treatment), and day 7 (chronic treatment). Saliva flow rates were measured and all four secretions were analysed for the concentration of sodium, potassium, chloride, and total protein. Xerostomia was assessed by means of a Visual Analogue Scale. Statistical analysis used the Wilcoxon signed rank test. For flow rate, only that of submandibular-sublingual secretion was affected, significantly so in the morning during chronic treatment with both drugs. In resting whole saliva the output of both sodium and chloride tended to decrease especially during treatment with bendroflumethiazide, while in submandibular-sublingual secretion the output of all the electrolytes was decreased, especially for potassium and chloride and during treatment with furosemide. Further, xerostomia tended to increase during treatment with furosemide, statistically significant at lunchtime during chronic treatment. In conclusion, this study has demonstrated a modest effect on salivary flow rate and a more pronounced effect on saliva composition, especially in submandibular-sublingual secretion during treatment of healthy volunteers with therapeutic doses of two different diuretics, encouraging clinical studies in hypertensive patients and basic research as to the presence of a thiazide sensitive Na-Cl cotransporter in human salivary glands.
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Affiliation(s)
- T Nederfors
- Department of Dentistry, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
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Sankar V, Brennan MT, Radfar L, Leakan RA, Pillemer SR. Elevated blood pressure is not related to saliva flow in patients with Sjögren's syndrome. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:179-83. [PMID: 12221385 DOI: 10.1067/moe.2002.123861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether systolic and diastolic blood pressures are associated with salivary flow, dry mouth, or dry eye symptoms in patients with primary Sjögren's syndrome as compared with xerostomic control subjects. STUDY DESIGN One hundred forty consecutive patients seen at the Sjögren's Syndrome Clinic were categorized retrospectively with various classification schemes: (1) subjective dry mouth; (2) subjective dry eye; (3) European criteria; and (4) international criteria. Data collection included age, gender, systolic blood pressure, diastolic blood pressure, salivary flow rate, focus score, Schirmer's test, and laboratory findings, including antinuclear antibodies, anti-SSA, anti-SSB, IgG, IgA, IgM, erythrocyte sedimentation rate, and rheumatoid factor. RESULTS No meaningful associations of salivary flow rates with systolic or diastolic blood pressures were found in patients with Sjögren's syndrome or in xerostomic control subjects. An inverse correlation was seen between salivary flow and elevated diastolic blood pressure in xerostomic control subjects only. CONCLUSION Elevated blood pressure was not related to saliva flow in patients with Sjögren's syndrome.
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Affiliation(s)
- Vidya Sankar
- Gene Therapy and Therapeutics Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA.
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Pai S, Ghezzi EM, Ship JA. Development of a Visual Analogue Scale questionnaire for subjective assessment of salivary dysfunction. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 91:311-6. [PMID: 11250628 DOI: 10.1067/moe.2001.111551] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study's objective was to develop a Visual Analogue Scale (VAS) xerostomia questionnaire and to evaluate the validity and reliability for the clinical diagnosis of salivary gland dysfunction. STUDY DESIGN Thirty-six healthy adults participated in this double-blind, crossover study. Each subject received an antisialagogue (glycopyrrolate) or placebo. Unstimulated and stimulated parotid and submandibular saliva samples were collected 16 times over a period of 6 hours. An 8-item VAS xerostomia questionnaire was administered after each saliva collection. RESULTS The results demonstrated significant reliability for 7 of the 8 VAS items, whereas validity was significant for unstimulated submandibular saliva. Moving averages were calculated for VAS and salivary flow rate values, and significant correlations were observed between these factors, indicating that changes in VAS responses were predictive of changes in salivary flow. CONCLUSIONS These findings suggest that this VAS xerostomia questionnaire may be helpful in the diagnosis of salivary dysfunction and for detecting changes in salivary flow rate values over time.
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Affiliation(s)
- S Pai
- Dental Public Health, University of Michigan School of Public Health, Ann Arbor, USA
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Abstract
Dry mouth must not be considered a trivial problem in the population, since it constitutes a phenomenon with many aspects relative to oral function as well as quality of life. Up until today, no global consensus has been reached with regard to the terminology of dry mouth, creating a substantial problem for research, education, diagnosis, and therapy. In this report, salivary gland hypofunction has been selected as the overarching term for subjective symptoms and objective signs of dry mouth. Its different aspects--xerostomia, hyposalivation, and altered saliva composition--are reviewed with respect to prevalence, diagnosis, and etiology. It is concluded that these aspects of salivary gland hypofunction are separate entities, which in many respects are interrelated, constituting not merely a dental but also a medical and social concern.
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Affiliation(s)
- T Nederfors
- Oral Health Centre, Central Hospital, Halmstad, Sweden.
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Abstract
The carbonic anhydrases (CAs) participate in the maintenance of pH homeostasis in various tissues and biological fluids of the human body by catalysing the reversible reaction CO2 + H2O HCO3- + H+ (Davenport & Fisher, 1938; Davenport, 1939; Maren, 1967). Carbonic anhydrase isoenzyme VI (CA VI) is the only secretory isoenzyme of the mammalian CA gene family. It is exclusively expressed in the serous acinar cells of the parotid and submandibular glands, from where it is secreted into the saliva. In this review, we will discuss recent advances in research focused on the physiological role of salivary CA VI in the oral cavity and upper alimentary canal.
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Affiliation(s)
- J Kivela
- Department of Anatomy and Cell Biology, University of Oulu, Oulu, Parolannummi Garrison Hospital, Finnish Defence Forces, Hattula.
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Närhi TO, Meurman JH, Ainamo A. Xerostomia and hyposalivation: causes, consequences and treatment in the elderly. Drugs Aging 1999; 15:103-16. [PMID: 10495070 DOI: 10.2165/00002512-199915020-00004] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Xerostomia and salivary gland hypofunction (SGH) are prevalent in elderly populations, causing much discomfort and even difficulties in eating. SGH also increases the occurrence and severity of oral diseases and makes the patient susceptible to candidiasis. The principal causes of SGH and xerostomia are systemic diseases and drugs used daily. The diagnosis of SGH and xerostomia is based on simple methods, of which measuring both unstimulated and stimulated salivary flow rate is the most important. Treatment calls for proper management of underlying disease, avoidance of all unnecessary medications, and topical remedies such as artificial saliva substitutes. However, good hydration is essential in the elderly with SGH and xerostomia, and water is the drink of choice. In extremely difficult cases, for instance in patients receiving radiotherapy for cancer of the head and neck regions, parasympathomimetic drugs may be administered if no contraindications exist.
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Affiliation(s)
- T O Närhi
- Sector of Oral Function and Prosthetic Dentistry, University of Nijmegen, The Netherlands.
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Lenander-Lumikari M, Laurikainen K, Kuusisto P, Vilja P. Stimulated salivary flow rate and composition in asthmatic and non-asthmatic adults. Arch Oral Biol 1998; 43:151-6. [PMID: 9602294 DOI: 10.1016/s0003-9969(97)00110-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The number of decayed, missed and filled permanent teeth (DMFT), the degree of periodontal inflammation (Periodontal Status Index, PSI), stimulated salivary flow rate and the concentrations of total protein, lactoferrin, lysozyme, myeloperoxidase, salivary peroxidase, calcium, potassium, sodium and thiocyanate in whole saliva of 26 adult asthma patients were compared with those of 33 non-asthmatic controls. The saliva was also analysed for mutans streptococci, lactobacilli, total anaerobic flora and Candida spp. The mean PSI (p < 0.05; 95% confidence interval for the difference between means (95% CI) 2.47-25.30) was higher and the mean stimulated salivary flow rate (p < or = 0.05; 95% CI 0.57-0.55) was lower in the asthmatic group than in the control group. No differences were found between the groups in non-immune defense factors, except for myeloperoxidase. The myeloperoxidase concentrations were higher in asthmatics than in non-asthmatics (p < 0.05; 95% CI 4.4-134.0 ng/ml). No differences in microbial counts were found. It was concluded that stimulated salivary flow rates decrease while myeloperoxidase concentrations increase in adult asthmatic patients compared with non-asthmatic adults. The higher concentrations of myeloperoxidase are explained by a higher PSI in asthmatics.
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