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Lasisi TJ, Lawal FB. Preference of saliva over other body fluids as samples for clinical and laboratory investigations among healthcare workers in Ibadan, Nigeria. Pan Afr Med J 2019; 34:191. [PMID: 32180865 PMCID: PMC7060920 DOI: 10.11604/pamj.2019.34.191.18738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 10/24/2019] [Indexed: 01/02/2023] Open
Abstract
Introduction The study aimed to assess the knowledge and practices of clinicians and laboratory scientists on the use of saliva for clinical or laboratory tests. Methods This was a cross-sectional survey of health care workers (100 clinicians and 62 laboratory scientists) closely involved with specimen collection for clinical and laboratory investigation at two health facilities (secondary and tertiary) in Nigeria. Information was obtained from participants using pretested structured questionnaires. Data were analyzed with SPSS and level of significance set at p < 5%. Results The mean age of the study participants was 34.1 (±6.6) years. The majority (95.7%) knew saliva could be used for clinical/laboratory test. A higher proportion of laboratory scientists knew saliva could be used in diagnosing HIV (59.2%), oral diseases (88.7%), oro-facial tumors (64.4%) and genetic testing (94.5%) compared to (41%), (80%), (40%) and (80%), of clinicians respectively (p < 0.05). More clinicians (85%) indicated saliva as a good specimen for diagnosing systemic diseases compared with scientists (63%), p < 0.001. Saliva was the most comfortable/convenient body fluid to obtain from patients with more clinicians (80%) mentioning this than scientists (49.1%), p < 0.001. Twenty-six clinicians had used saliva for disease diagnosis (64%), treatment monitoring (28%) or research purposes (8%). Saliva sampling for research purposes was more prevalent among clinicians (p = 0.004). Conclusion The majority of the health care workers knew the various uses and advantages of saliva as a specimen for clinical and laboratory investigation. However, few indicated previous use for clinical and laboratory investigation especially in the area of research.
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Affiliation(s)
- Taye Jemilat Lasisi
- Department of Physiology, University of Ibadan, Ibadan, Nigeria.,Department of Oral Pathology, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Folake Barakat Lawal
- Department of Periodontology & Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Nagy N, Sunkari VG, Kaber G, Hasbun S, Lam DN, Speake C, Sanda S, McLaughlin TL, Wight TN, Long SR, Bollyky PL. Hyaluronan levels are increased systemically in human type 2 but not type 1 diabetes independently of glycemic control. Matrix Biol 2019; 80:46-58. [PMID: 30196101 PMCID: PMC6401354 DOI: 10.1016/j.matbio.2018.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 01/19/2023]
Abstract
Hyaluronan (HA), an extracellular matrix glycosaminoglycan, is implicated in the pathogenesis of both type 1 diabetes (T1D) as well as type 2 diabetes (T2D) and has been postulated to be increased in these diseases due to hyperglycemia. We have examined the serum and tissue distribution of HA in human subjects with T1D and T2D and in mouse models of these diseases and evaluated the relationship between HA levels and glycemic control. We found that serum HA levels are increased in T2D but not T1D independently of hemoglobin-A1c, C-peptide, body mass index, or time since diabetes diagnosis. HA is likewise increased in skeletal muscle in T2D subjects relative to non-diabetic controls. Analogous increases in serum and muscle HA are seen in diabetic db/db mice (T2D), but not in diabetic DORmO mice (T1D). Diabetes induced by the β-cell toxin streptozotozin (STZ) lead to an increase in blood glucose but not to an increase in serum HA. These data indicate that HA levels are increased in multiple tissue compartments in T2D but not T1D independently of glycemic control. Given that T2D but not T1D is associated with systemic inflammation, these patterns are consistent with inflammatory factors and not hyperglycemia driving increased HA. Serum HA may have value as a biomarker of systemic inflammation in T2D.
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Affiliation(s)
- Nadine Nagy
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA, 94305
| | - Vivekananda G. Sunkari
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA, 94305
| | - Gernot Kaber
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA, 94305
| | - Sonia Hasbun
- Department of Cardiology, Good Samaritan Regional Medical Center, 3600 NW Samaritan Dr, Corvallis, OR, 97330
| | - Dung N. Lam
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA, 94305
| | - Cate Speake
- Diabetes Clinical Research Program, Benaroya Research Institute, 1201 Ninth Ave, Seattle, WA, 98101
| | - Srinath Sanda
- Department of Pediatrics, UCSF School of Medicine, 513 Parnassus Avenue, San Francisco, CA, 94143
| | - Tracey L. McLaughlin
- Department of Medicine, Medicine – Endocrinology, Endocrine Clinic, Stanford School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305
| | - Thomas N. Wight
- Matrix Biology Program, Benaroya Research Institute, 1201 Ninth Ave, Seattle, WA, 98101
| | - Steven R. Long
- Department of Pathology, Stanford University School of Medicine, Lane 235, 300 Pasteur Drive, Stanford, CA, 94305
| | - Paul L. Bollyky
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA, 94305
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3
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Prims S, Van Raemdonck G, Vanden Hole C, Van Cruchten S, Van Ginneken C, Van Ostade X, Casteleyn C. On the characterisation of the porcine gland-specific salivary proteome. J Proteomics 2019; 196:92-105. [DOI: 10.1016/j.jprot.2019.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/14/2019] [Accepted: 01/25/2019] [Indexed: 12/22/2022]
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Nagy N, Kuipers HF, Marshall PL, Wang E, Kaber G, Bollyky PL. Hyaluronan in immune dysregulation and autoimmune diseases. Matrix Biol 2018; 78-79:292-313. [PMID: 29625181 DOI: 10.1016/j.matbio.2018.03.022] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/10/2018] [Accepted: 03/30/2018] [Indexed: 02/06/2023]
Abstract
The tissue microenvironment contributes to local immunity and to the pathogenesis of autoimmune diseases - a diverse set of conditions characterized by sterile inflammation, immunity against self-antigens, and destruction of tissues. However, the specific factors within the tissue microenvironment that contribute to local immune dysregulation in autoimmunity are poorly understood. One particular tissue component implicated in multiple autoimmune diseases is hyaluronan (HA), an extracellular matrix (ECM) polymer. HA is abundant in settings of chronic inflammation and contributes to lymphocyte activation, polarization, and migration. Here, we first describe what is known about the size, amount, and distribution of HA at sites of autoimmunity and in associated lymphoid structures in type 1 diabetes, multiple sclerosis, and rheumatoid arthritis. Next, we examine the recent literature on HA and its impact on adaptive immunity, particularly in regards to the biology of lymphocytes and Foxp3+ regulatory T-cells (Treg), a T-cell subset that maintains immune tolerance in healthy individuals. We propose that HA accumulation at sites of chronic inflammation creates a permissive environment for autoimmunity, characterized by CD44-mediated inhibition of Treg expansion. Finally, we address potential tools and strategies for targeting HA and its receptor CD44 in chronic inflammation and autoimmunity.
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Affiliation(s)
- Nadine Nagy
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Hedwich F Kuipers
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Payton L Marshall
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Esther Wang
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Gernot Kaber
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Paul L Bollyky
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Ma IH, Chen LW, Tu WH, Lu CJ, Huang CJ, Chen WL. Serum components and clinical efficacies of autologous serum eye drops in dry eye patients with active and inactive Sjogren syndrome. Taiwan J Ophthalmol 2017; 7:213-220. [PMID: 29296554 PMCID: PMC5747232 DOI: 10.4103/tjo.tjo_102_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
PURPOSE: Autologous serum eye drops are considered safe and efficient for the treatment of various ocular surface disorders, including dry eye diseases (DED) caused by the primary and secondary Sjogren syndrome (SS). However, the serum components in patients of SS may be different from those of normal patients and can thus lead to unpredictable therapeutic effects. This study divided the SS patients into active and inactive types based on the erythrocyte sedimentation rate and the presence or absence of active rheumatoid arthritis. METHODS: We compared the serum components of these two groups with standard and multiplex enzyme linked immunosorbent assay arrays and predicted the therapeutic effects of topical autologous serum for the treatment of DED with ocular surface disease index (OSDI) and Oxford Schema scale (OSS). RESULTS: Hyaluronic acid and transforming growth factor b1 levels were significantly higher in the active SS group compared to the inactive SS group (P < 0.01), whereas epidermal growth factors, insulin growth factor 1, and fibroblast growth factor b had no significant differences between these two groups. Active SS group had significantly higher expressions of interleukin (IL) 1 beta, IL 6, and tumor necrosis factor alpha compared to inactive SS patients (P < 0.05). There were no statistical differences in therapeutic effects between these two groups, as measured with the OSDI or OSS. CONCLUSION: Dividing the Sjogren dry eye patients into active and inactive groups may appear as a reasonable method to predict the quality of autologous serum eye drops, but there seems to be no significant predictability to the therapeutic effects.
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Affiliation(s)
- I-Hsin Ma
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Lily Wei Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Hui Tu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Ju Lu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Jung Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Li Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Center of Corneal Tissue Engineering and Stem Cell Biology, National Taiwan University Hospital, Taipei, Taiwan
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Nagy N, Kuipers HF, Frymoyer AR, Ishak HD, Bollyky JB, Wight TN, Bollyky PL. 4-methylumbelliferone treatment and hyaluronan inhibition as a therapeutic strategy in inflammation, autoimmunity, and cancer. Front Immunol 2015; 6:123. [PMID: 25852691 PMCID: PMC4369655 DOI: 10.3389/fimmu.2015.00123] [Citation(s) in RCA: 192] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/06/2015] [Indexed: 12/27/2022] Open
Abstract
Hyaluronan (HA) is a prominent component of the extracellular matrix at many sites of chronic inflammation, including type 1 diabetes (T1D), multiple sclerosis, and numerous malignancies. Recent publications have demonstrated that when HA synthesis is inhibited using 4-methylumbelliferone (4-MU), beneficial effects are observed in several animal models of these diseases. Notably, 4-MU is an already approved drug in Europe and Asia called "hymecromone" where it is used to treat biliary spasm. However, there is uncertainty regarding how 4-MU treatment provides benefit in these animal models and the potential long-term consequences of HA inhibition. Here, we review what is known about how HA contributes to immune dysregulation and tumor progression. Then, we review what is known about 4-MU and hymecromone in terms of mechanism of action, pharmacokinetics, and safety. Finally, we review recent studies detailing the use of 4-MU to treat animal models of cancer and autoimmunity.
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Affiliation(s)
- Nadine Nagy
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine , Stanford, CA , USA
| | - Hedwich F Kuipers
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine , Stanford, CA , USA
| | - Adam R Frymoyer
- Department of Pediatrics, Stanford University School of Medicine , Stanford, CA , USA
| | - Heather D Ishak
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine , Stanford, CA , USA
| | - Jennifer B Bollyky
- Department of Pediatrics and Systems Medicine, Stanford University School of Medicine , Stanford, CA , USA
| | - Thomas N Wight
- Matrix Biology Program, Benaroya Research Institute , Seattle, WA , USA
| | - Paul L Bollyky
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine , Stanford, CA , USA
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Simon J, DiCarlo LM, Kruger C, Johnson WD, Kappen C, Richards BK. Gene expression in salivary glands: effects of diet and mouse chromosome 17 locus regulating macronutrient intake. Physiol Rep 2015; 3:3/2/e12311. [PMID: 25713331 PMCID: PMC4393215 DOI: 10.14814/phy2.12311] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Dcpp2, Prrt1, and Has1 are plausible candidate genes for the Mnic1 (macronutrient intake-carbohydrate) locus on mouse chromosome 17, based on their map positions and sequence variants, documented expression in salivary glands, and the important role of saliva in oral food processing and taste. We investigated the effects of genotype and diet on gene expression in salivary glands (parotid, submandibular, sublingual) of carbohydrate-preferring, C57BL6J.CAST/EiJ-17.1 subcongenic mice compared to fat-preferring wild-type C57BL/6J. To achieve accurate normalization of real-time quantitative RT-PCR data, we evaluated multiple reference genes to identify the most stably expressed control genes in salivary gland tissues, and then used geometric averaging to produce a reliable normalization factor. Gene expression was measured in mice fed different diets: (1) rodent chow, (2) macronutrient selection diets, (3) high-fat diet, and (4) low-fat diet. In addition, we measured salivary hyaluronan concentrations. All three genes showed strain differences in expression, in at least one major salivary gland, and diet effects were observed in two glands. Dcpp2 expression was limited primarily to sublingual gland, and strongly decreased in B6.CAST-17.1 subcongenic mice compared to wild-type B6, regardless of diet. In contrast, both genotype and diet affected Prrt1 and Has1 expression, in a gland-specific manner, for example, Prrt1 expression in the parotid gland alone was strongly reduced in both mouse strains when fed macronutrient selection diet compared to chow. Notably, we discovered an association between diet composition and salivary hyaluronan content. These results demonstrate robust effects of genetic background and diet composition on candidate gene expression in mouse salivary glands.
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Affiliation(s)
- Jacob Simon
- Genetics of Eating Behavior Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana
| | - Lisa M DiCarlo
- Genetics of Eating Behavior Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana
| | - Claudia Kruger
- Department of Developmental Biology, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana
| | - William D Johnson
- Department of Biostatistics, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana
| | - Claudia Kappen
- Department of Developmental Biology, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana
| | - Brenda K Richards
- Genetics of Eating Behavior Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana
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Dhima M, Salinas TJ, Wermers RA, Weaver AL, Koka S. Preference changes of adult outpatients for giving saliva, urine and blood for clinical testing after actual sample collection. J Prosthodont Res 2013; 57:51-6. [PMID: 23376012 DOI: 10.1016/j.jpor.2012.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 07/17/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Patients' preferences of the type of sample collections for clinical testing are currently unknown. The aims of this study were: (1) to assess patients' preferences of three types of samples for clinical testing (saliva, urine and blood) both before and after collection and (2) to assess whether prior experiences with collection of saliva impacted patients responses. METHODS Adult outpatients underwent collection of one sample each of saliva, urine and blood. Patients' perceptions of comfort, convenience and easiness were assessed in pre-collection and post-collection questionnaires. RESULTS Post-collection, patients' endorsement of saliva as being the "most comfortable" and "most convenient" significantly declined (pre vs. post, 61.5% vs. 37.5% and 73.1% vs. 42.3%). However, saliva was still endorsed as the "most convenient" post-collection (compared to urine 33.7% and blood 24.0%). Although not statistically significant, the proportion of patients who changed their response in terms of what sample was "easiest to collect at home" was considerably higher in the group with vs. without prior experience giving saliva (54.6% vs. 32.6%, p=0.19 Fisher's exact test). CONCLUSIONS Overall, saliva remained as the most highly preferred sample to donate despite a decline in patients' preferences of saliva donation after sample collection. The results of the study are promising for future widespread patient acceptance of saliva as a diagnostic fluid.
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Affiliation(s)
- Matilda Dhima
- Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, Rochester, MN 55905, United States.
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Cho YS, Ahn KH. Molecular interactions between charged macromolecules: colorimetric detection and quantification of heparin with a polydiacetylene liposome. J Mater Chem B 2013; 1:1182-1189. [DOI: 10.1039/c2tb00410k] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Lima DP, Diniz DG, Moimaz SAS, Sumida DH, Okamoto AC. Saliva: reflection of the body. Int J Infect Dis 2010; 14:e184-8. [DOI: 10.1016/j.ijid.2009.04.022] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Revised: 04/03/2009] [Accepted: 04/15/2009] [Indexed: 11/27/2022] Open
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Higuchi Y, Ansai T, Awano S, Soh I, Yoshida A, Hamasaki T, Kakinoki Y, Takehara T. Salivary levels of hyaluronic acid in female patients with dry mouth compared with age-matched controls: a pilot study. ACTA ACUST UNITED AC 2009; 30:63-8. [PMID: 19265265 DOI: 10.2220/biomedres.30.63] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Little is known regarding the association between the level of hyaluronic acid (HA) in saliva and dry mouth status. The aim of this study was to evaluate the salivary levels of HA in female patients with dry mouth (perceived xerostomia and hyposalivation) and compare them with age-matched controls. We studied 46 females, and classified them into two groups based on perceived xerostomia and salivary flow rate, as well as a control group without symptoms. HA concentrations in unstimulated whole saliva were determined and a significant difference was found between the groups. The statistical association was stronger in patients (perceived xerostomia, normosalivation) administrated xerogenic drugs, while the HA levels in that group were significantly lower than those in the controls when converted to absolute amount of saliva per min. Within the limitations of the present study, patients with dry mouth had lower HA levels in saliva, which may serve as a marker of local dryness or oral mucosa lubrication.
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Affiliation(s)
- Yasushi Higuchi
- Division of Community Oral Health Science, Kyushu Dental College, Kitakyushu, Japan
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Balogh GT, Illés J, Székely Z, Forrai E, Gere A. Effect of different metal ions on the oxidative damage and antioxidant capacity of hyaluronic acid. Arch Biochem Biophys 2003; 410:76-82. [PMID: 12559978 DOI: 10.1016/s0003-9861(02)00661-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Degradation and the antioxidative effect of Na-, Zn-, Co-, Cu-, and Mn-hyaluronic acid (HA) associates were studied. Our findings revealed the protective effect of certain counterions against ROS-induced HA degradation. We could also separate the antioxidative effect of certain counterions from that of the HA by examining the effect of the counterions in their free ionic forms. The result showed that metal ions with altering oxidative status (Co(2+), Cu(2+), Mn(2+)) proved to be effective in themselves or their effect added to that of HA when HA was also effective. Moreover, the effects of Co-HA against z.rad;O(2)(-) and of Mn-HA against ONOO(-) as well as the synergic effect of Zn-HA associates where Zn(2+) is of fixed oxidative status were attributed to the structure-stabilizing complex formed between certain counterions and HA. Our examination also concerned the influence of HA associates on the indirect antioxidation related to Fe(2+) chelating. The individual effects of Zn(2+), Co(2+), and Cu(2+) were only detectable, which could be explained by the competitive displacement of ferrous from its binding site.
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Kalk WW, Vissink A, Spijkervet FK, Bootsma H, Kallenberg CG, Nieuw Amerongen AV. Sialometry and sialochemistry: diagnostic tools for Sjögren's syndrome. Ann Rheum Dis 2001; 60:1110-6. [PMID: 11709452 PMCID: PMC1753437 DOI: 10.1136/ard.60.12.1110] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The common occurrence of xerostomia in Sjögren's syndrome (SS) as well as the easy accessibility of saliva supports the use of sialometry and sialochemistry in the diagnosis of SS. Collection and analysis of whole saliva (oral fluid) is currently the routine technique for sialometry, despite the fact that it is rather inaccurate and impure. OBJECTIVE To assess the value of glandular sialometry and sialochemistry as diagnostic instruments in SS. METHODS In a group of 100 consecutive patients referred for diagnosis of SS, glandular secretory flow rates and a spectrum of salivary components (sodium, potassium, chloride, calcium, phosphate, urea, amylase, total protein) were assessed. The patients were classified as positive or negative for SS according to the revised European classification criteria. RESULTS Patients with SS differed clearly from those who tested negative for SS, showing lower submandibular/sublingual (SM/SL) flow rates and an appreciably changed salivary composition of parotid and SM/SL saliva. Besides changes in salivary flow rate and composition, distinct sialometric profiles were observed, characteristic of either early or late salivary manifestation of SS, or of the xerogenic side effects of medication. CONCLUSIONS Glandular sialometry and sialochemistry are not only useful tools for differentiating SS from other salivary gland disease in clinical practice, but they also have great potential as diagnostic criteria for SS, showing distinct sialometric and sialochemical changes as well as profiles. Being simple, safe (non-invasive), and sensitive (early disease detection), they have three major advantages over other oral tests for SS.
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Affiliation(s)
- W W Kalk
- Department of Oral and Maxillofacial Surgery, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
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