Evaluation of salivary oxidative parameters in overweight and obese young adults

Association of socio-demographic characteristics, comorbidities, lifestyle habits, and saliva parameters with dental caries in adults with obesity

OBJECTIVE

To describe the oral health status of patients with obesity and to explore the socio-demographic characteristics, comorbidities, lifestyle habits (tobacco, alcohol, sweet/acidic diet), and saliva parameters most associated with the dental caries experience.  Material and methods: We conducted a cross-sectional analysis of 204 patients' data with obesity attending a therapeutic education programme. Caries experience (number of decayed, missing, and filled teeth [DMFT]), periodontal status, oral hygiene, occlusal tooth wear, masticatory inefficiency, and saliva parameters were recorded.

RESULTS

Mean DMFT was 12 ± 7 and was independently associated with age (mean 47 ± 14 years; for 1 standard deviation (SD) increase: β = 0.22, 95% confidence interval [CI] = 0.16-0.29), female sex (72%; β = 3.76, 95% CI = 1.65-5.87), brushing <2 times/day (35%; β = 2.86, 95% CI = 0.81-4.90), salivary buffering capacity (low [46%] vs. normal [40%]: β = 2.02, 95% CI = 0.08-3.95; very low [10%] vs. normal: β = 3.34, 95% CI = 0.31-6.37), and salivary consistency (bubbly [30%] vs. clear [57%]: β = 2.45, 95% CI = 0.52-4.38).

CONCLUSIONS

Improving patients' competencies for oral care, such as teeth brushing twice daily, is necessary to limit the burden of dental caries in individuals with obesity. Acting on salivary composition may also be of interest, and further studies are required to explore the underlying mechanisms.

Bulk RNA-seq and scRNA-seq analysis reveal an activation of immune response and compromise of secretory function in major salivary glands of obese mice

Obesity affects the function of multiple organs/tissues including the exocrine organ salivary glands. However, the effects of obesity on transcriptomes and cell compositions in the salivary glands have yet been studied by bulk RNA-sequencing and single-cell RNA-sequencing. Besides, the cell types in the sublingual gland, one of the three major salivary glands, have yet been characterized by the approach of single-cell RNA-sequencing. In this report, we find that the histological structure of the three major salivary glands are not obviously affected in the obese mice. Bulk RNA-sequencing analysis shows that the most prominent changes observed in the three major salivary glands of the obese mice are the mobilization of transcriptomes related to the immune response and down-regulation of genes related to the secretory function of the salivary glands. Based on single-cell RNA-sequencing analysis, we identify and annotate 17 cell clusters in the sublingual gland for the first time, and find that obesity alters the relative compositions of immune cells and secretory cells in the major glands of obese mice. Integrative analysis of the bulk RNA-sequencing and single-cell RNA-sequencing data confirms the activation of immune response genes and compromise of secretory function in the three major salivary glands of obese mice. Consequently, the secretion of extracellular matrix proteins is significantly reduced in the three major salivary glands of obese mice. These results provide new molecular insights into understanding the effect of obesity on salivary glands.

Novel impacts of saliva with regard to oral health

The maintenance of balanced oral homeostasis depends on saliva. A readily available and molecularly rich source of biological fluid, saliva fulfills many functions in the oral cavity, including lubrication, pH buffering, and tooth mineralization. Saliva composition and flow can be modulated by different factors, including circadian rhythm, diet, age, drugs, and disease. Recent events have revealed that saliva plays a central role in the dissemination and detection of the SARS-CoV-2 coronavirus. A working knowledge of saliva function and physiology is essential for dental health professionals.

Salivary Redox Biomarkers in Insulin Resistance: Preclinical Studies in an Animal Model

Insulin resistance (IR) is a condition of impaired tissue response to insulin. Although there are many methods to diagnose IR, new biomarkers are still being sought for early and noninvasive diagnosis of the disease. Of particular interest in laboratory diagnostics is saliva collected in a stress-free, noninvasive, and straightforward manner. The purpose of the study was to evaluate the diagnostic utility of salivary redox biomarkers in preclinical studies in an animal model. The study was conducted on 20 male Wistar rats divided into two equal groups: a standard diet and a high-fat diet (HFD). In all rats fed the HFD, IR was confirmed by an elevated homeostasis model assessment (HOMA-IR) index. We have shown that IR is responsible for the depletion of the enzymatic (↓superoxide dismutase) and nonenzymatic (↓ascorbic acid, ↓reduced glutathione (GSH)) antioxidant barrier at both the central (serum/plasma) and salivary gland (saliva) levels. In IR rats, we also demonstrated significantly higher concentrations of protein/lipid oxidation (↑protein carbonyls, ↑4-hydroxynoneal (4-HNE)), glycation (↑advanced glycation end products), and nitration (↑3-nitrotyrosine) products in both saliva and blood plasma. Salivary nonenzymatic antioxidants and oxidative stress products generally correlate with their blood levels, while GSH and 4-HNE have the highest correlation coefficient. Salivary GSH and 4-HNE correlate with body weight and BMI and indices of carbohydrate metabolism (glucose, insulin, HOMA-IR) and proinflammatory adipokines (leptin, resistin, TNF-α). These biomarkers differentiate IR from healthy controls with very high sensitivity (100%) and specificity (100%). The high diagnostic utility of salivary GSH and 4-HNE is also confirmed by multivariate regression analysis. Summarizing, saliva can be used to assess the systemic antioxidant status and the intensity of systemic oxidative stress. Salivary GSH and 4-HNE may be potential biomarkers of IR progression. There is a need for human clinical trials to evaluate the diagnostic utility of salivary redox biomarkers in IR conditions.

Salivary Biomarkers of Oxidative Stress and Inflammation in Stroke Patients: From Basic Research to Clinical Practice

Cerebral stroke is a serious worldwide health problem, as can be seen by the global epidemic of the disease. In this disorder, when the blood flow is compromised by ruptures or blocked arteries, sudden death of neurons is observed as a result of a lack of oxygen and nutrients. Numerous severe problems and frequent complications also exist in stroke patients; therefore, there is an urgent need to develop new therapeutic, diagnostic, and prognostic methods for the disease. At present, the diagnosis of stroke is based on a neurological examination, medical history, and neuroimaging, due to the fact that rapid and noninvasive diagnostic tests are unavailable. Nevertheless, oxidative stress and inflammation are considered key factors in stroke pathogenesis. Oxygen free radicals are responsible for oxidation of lipids, proteins, and DNA/RNA, which in turn contributes to oxidative damage of the brain. Toxic products of the oxidation reactions act cytostatically on the cell by damaging cell membranes and leading to neuronal death by apoptosis or necrosis. Thus, it seems that redox/inflammatory biomarkers might be used in the diagnosis of the disease. Nowadays, saliva is of increasing interest in clinical laboratory medicine. Redox biomarkers could be obtained easily, noninvasively, cheaply, and stress-free from saliva. This minireview is aimed at presenting the current knowledge concerning the use of salivary biomarkers of oxidative stress and inflammation in the diagnosis and prognosis of stroke.

The Relationship Between Salivary Redox, Diet, and Food Flavor Perception

The mouth is the gateway for entrance of food and microorganisms into the organism. The oral cavity is bathed by saliva, which is thus the first fluid that food and microorganisms will face after their entrance. As a result, saliva plays different functions, including lubrication, predigestion, protection, detoxification, and even transport of taste compounds to chemoreceptors located in the taste buds. To ensure its function of protection, saliva contains reactive harmful compounds such as reactive oxygen species that are controlled and neutralized by the antioxidant activity of saliva. Several antioxidant molecules control the production of molecules such as reactive oxygen compounds, neutralize them and/or repair the damage they have caused. Therefore, a balance between reactive oxidant species and antioxidant compounds exists. At the same time, food can also contain antioxidant compounds, which can participate in the equilibrium of this balance. Numerous studies have investigated the effects of different food components on the antioxidant capacity of saliva that correspond to the ability of saliva to neutralize reactive oxygen species. Contradictory results have sometimes been obtained. Moreover, some antioxidant compounds are also cofactors of enzymatic reactions that affect flavor compounds. Recent studies have considered the salivary antioxidant capacity to explain the release of flavor compounds ex vivo or in vivo. This article aims to review the effect of food on the antioxidant capacity of saliva and the impact of salivary antioxidant capacity on flavor perception after a brief presentation of the different molecules involved.

Salivary Gland Dysfunction in Patients with Chronic Heart Failure Is Aggravated by Nitrosative Stress, as Well as Oxidation and Glycation of Proteins

Chronic heart failure (HF) is an important clinical, social, and economic problem. A key role in HF progression is played by oxidative stress. Free oxygen radicals, formed under the conditions of hypoxia and reperfusion, participate in myocardial stunning and other forms of post-reperfusion damage. HF patients also suffer from disorders connected with saliva secretion. However, still little is known about the mechanisms that impair the secretory function of salivary glands in these patients. In the presented study, we were the first to compare the antioxidant barrier, protein glycoxidation, and nitrosative/nitrative stress in non-stimulated (non-stimulated whole saliva (NWS)) and stimulated (SWS) saliva of HF patients. The study included 50 HF patients with normal saliva (NS) secretion (n = 27) and hyposalivation (HS) (n = 23), as well as an age- and gender-matched control group (n = 50). We demonstrated that, in NWS of HF patients with HS, the concentration of low-molecular-weight non-enzymatic antioxidants decreased (↓total polyphenols, ↓ascorbic acid, ↓reduced glutathione, ↓albumin) compared to HF patients with normal saliva (NS) secretion, as well as the control group (except albumin). We also observed increased content of protein glycoxidation products (↑dityrosine, ↑kynurenine, ↑glycophore) in NWS and SWS of HF patients with HS compared to healthy controls. Interestingly, the content of dityrosine, N-formylkynurenine, and glycophore in NWS was also significantly higher in HF patients with HS compared to those with NS secretion. The concentration of NO was considerably lower, while the levels of peroxynitrite and nitrotyrosine were significantly higher in NWS and SWS of HF subjects with HS compared to the controls. Salivary gland dysfunction occurs in patients with chronic HF with the submandibular salivary glands being the least efficient. Oxidative/nitrosative stress may be one of the mechanisms responsible for the impairment of salivary gland secretory function in HF patients.

Physiological and oral parameters contribute prediction of retronasal aroma release in an elderly cohort

Malnutrition is a serious problem in the elderly while understanding flavour perception could be a tool for controlling appetite or food choices. To increase our knowledge, we characterised the health and oral physiology (oral volume, swallowing tongue force, number of teeth and salivary flow rate, protein content and antioxidant capacity) of a cohort of 54 community-dwelling French elderly as well as their individual retronasal release of five aroma compounds (2-pentanone, 2-nonanone, 2,3-hexanedione, octanal and linalool) by proton-transfer-reaction mass spectrometry (PTR-MS). In general, large variability across participants was observed in both oral physiological (>40%) and retronasal aroma release (>56%) parameters. Multivariate analyses revealed a relationship between physiological parameters (mostly salivary antioxidant capacity) and retronasal aroma release that explained up to 46% of the variability observed. This study provides new insights to understand retronasal aroma release in the elderly that could contribute to the development of personalised nutrition strategies.

Myogenous temporomandibular disorders and salivary markers of oxidative stress-A cross-sectional study

BACKGROUND

The clinical care of chronic pain requires personalised understanding of the mechanisms involved. Temporomandibular disorders (TMD) are the most common chronic orofacial pain conditions, and oxidative stress has been proposed to be implicated in their pathophysiology, especially in arthrogenous TMD. However, few studies have explored oxidative stress in myogenous TMD (TMDM).

OBJECTIVE

The aims of this study were to compare the salivary oxidative stress profiles between individuals with TMDM and healthy controls, and to explore associations of these markers with clinical characteristics.

METHODOLOGY

Saliva samples were collected from 39 individuals with TMDM and 37 age and sex-matched healthy volunteers. Psychological stress levels and clinical characteristics were assessed in all participants. The samples were analysed for total oxidant status (TOS), total antioxidative capacity (TAC) and superoxide dismutase activity (SODa). Comparisons between groups were performed using parametric and non-parametric tests depending on data distribution.

RESULTS

Psychological stress was higher in TMDM compared to controls (P < .001). TAC levels were significantly higher (P < .05) whereas TOS levels were significantly lower (P < .05) in TMDM compared to controls. There were no differences in SODa levels between groups and no correlations were found between clinical characteristics and oxidative stress markers.

CONCLUSION

Individuals with TMDM showed higher levels of antioxidative markers, but lower levels of oxidative markers. These results can be explained in part by chronicity and adaptation to the disease and other factors, such as psychological stress. Longitudinal studies must be conducted to clarify the role of oxidative stress in TMDM.

Changes in Markers of Oxidative Stress and α-Amylase in Saliva of Children Associated with a Tennis Competition

The purpose of this paper was to analyze the changes caused by a one-day tennis tournament in biomarkers of oxidative stress and α-amylase in saliva in children. The sample was 20 male active children with the following characteristics: (a) age of players = 9.46 ± 0.66 years; (b) weight = 34.8 ± 6.5 kg; (c) height = 136.0 ± 7.9 cm; (d) mean weekly training tennis = 2.9 ± 1.0 h. The tennis competition ran for one day, with four matches for each player. Data were taken from the average duration per match and the rating of perceived exertion (RPE). Four biomarkers of antioxidant status: uric acid (AU), Trolox equivalent antioxidant capacity (TEAC), ferric reducing ability of saliva (FRAS, cupric reducing antioxidant capacity (CUPRAC) and salivary alpha-amylase (sAA) as a biomarker of psychological stress were measured in saliva. The time points were baseline (at home before the tournament), pre-competition (immediately before the first match) and post-match (after each match) measurements. The four biomarkers of antioxidant status showed a similar dynamic with lower values at baseline and a progressive increase during the four matches. Overall one-day tennis competition in children showed a tendency to increase antioxidant biomarkers in saliva. In addition, there was an increase in pre-competition sAA possibly associated with psychological stress. Further studies about the possible physiological implications of these findings should be performed in the future.

Association Between Magnesium and Oxidative Stress in Patients with Obesity

Background:

The role of minerals in preventing the generation of oxidative stress in obese individuals has been evaluated. Magnesium is an antioxidant nutrient and a cofactor of enzymes involved in the cell membrane stabilization, attenuating the effects of oxidative stress.

Objective:

To evaluate the association between magnesium and concentrations of thiobarbituric acid reactive substances (TBARS) in patients with obesity and eutrophic women.

Methods:

A cross-sectional study was conducted with 73 women, divided into two groups: case group (patients with obesity, n=27) and control group (eutrophic women, n=46). Measurements of body mass index and waist circumference were performed. Dietary magnesium intake was assessed by the three-day food record using the NutWin software. Urinary magnesium concentration was measured by atomic absorption spectrophotometry method. Plasma concentrations of thiobarbituric acid reactive substances (TBARS) were also determined.

Results:

Mean values of dietary magnesium intake were 161.59 ± 60.04 and 158.73 ± 31.96 for patients with obesity and control group, respectively, with no significant difference between the groups studied (p >0.05). The value of urinary excretion of magnesium was lower than the reference values in both groups, with no significant difference between the groups studied (p >0.05). The plasma concentration of thiobarbituric acid reactive substances was significantly higher in patients with obesity compared to the control group (p <0.001). There was no correlation between levels of magnesium biomarkers and the concentration of TBARS (p >0.05).

Conclusion:

Patients with obesity showed a reduced dietary magnesium intake which seems to induce hypomagnesuria as a compensatory mechanism. The marker of oxidative stress evaluated in this study was not influenced by magnesium.

Dysfunction of Salivary Glands, Disturbances in Salivary Antioxidants and Increased Oxidative Damage in Saliva of Overweight and Obese Adolescents

Obesity is inseparably connected with oxidative stress. This process may disturb the functioning of the oral cavity, although the effect of oxidative stress on salivary gland function and changes in the qualitative composition of saliva are still unknown. Our study is the first to evaluate salivary redox homeostasis in 40 overweight and obese adolescents and in the age- and gender-matched control group. We demonstrated strengthening of the antioxidant barrier (superoxide dismutase, catalase, peroxidase, uric acid, total antioxidant capacity (TAC)) with a simultaneous decrease in reduced glutathione concentration in saliva (non-stimulated/stimulated) in overweight and obese teenagers compared to the controls. The concentration of the products of oxidative damage to proteins (advanced glycation end products), lipids (malondialdehyde, 4-hydroxynonenal) and DNA (8-hydroxydeoxyguanosine) as well as total oxidative status were significantly higher in both non-stimulated and stimulated saliva as well as plasma of overweight and obese adolescents. Importantly, we observed more severe salivary and plasma redox alterations in obese adolescents compared to overweight individuals. In the study group, we also noted a drop in stimulated salivary secretion and a decrease in total protein content. Interestingly, dysfunction of parotid glands in overweight and obese teenagers intensified with the increase of BMI. We also showed that the measurement of salivary catalase and TAC could be used to assess the central antioxidant status of overweight and obese adolescents.

Salivary Redox Biomarkers in Selected Neurodegenerative Diseases

Neurodegenerative diseases (NDDs), such as Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease, are disorders, which cause irreversible and progressive deterioration of the central nervous system. The pathophysiology of NDDs is still not fully explained; nevertheless, oxidative stress is considered as a critical mediator of cerebral degeneration, brain inflammation, as well as neuronal apoptosis. Therefore, it is not surprising that redox biomarkers are increasingly used in the diagnosis of neurodegenerative diseases. As saliva is a very easy to obtain bioliquid, it seems promising to use this biomaterial in the diagnosis of NDDs. Saliva collection is easy, cheap, stress-free, and non-infectious, and it does not require the help of a specialised medical personnel. Additionally, the concentrations of many salivary redox biomarkers correlate with their content in blood serum as well as the degree of disease progression, which makes them non-invasive indicators of NDDs. This paper reviews the latest knowledge concerning the use of salivary redox biomarkers in the diagnosis and prognosis of selected neurodegenerative diseases.

Influence of Sampling Conditions, Salivary Flow, and Total Protein Content in Uric Acid Measurements in Saliva

Uric acid (UA) is the most abundant antioxidant compound in saliva and one of the most sensitive biomarkers for detecting changes in the oxidative status of the organism. The aim of this study was to evaluate the effect of: (i) different methods of saliva sampling and (ii) the correction by salivary flow or total protein on UA concentrations in saliva. Paired saliva (collected by two different methods, passive drooling and using Salivette cotton rolls) and serum samples were obtained from 12 healthy men after the performance of two resistance training exercises of different level of effort that can produce different concentrations in UA in saliva. There were no significant differences between values of uric acid in saliva using Salivette and passive drool. Correlations between UA in serum and saliva and increases in UA in saliva after exercise were detected when saliva samples were obtained by passive drool and Salivette and were not corrected by salivary flow or total protein concentration. Therefore for UA measurements in saliva it would not be recommended to normalize the results by salivary flow or protein concentration. This study highlights the importance of choosing an adequate sampling method selection as well as the expression of results when analytes are measured in saliva.

Salivary and plasma native and non-urate total antioxidant capacity versus oral health status in older non-smoking adults

OBJECTIVE

The aim of this study was to evaluate the salivary C-reactive protein and native and non-urate total antioxidant capacity (TAC) of saliva and plasma in relation to various oral health status indexes in older non-smoking adults.

DESIGN

Oral health status indices involved the Decayed, Missing, Filled Teeth index, the number of decayed teeth, Approximal Plaque Index, Plaque Index and Community Periodontal Index with Treatment Needs. Sixty older patients (67.0 ± 4.5 years) with different levels of oral health were examined. Salivary C-reactive protein was assessed. The Ferric Reducing Ability of Saliva/Plasma (FRAS/FRAP) and 2.2-diphenyl-1-picryl-hydrazyl test of saliva/plasma (DPPHS/DPPH) were used to assess the native and non-urate salivary (FRAS, non-urate FRAS, DPPHS, non-urate DPPHS, and plasma TAC (FRAP, non-urate FRAP, DPPH, non-urate DPPH).

RESULTS

Salivary C-reactive protein, native TAC and non-urate TAC did not correspond to any oral health status index. No relation was found for plasma native and non-urate TAC either. In multivariate analyses, age was the only independent predictor of DPPHS and salivary uric acid (p < 0.05) while non-urate DPPH was only negatively predicted by Body Mass Index (p < 0.001). None of oral health status indices was selected as an independent predictor of salivary and plasma TAC or C-reactive protein of saliva.

CONCLUSION

Oral health status indexes did not appear to influence the native or the non-urate local antioxidant status of saliva, or the systemic antioxidant status of plasma; they had no local effect related to salivary C-reactive protein. However, lower plasma non-urate antioxidant potential was related to overweight/obesity.

Consumption of cranberry functional beverage reduces gingival index and plaque index in patients with gingivitis

Periodontal disease is highly prevalent worldwide, and consumption of certain foods, such as fruits, seem to improve the effectiveness of periodontal therapy (PT) due to their antiadhesive, immunomodulatory, and antioxidative properties. We hypothesized that the cranberry functional beverage (CFB) consumed for eight weeks improves gingival inflammation indices via inhibition of dental plaque, and alterations in antioxidant status, and systemic inflammation in patients with gingivitis. In this two-arm randomized controlled study, fifty participants were divided into an experimental group (CFB), administered daily with 750 ml CFB, or a control group administered the same amount of water. All patients underwent nonsurgical PT prior to the intervention. Gingival (GI) and bleeding on probing (BoP) indices of inflammation, plaque (PI) and approximal plaque (API) indices of dental plaque deposition, saliva and serum total antioxidant status (TAS), serum malonylodialdehyde level (MDA), and interleukin 1-beta level (IL-1beta) were measured pre- and postintervention. A risk of caries development was determined by Streptococcus mutans (SM) and Lactobacillus spp. (LAB) counts in supragingival dental plaque. Changes in GI and PI but not BoP and API were significantly more pronounced in the CFB group compared to the control group. Serum or saliva TAS, IL-1beta, and MDA did not differ between groups. The number of SM reduced in CFB, but not in the control group. We demonstrated that the consumption of CFB improves gingival and plaque indices without posing a risk of caries development. Thus CFB can be recommended as a safe adjunct for nonsurgical PT in patients with gingivitis.