Synphilin-1 isoforms in Parkinson's disease: regulation by phosphorylation and ubiquitylation

Parkinson's disease (PD) is characterized by the death of dopaminergic neurons and the presence of Lewy bodies in the substantia nigra pars compacta. The mechanisms involved in the death of neurons as well as the role of Lewy bodies in the pathogenesis of the disease are still unclear. Lewy bodies are made of aggregated proteins, in which alpha-synuclein represents their major component. Alpha-synuclein interacts with synphilin-1, a protein that is also present in Lewy bodies. When expressed in cells, synphilin-1 forms inclusions together with alpha-synuclein that resemble Lewy bodies. Synphilin-1 is ubiquitylated by various E3 ubiquitin-ligases, such as SIAH, parkin and dorfin. Ubiquitylation of synphilin-1 by SIAH is essential for its aggregation into inclusions. We recently identified a new synphilin-1 isoform, synphilin-1A, that is toxic to neurons, aggregation-prone and accumulates in detergent-insoluble fractions of brains from alpha-synucleinopathy patients. Synphilin-1A inclusions recruit both alpha-synuclein and synphilin-1. Aggregation of synphilin-1 and synphilin-1A seems to be protective to cells. We now discuss several aspects of the neurobiology and pathology of synphilin-1 isoforms, focusing on possible implications for PD.

The deoxyguanosine kinase gene is mutated in individuals with depleted hepatocerebral mitochondrial DNA

Mitochondrial DNA (mtDNA)-depletion syndromes (MDS; OMIM 251880) are phenotypically heterogeneous, autosomal-recessive disorders characterized by tissue-specific reduction in mtDNA copy number. Affected individuals with the hepatocerebral form of MDS have early progressive liver failure and neurological abnormalities, hypoglycemia and increased lactate in body fluids. Affected tissues show both decreased activity of the mtDNA-encoded respiratory chain complexes (I, III, IV, V) and mtDNA depletion. We used homozygosity mapping in three kindreds of Druze origin to map the gene causing hepatocerebral MDS to a region of 6.1 cM on chromosome 2p13, between markers D2S291 and D2S2116. This interval encompasses the gene (DGUOK) encoding the mitochondrial deoxyguanosine kinase (dGK). We identified a single-nucleotide deletion (204delA) within the coding region of DGUOK that segregates with the disease in the three kindreds studied. Western-blot analysis did not detect dGK protein in the liver of affected individuals. The main supply of deoxyribonucleotides (dNTPs) for mtDNA synthesis comes from the salvage pathway initiated by dGK and thymidine kinase-2 (TK2). The association of mtDNA depletion with mutated DGUOK suggests that the salvage-pathway enzymes are involved in the maintenance of balanced mitochondrial dNTP pools.

Hypotrichosis with juvenile macular dystrophy is caused by a mutation in CDH3, encoding P-cadherin

Congenital hypotrichosis associated with juvenile macular dystrophy (HJMD; MIM601553) is an autosomal recessive disorder of unknown etiology, characterized by hair loss heralding progressive macular degeneration and early blindness. We used homozygosity mapping in four consanguineous families to localize the gene defective in HJMD to 16q22.1. This region contains CDH3, encoding P-cadherin, which is expressed in the retinal pigment epithelium and hair follicles. Mutation analysis shows in all families a common homozygous deletion in exon 8 of CDH3. These results establish the molecular etiology of HJMD and implicate for the first time a cadherin molecule in the pathogenesis of a human hair and retinal disorder.

The spectrum of mutations, including four novel ones, in the thiamine-responsive megaloblastic anemia gene SLC19A2 of eight families

Thiamine responsive megaloblastic anemia (TRMA) is an autosomal recessive disorder with a triad of symptoms: megaloblastic anemia, deafness, and non-type 1 diabetes mellitus. Occasionally, cardiac abnormalities and abnormalities of the optic nerve and retina occur as well. Patients with TRMA often respond to treatment with pharmacological doses of thiamine. Recently, mutations were found in patients with TRMA in a thiamine transporter gene (SLC19A2). We here describe the mutations found in eight additional families. We found four novel mutations and three that were previously described. Of the novel ones, one is a nonsense mutation in exon 1 (E65X), two are missense mutations in exon 2 (S142F, D93H), and another is a mutation in the splicing donor site at the 5' end of intron 4 (C1223+1G>A). We also summarize the state of knowledge on all mutations found to date in TRMA patients. SLC19A2 is the first thiamine transporter gene to be described in humans. Reviewing the location and effect of the disease causing mutations can shed light on the way the protein functions and suggest ways to continue its investigation.

Androgenetic alopecia in heterozygous carriers of a mutation in the human hairless gene

BACKGROUND

Androgenetic alopecia is considered to be genetically determined. Recently, a rare autosomal recessive form of hereditary alopecia, termed atrichia with papular lesions (APL), was found to result from mutations in the human hairless gene.

OBJECTIVE

Our aim was to assess the pattern of androgenetic alopecia in heterozygous carriers of a deleterious mutation in the human hairless gene.

METHODS

Healthy male second-degree relatives (n = 31) of patients affected with APL and belonging to a large consanguineous kindred were interviewed and given a Hamilton score of baldness. DNA was obtained from each subject and analyzed for the presence of a mutation in the human hairless gene known to affect this family. The age at onset and extent of baldness were compared in healthy homozygotes and heterozygous carriers of the mutation.

RESULTS

Statistical analysis of the results revealed no differences in age at onset and extent of androgenetic alopecia between the two groups of subjects.

CONCLUSION

The present study reports the first attempt to characterize the phenotype of heterozygous carriers of a mutation in the human hairless gene. It indicates that the presence of a deleterious mutation in one allele of the hairless gene does not affect the pattern of androgenetic hair loss.

Atrichia with papular lesions resulting from a nonsense mutation within the human hairless gene

Atrichia with papular lesions is a rare autosomal recessive form of alopecia characterized by hair loss soon after birth and the development during childhood of a diffuse papular rash. We have previously shown that this disorder results from a deleterious mutation in the human hairless gene, a gene also involved in the pathogenesis of a related but clinically distinct form of congenital alopecia, termed alopecia universalis congenita. In this report, we describe a novel nonsense mutation in exon 4 of the human hairless gene in a consanguineous kindred affected with atrichia with papular lesions. This report provides additional evidence for phenotypic heterogeneity among inherited atrichias and for an association between the papular rash of atrichia with papular lesions and nonsense mutations in the human hairless gene.

Mutations in SLC19A2 cause thiamine-responsive megaloblastic anaemia associated with diabetes mellitus and deafness

Thiamine-responsive megaloblastic anaemia (TRMA), also known as Rogers syndrome, is an early onset, autosomal recessive disorder defined by the occurrence of megaloblastic anaemia, diabetes mellitus and sensorineural deafness, responding in varying degrees to thiamine treatment (MIM 249270). We have previously narrowed the TRMA locus from a 16-cM to a 4-cM interval on chromosomal region 1q23.3 (refs 3,4) and this region has been further refined to a 1.4-cM interval. Previous studies have suggested that deficiency in a high-affinity thiamine transporter may cause this disorder. Here we identify the TRMA gene by positional cloning. We assembled a P1-derived artificial chromosome (PAC) contig spanning the TRMA candidate region. This clarified the order of genetic markers across the TRMA locus, provided 9 new polymorphic markers and narrowed the locus to an approximately 400-kb region. Mutations in a new gene, SLC19A2, encoding a putative transmembrane protein homologous to the reduced folate carrier proteins, were found in all affected individuals in six TRMA families, suggesting that a defective thiamine transporter protein (THTR-1) may underlie the TRMA syndrome.

Identification of a genetic defect in the hairless gene in atrichia with papular lesions: evidence for phenotypic heterogeneity among inherited atrichias

Recently, we showed that atrichia with papular lesions (APL), a rare inherited form of alopecia, is transmitted as an autosomal recessive trait in a large inbred kindred of Israeli-Arab origin. Furthermore, we mapped the APL locus to a 5-cM region of chromosome 8p12 in this family. The human "hairless" gene is a candidate target gene for the disease mutation because it maps to the APL locus and because it was recently found to be mutated in a related but clinically distinct form of alopecia known as "alopecia universalis" or "congenital alopecia." In the present study, the coding sequence of the hairless gene was compared by reverse transcription-PCR in fibroblast cell lines derived from an affected patient and an unrelated individual. We identified a single-base deletion (3434delC) in the hairless gene that cosegregated with the disease phenotype in the family. This deletion is predicted to cause a frameshift mutation in the highly conserved C-terminal part of the hairless protein, a region putatively involved in the transcription factor activity of the hairless gene product. The present results are indicative of phenotypic heterogeneity in inherited atrichias caused by mutations in the hairless gene, suggesting different roles for the regions mutated in APL and in other forms of congenital atrichia during hair development.

Atrichia with papular lesions maps to 8p in the region containing the human hairless gene

Atrichia with papular lesions (APL) (OMIM 209500) is a hereditary form of alopecia. Hair loss occurs soon after birth and is followed years later by the development of a diffuse papular eruption. Its mode of transmission is still uncertain. A related but clinically distinct form of alopecia, known as alopecia universalis (OMIM 203655), has recently been found to be associated with a mutation in the human hairless gene. The present report describes the largest consanguineous kindred of APL reported to date and provides strong evidence for autosomal recessive inheritance of this rare disorder. On the basis of a linkage analysis of this kindred using six microsatellite markers spanning the human hairless gene region, we found that the APL locus maps to chromosome region 8p12 in a 5 cM interval between marker D8S560 and marker D8S1739. A maximum lodscore of 3.7 was obtained with marker D8S1786, at a recombination fraction of 0. Our results suggest phenotypic variability at the hairless locus although they do not rule out the existence of a gene cluster associated with hair disorders in the same region.

Refined mapping of the gene for thiamine-responsive megaloblastic anemia syndrome and evidence for genetic homogeneity

Thiamine-responsive megaloblastic anemia (TRMA, also known as Rogers syndrome, OMIM 249270) is a rare autosomal recessive disorder characterized by a triad of megaloblastic anemia, diabetes mellitus, and sensorineural deafness. Patients respond, to varying degrees, to treatment with megadoses of thiamine. We have recently shown genetic linkage of the TRMA gene to a 16-centimorgan (cM) region on 1q23.2-1q23.3 based on the analysis of four large, inbred families of Alaskan, Italian, and Israeli-Arab origin. Here we narrow the TRMA interval down to 4 cM based on genetic recombination, homozygosity mapping, and linkage disequilibrium (highest LOD score of 12.5 at D1S2799, at a recombination fraction of 0). We provide further evidence that the TRMA gene is located in this region and confirm the homogeneity of the disease. In this analysis, we genotyped seven additional families of diverse ethnic origin (Pakistani, Indian, Italian, Brazilian, and Japanese), and analyzed additional markers in two previously reported families showing evidence of linkage disequilibrium in a large area of their haplotypes. The multi-system manifestations of TRMA suggest that thiamine has a pivotal role in a multiplicity of physiological processes. Mapping the TRMA gene and understanding the molecular basis of the disease might, thus, shed light on the role of thiamine in common disorders such as deafness, anemia, and diabetes.

Localization of a gene for molybdenum cofactor deficiency, on the short arm of chromosome 6, by homozygosity mapping

Molybdenum cofactor deficiency (MoCoD) is a fatal disorder manifesting, shortly after birth, with profound neurological abnormalities, mental retardation, and severe seizures unresponsive to any therapy. The disease is a monogenic, autosomal recessive disorder, and the existence of at least two complementation groups suggests genetic heterogeneity. In humans, MoCoD leads to the combined deficient activities of sulfite oxidase, xanthine dehydrogenase, and aldehyde oxidase. By using homozygosity mapping and two consanguineous affected kindreds of Israeli-Arab origin, including five patients, we demonstrated linkage of a MoCoD gene to an 8-cM region on chromosome 6p21.3, between markers D6S1641 and D6S1672. Linkage analysis generated the highest combined LOD-score value, 3.6, at a recombination fraction of 0, with marker D6S1575. These results now can be used to perform prenatal diagnosis with microsatellite markers. They also provide the only tool for carrier detection of this fatal disorder.

Localization of the gene for thiamine-responsive megaloblastic anemia syndrome, on the long arm of chromosome 1, by homozygosity mapping

Thiamine-responsive megaloblastic anemia, also known as "TRMA" or "Rogers syndrome," is an early-onset autosomal recessive disorder defined by the occurrence of megaloblastic anemia, diabetes mellitus, and sensorineural deafness, responding in varying degrees to thiamine treatment. On the basis of a linkage analysis of affected families of Alaskan and of Italian origin, we found, using homozygosity mapping, that the TRMA-syndrome gene maps to a region on chromosome 1q23.2-23.3 (maximum LOD score of 3.7 for D1S1679). By use of additional consanguineous kindreds of Israeli-Arab origin, the putative disease-gene interval also has been confirmed and narrowed, suggesting genetic homogeneity. Linkage analysis generated the highest combined LOD-score value, 8.1 at a recombination fraction of 0, with marker D1S2799. Haplotype analysis and recombination events narrowed the TRMA locus to a 16-cM region between markers D1S194 and D1S2786. Several heterozygote parents had diabetes mellitus, deafness, or megaloblastic anemia, which raised the possibility that mutations at this locus predispose carriers in general to these manifestations. Characterization of the metabolic defect of TRMA may shed light on the role of thiamine deficiency in such common diseases.

Salivary flow-rate and composition in schizophrenic patients on clozapine: subjective reports and laboratory data

The extent of hypersalivation was evaluated in a group of 25 schizophrenic patients on clozapine. A high prevalence of the complaint was detected by a questionnaire; up to 80% of the patients complained of hypersalivation at night. Salivary flow-rate and composition was examined in 17 patients who agreed to participate and in a matched group of healthy controls. No significant differences were detected in composition or flow-rates of resting and stimulated saliva. The salivary flow-rates in the schizophrenic patients on clozapine did not correlate with the subjective complaint of hypersalivation. Because the severity and prevalence of the complaint was higher at night, a possibility of an altered circadian rhythm of salivation might be suggested in these patients.

Oral Candida carriage and blood group antigen secretor status

Oral Candida carriage and blood group antigen secretor status were examined in 92 healthy, young volunteers. Candida was isolated from 61 of 92 saliva samples (66% Candida carriage). In 76% of cases this was Candida albicans. Oral Candida carriage was found to be significantly associated with non-secretion of blood group antigens (P < 0.05). However, the numbers of Candida were higher in the saliva of secretors than of non-secretors (P < 0.01). A higher percentage of Candida carriage was observed in individuals with blood group O. Thus, the finding of higher carrier frequency in the non-secretors and in blood group O subjects is confirmed.

Whole saliva in systemic lupus erythematosus patients

Whole saliva composition and flow rate were examined in 22 patients with systemic lupus erythematosus and compared with matched healthy controls. Significantly lowered salivary flow rate was observed in patients with systemic lupus erythematosus unrelated to the subjective complaint of xerostomia. Salivary sodium, calcium, and magnesium concentrations were significantly higher in the SLE patients with systemic lupus erythematosus, whereas potassium and total protein concentrations and amylase activity did not differ significantly from the controls. Salivary IgA and IgM levels were significantly higher in the patients than in controls. IgA, IgG, IgM, C3, C4, antinuclear antibody, and anti-DNA antibody levels were measured in serum of the patients with systemic lupus erythematosus and correlated with salivary immunoglobulins. The only significant correlation between saliva and serum was found between levels of salivary IgG and serum anti-DNA antibody. The altered salivary composition might indicate a subclinical involvement of salivary glands in the patients.

Oral health and salivary composition in diabetic patients

The salivary composition and flow rate were examined in 20 patients with insulin-dependent diabetes mellitus (IDDM) and in 19 patients with non-insulin-dependent diabetes mellitus (NIDDM) and compared with 20 healthy controls. Resting and stimulated whole and submandibular saliva was analyzed. Significantly lower resting salivary flow rates were found in the IDDM patients as compared to the NIDDM group. In the IDDM patients potassium concentration in resting saliva was significantly higher compared with healthy controls and in stimulated whole saliva compared with NIDDM patients. No difference in salivary total protein, amylase, lactoferrin, or lysozyme was found among the three groups examined. The IgA concentration of the IDDM patients was significantly higher in whole resting saliva compared with controls and in the submandibular saliva compared with both NIDDM patients and controls. No difference was found between controls and the diabetic patients examined in prevalence of complaint of dry mouth. The salivary flow rates, however, were significantly lower in the three subgroups with dry mouth compared with the subgroups without this complaint. Caries were detected in 100% of the diabetic patients and controls. No correlation was observed between the incidence of caries and any of the salivary parameters examined. A higher prevalence and severity of periodontal disease was detected in the diabetic patients as compared to the controls. A significant positive correlation was found between the gingival index and the concentrations of total protein, albumin, lysozyme, and lactoferrin in whole resting saliva in the three groups examined.

Salivary secretion and seasickness susceptibility

The salivary flow rate and composition of 2 groups of 31 subjects, one group at each extreme of the seasickness susceptibility scale, were compared. No significant differences were found between the two groups in flow rates and electrolyte concentrations of whole resting and stimulated saliva. Amylase activity and rate of secretion in resting saliva were significantly higher in subjects susceptible to seasickness as compared with nonsusceptible subjects. Also, the total protein rate of secretion in resting saliva was significantly higher in the susceptible group. The present findings could be explained in terms of higher sympathetic tone in subjects susceptible to seasickness, and salivary amylase levels might be recommended as an additional parameter in the evaluation of seasickness susceptibility.

Comparison of unbound and total serum theophylline concentrations with those of stimulated and unstimulated saliva in asthmatic children

Unstimulated saliva, citric acid stimulated saliva, and serum were collected from 31 asthmatic children taking theophylline. Salivary theophylline concentrations, and total and unbound serum theophylline concentrations were measured. The correlation coefficients between both types of saliva, and total and unbound serum theophylline were all statistically significant (p less than 0.001). The highest correlation coefficients were obtained with stimulated saliva and total serum concentrations (r = 0.98), and stimulated saliva and unbound serum (r = 0.96). The coefficients when unstimulated saliva was compared to either total or unbound serum concentrations were 0.90 and 0.89, respectively. Serum binding of theophylline averaged 58.1%. Unstimulated saliva had a higher mean theophylline concentration than stimulated saliva. The results suggest that salivary monitoring using stimulated saliva may be used to predict serum concentrations with a high degree of confidence when the saliva levels are substantially lower than, higher than, or in the middle of the therapeutic range, but there is a considerable degree of uncertainty when the salivary values are near the lower or upper end of the therapeutic range.

Composition of whole unstimulated saliva of healthy children: changes with age

Whole unstimulated saliva was collected from 136 healthy subjects divided into 5 groups according to age: (1) 25 infants, 7-11 months old; (2) 28 toddlers, 2-3 yr old; (3) 28 children, 6-8 yr old; (4) 28 adolescents, 12-14 yr old; (5) 27 adults, 25-63 yr old. The concentrations of Na, K, total protein, IgA and amylase activity were measured. A significant ascending linear correlation with age was found for concentrations of Na, total protein, IgA and amylase activity. There were significant differences between age groups in K and IgA concentrations. Salivary amylase activity was very variable, and a significant difference was found between infants and toddlers only. Salivary composition thus changes significantly during childhood, implying a process of development and maturation of the salivary glands and indicating the need of age-matched controls for the clinical use of saliva.

Effect of exercise on salivary composition and cortisol in serum and saliva in man

The effect of exercise on electrolytes and cortisol levels in serum and saliva was examined in 27 young, healthy male volunteers who performed graded submaximal cycle exercise for nine min at up to 85% of their age-predicted maximal heart rate. Seventeen men performed the Wingate anaerobic test for 30 s. A significant increase in pulse rate and systolic blood pressure and a decrease in diastolic blood pressure were found, and serum concentrations of Na+, K+, and lactate were significantly elevated immediately after exercise. A nonsignificant increase in saliva and serum cortisol levels was found. Significantly lowered salivary flow rate and elevated salivary K+, protein, and lactate concentrations were found within ten min after exercise. Salivary Mg2+ was significantly elevated after anaerobic exercise only.

Salivary changes associated with seasickness

Salivary composition and flow rate were measured in 13 healthy male volunteers exposed to a real seasickness situation. The flow rates of whole unstimulated and stimulated saliva were significantly reduced at sea in about 80% of the subjects. Salivary flow rate was negatively correlated with seasickness severity. These results contrast with the classic concept of increased salivation during seasickness. At sea, the potassium concentration of both unstimulated and stimulated saliva was significantly reduced, while sodium concentration was consistently elevated. The sodium and protein concentrations were positively correlated with seasickness severity. Thus, objective measurements of salivary flow rate and composition may be recommended for evaluation of the seasickness syndrome.

Salivary composition in diabetic patients

Salivary composition and flow rate were examined in 35 patients with insulin-dependent diabetes mellitus (IDDM) and compared to 31 healthy controls. Significantly lower whole-saliva flow rate was observed in the IDDM patients, but was not correlated with the subjective complaint of xerostomy. Glucose concentration was significantly higher in the parotid saliva of the IDDM patients. Potassium concentration was significantly higher in whole and parotid, resting and stimulated saliva, as was total protein concentration in resting whole and in stimulated parotid saliva of the diabetics. No significant difference between diabetics and healthy controls was found in sodium and IgA concentration or in amylase activity. The significantly higher glucose, lower flow rate, and higher potassium and protein concentrations indicate that salivary glands are affected in IDDM. The subjective complaint of dry mouth, often present in diabetics, while not correlated with salivary flow rate, might reflect qualitative changes in salivary composition and/or altered mucosal perception. Salivary glucose concentration, although significantly higher in the diabetics, was not significantly correlated with serum glucose, preventing the use of saliva for monitoring blood sugar.

Salivary changes associated with experimental motion sickness condition in man

The effect of experimental motion sickness condition (rotation) on salivary flow and composition was studied in 34 healthy male volunteers. In most subjects, the flow rate of whole saliva was significantly decreased, while the potassium concentration was markedly increased during rotation. These results contrast with the classic reports of subjectively increased salivation in the first stages of motion sickness and may tentatively be explained in terms of sympathetic activation. The salivary protein concentration and secretion rate observed before and during rotation were consistently higher in those subjects categorized as moderately or severely sick during rotation. The salivary protein levels may perhaps be considered as an additional objective variable in the prediction of susceptibility to motion sickness.

Chemical analysis of whole saliva in Sjögren's syndrome

In some studies, but not in all, abnormally high concentrations of salivary Na+, K+, and IgA have been found in patients with Sjögren's syndrome (SS). The lack of agreement between various reports might be due to the different ways in which saliva was collected. Some analysed stimulated parotid or whole saliva, whereas others used unstimulated saliva. In this study, therefore, the rate of flow and Na+, K+, and IgA levels in unstimulated and stimulated whole saliva in normals and in rheumatoids with and without SS have been determined. The results confirmed significantly raised levels of Na+, K+, and IgA in unstimulated whole saliva in SS. In response to stimulation there was marked decrease in Na+, K+, and IgA levels, whereas normally, as shown by the other two groups, there is an increase in Na+, no change in K+, and a mild decrease in IgA. As a result, the differences between SS and normals became much less significant (K+, IgA) or were even completely obliterated (Na+). The abnormal response of SS to stimulation may be partially explained by the initially low rate of flow and by the extremely high IgA levels. Thus chemical analysis of unstimulated whole saliva is much more sensitive than analysis of stimulated whole saliva in the detection of salivary gland involvement in SS.

The salivary flow rate and composition of whole and parotid resting and stimulated saliva in young and old healthy subjects

Resting and stimulated whole and parotid salivary composition and flow rate were examined in 63 healthy volunteers. No significant differences were found between the young and old in secretion rates and salivary concentrations of sodium, potassium, calcium, magnesium, and total protein. The activity of amylase in the resting and stimulated parotid saliva was significantly lower in the old.

Oral side effects of head and neck irradiation: correlation between clinical manifestations and laboratory data

Salivary flow rate and composition, oral microflora and clinical manifestations of radiation damage were studied in 32 patients treated with external irradiation to head and neck areas. Several parameters were investigated: field arrangement, amount of salivary glands irradiated, clinical manifestations such as dryness of the mouth, taste impairment, dysphagia, salivary secretion and composition, and oral yeast flora. The salivary glands have a greater sensitivity to radiation damage than the gustatory tissues. The decrease in salivary secretion is accompanied by a rise in salivary sodium concentration, and in oral yeast flora. The clinical symptomatology was correlated with the amount of salivary glands irradiated. We found that most of the parotids have to be outside of the treated volume, when the rest of the major salivary glands are irradiated, to prevent severe dryness phenomena.

The concentration of salivary IgA in whole and parotid saliva and the effect of stimulation

The concentration of salivary IgA was measured in 24 healthy volunteers. The resting salivary IgA (n = 19) was 14.5 +/- 7.5 mg/dl in parotid saliva and 6.5 +/- 3.6 mg/dl in whole saliva. After stimulation (n = 5), parotid IgA decreased to 6.8 +/- 5.0 mg/dl and whole-saliva IgA to 3.1 +/- 2.22 mg/dl. Freezing caused a diversified decrease in IgA concentration.

Effect of transdermal scopolamine on salivation

The effect of transdermal scopolamine on salivary flow and composition was analyzed in 21 healthy volunteers. The flow rate of whole saliva was significantly lowered by transdermal scopolamine. Significant positive correlations were found between the placebo rate of flow and both the quantity and percentage decreases in response to transdermal scopolamine. The magnesium concentration was significantly increased during transdermal scopolamine administration, whereas the sodium, potassium, and calcium concentrations were not consistently altered. Accordingly, the magnesium secretion rate was unaltered, whereas sodium, potassium, and calcium secretion rates were significantly lowered by transdermal scopolamine administration.

Whole-saliva secretion rates in old and young healthy subjects

Resting and stimulated whole-saliva secretion rates were compared in old and young healthy volunteers. The stimulated secretion rate was similar in both age groups, while the resting flow rate was significantly lower in the old females and males as compared with rates in the young.

Saliva for monitoring of patients with primary affective disorders

The salivary composition and flow rate of 78 patients with primary affective disorders and of 49 healthy volunteers were examined. The former were divided into two groups: Group 1--57 patients receiving lithium carbonate and psychoactive drugs, and Group 2--21 patients receiving psychoactive drugs only. A significant correlation between salivary and serum lithium was found in patients on chronic lithium therapy. Significantly reduced salivary flow rates and elevated potassium, calcium, magnesium and IgA concentrations were found in all the patients as compared with those of the healthy volunteers. Salivary sodium concentrations were significantly elevated in patients on lithium carbonate as compared with the levels in patients on psychoactive drugs only. These results indicate that changes in salivary gland function may occur in patients with primary affective disorders and in those receiving drug treatment. The use of saliva analysis for monitoring lithium dosage is recommended.

Composition of whole unstimulated saliva of human infants

Whole unstimulated saliva of 168 infants aged 3 days to 12 months was analysed. The concentration of Ca, Mg and Cl was higher in the saliva of infants than in adults. The concentration of phosphate, IgA, amylase and pH was lower in infants; Na, K and total protein did not differ significantly. A wide range of all the concentrations was observed in the saliva of infants. No significant difference was found between the salivary composition of male versus female or of breast-fed as compared to bottle-fed infants. No difference before and after eruption of teeth was detected. Significant differences between different age groups were observed in the concentrations of Na, K, Cl, phosphate, protein, amylase and pH. No significant differences were found in Ca, Mg and IgA concentrations within the first year. A negative correlation between the age of the infants and the concentrations of Na, K, Cl and total protein was observed. A positive correlation was found for phosphate and amylase as a function of age.

Salivary and lacrimal secretions in patients on lithium therapy

Salivary and lacrimal secretion rates and salivary composition were examined in 22 manic-depressive patients on lithium therapy and in 21 matched, healthy controls. Serum immunoglobulins (IgG and IgA) were measured in these patients. Their oral health was examined and found to be unimpaired. Significantly lowered tear secretion was detected in the patients, while their salivary secretion rates were normal. The salivary concentrations of NA, K and IgA were significantly elevated in whole saliva. In parotid saliva, the concentrations of K and IgA were elevated, while Na was in the normal range. A significant correlation between serum and salivary lithium concentrations was found, indicating the usefulness of salivary measurements for monitoring. Informed consent of the patients was obtained after the nature of the procedures had been fully explained.

Oral Candida in children

One hundred forty healthy children, 3 to 12 years of age, were examined for the presence of oral Candida. Forty-five percent of the 3 to 5 1/2-year olds and 65% of the 6- to 12-year olds were found to be Candida "carriers" (p less than 0.05). No significant sex difference was found in the incidence of Candida "carriers." The salivary IgA concentration did not differ significantly in Candida "carriers" and noncarriers. A significantly higher IgA concentration was found in children 6 to 12 years old (0.02 less than p less than 0.05). The concentration of salivary electrolytes was similar in Candida-positive and Candida-negative children.

Salivary IgA in Sjögren patients

Salivary flow-rate, Na, K and IgA were measured in 12 KCS patients for diagnosis of Sjögren's syndrome. 8 had elevated salivary IgA concentrations. The IgA was analysed on anti-IgA plates and on anti-secretory IgA plates. The results indicate that the elevation in salivary IgA in Sjögren patients is due to secretory IgA.

Sialochemistry for diagnosis of Sjögren's syndrome in xerostomic patients

The flow rate and composition of whole unstimulated saliva were measured in fifteen healthy controls and in forty-eight xerostomic patients, fourteen suffering from xerostomia per se, twenty-two from xerostomia with keratoconjunctivitis sicca (KCS), and twelve from xerostomia, KCS, and rheumatoid arthritis. A significant lower salivary flow rate was found in all the xerostomic patients. Sodium, potassium, and IgA concentrations were significantly elevated in the KCS and in the RA + KCS group in comparison with the patients who had xerostomia per se and with the healthy controls. Sialochemistry is thus recommended for the diagnosis of Sjögren's syndrome in xerostomic patients.

Xerostomia--diagnosis and treatment

Seventy-one patients complaining of mouth dryness were examined. Decreased salivary rate of flow was found in fifty-six. Twenty-two patients did not respond to stimulation and were treated with artificial saliva. The thirty-four responding patients were treated with a mouthwash containing citric acid (Saliram). Of the patients using Saliram, 91 percent were satisfied with the results, and in 16 percent of these an increase in salivation was observed and persisted after treatment was discontinued.

Salivary lithium concentration--a tool for monitoring psychiatric patients

Salivary and serum lithium concentrations were measured simultaneously in 118 manic-depressive patients. Lithium concentration in saliva was 2.24 +/- 0.35 times higher than in serum. An equation to calculate serum lithium concentration from salivary measurements was derived: Li serum = 0.36 Li saliva + 0.13. Psychotropic drugs had no effect on the salivary:serum ratio. Eighteen patients were followed for several weeks. A significant correlation coefficient between salivary and serum lithium concentrations was found in thirteen of the eighteen patients studied.

Oral candida of asymptomatic denture wearers

The presence of Candida in the oral cavity of denture wearers was compared to a control group. A significantly higher percentage (88%) of Candida "carriers" was found among the denture wearers in comparison to the control group (52%). No difference between the sialochemistry of denture wearers and controls was found in oral Candida "carrier".