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Fernández-Agra M, González-Serrano J, de Pedro M, Virto L, Caponio VCA, Ibáñez-Prieto E, Hernández G, López-Pintor RM. Salivary biomarkers in burning mouth syndrome: A systematic review and meta-analysis. Oral Dis 2023; 29:2600-2613. [PMID: 36135356 DOI: 10.1111/odi.14390] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 12/01/2022]
Abstract
The objective of this systematic review was to evaluate which salivary biomarkers are altered in patients with burning mouth syndrome (BMS) compared to a control group (CG). A comprehensive literature search was conducted in four databases. Case-control studies evaluating salivary biomarkers in BMS patients were included. Risk of bias was assessed using the Newcastle-Ottawa tool. RevMan was used for meta-analysis. Seventeen studies were selected. The included studies collected 54 different biomarkers. Of these biomarkers, only three (cortisol, α-amylase, and dehydroepiandrosterone) were analyzed in three or more studies. Dehydroepiandrosterone obtained contradictory results among the studies. However, cortisol and α-amylase levels were found to be higher in BMS patients. Cortisol was the only biomarker which could be included for meta-analysis. Cortisol levels were significantly higher in the BMS group compared to the CG (Mean Difference = 0.39; 95% CI [0.14-0.65]; p = 0.003). In conclusion, different studies investigated salivary biomarkers in patients with BMS compared to a CG, with controversial results. Meta-analysis, confirmed by trial-sequential analysis, showed how cortisol levels were significantly higher in BMS. Cortisol emerges as an interesting salivary biomarker in BMS, but future properly designed studies are needed to evaluate its role in diagnosis and/or response to treatment.
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Affiliation(s)
- María Fernández-Agra
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - José González-Serrano
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Miguel de Pedro
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
- Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Leire Virto
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | | | - Elena Ibáñez-Prieto
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Gonzalo Hernández
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
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Moreau C, El Habnouni C, Lecron JC, Morel F, Delwail A, Le Gall-Ianotto C, Le Garrec R, Misery L, Piver E, Vaillant L, Lefevre A, Emond P, Blasco H, Samimi M. Salivary metabolome indicates a shift in tyrosine metabolism in patients with burning mouth syndrome: a prospective case-control study. Pain 2023; 164:e144-e156. [PMID: 35916738 DOI: 10.1097/j.pain.0000000000002733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT The pathophysiology of primary burning mouth syndrome (BMS) remains controversial. Targeted analyses or "omics" approach of saliva provide diagnostic or pathophysiological biomarkers. This pilot study's primary objective was to explore the pathophysiology of BMS through a comparative analysis of the salivary metabolome among 26 BMS female cases and 25 age- and sex-matched control subjects. Secondary objectives included comparative analyses of inflammatory cytokines, neuroinflammatory markers, and steroid hormones among cases and control subjects, and among BMS patients according to their clinical characteristics. Salivary metabolome, neuroinflammatory markers, cytokines, and steroids were, respectively, analysed by liquid chromatography coupled with mass spectrometry, ELISA and protease activity assay, and multiparametric Luminex method. Among the 166 detected metabolites, univariate analysis did not find any discriminant metabolite between groups. Supervised multivariate analysis divided patients into 2 groups with an accuracy of 60% but did not allow significant discrimination (permutation test, P = 0.35). Among the metabolites contributing to the model, 3 belonging to the tyrosine pathway ( l -dopa, l -tyrosine, and tyramine) were involved in the discrimination between cases and control subjects, and among BMS patients according to their levels of pain. Among the detectable molecules, levels of cytokines, steroid hormones, and neuroinflammatory markers did not differ between cases and control subjects and were not associated with characteristics of BMS patients. These results do not support the involvement of steroid hormones, inflammatory cytokines, or inflammatory neurogenic mediators in the pathophysiology of pain in BMS, whereas the observed shift in tyrosine metabolism may indicate an adaptative response to chronic pain or an impaired dopaminergic transmission.
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Affiliation(s)
- Charlotte Moreau
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Chakib El Habnouni
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Jean-Claude Lecron
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Franck Morel
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Adriana Delwail
- ImageUP, Plate-forme d'Imagerie and Laboratoire Signalisation et Transport Ioniques Membranaires ERL CNRS 7003/EA 7349, Poitiers University, Poitiers, France
| | | | - Raphaele Le Garrec
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Laurent Misery
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Eric Piver
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- Inserm UMR 1259-Morphogenèse et antigénicité du VIH et des virus des hépatites (MAVIVH)
| | - Loïc Vaillant
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | | | - Patrick Emond
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
- Department of In Vitro Nuclear Medicine, University Hospital of Tours, Tours Cedex, France
| | - Hélène Blasco
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
| | - Mahtab Samimi
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
- BIP, 1282 INRA University of Tours, Tours, France
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Aitken-Saavedra J, Tarquinio SB, Kinalski M, Haubman D, Martins MW, Vasconcelos AC. Salivary characteristics in burning mouth syndrome: a systematic review. Minerva Dent Oral Sci 2022; 71:233-241. [PMID: 35920290 DOI: 10.23736/s2724-6329.22.04647-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Compare through case-control studies, the salivary characteristics of patients with and without BMS. EVIDENCE ACQUISITION Searches in Embase, PubMed, Web of Science, Scopus, Cochrane, and BIREME were conducted for the identification of case-controls studies reported. EVIDENCE SYNTHESIS Thirty-three studies were included, of which 26 articles evaluated OSB, 17 SRF, and 7 SE. Nineteen organic biomarkers showed higher levels in BMS patients, the two most indicated being α-amylase and cortisol. Ten organic biomarkers, including Tumor Necrosis Factor-alpha (TNF-α) and IL-6, showed lower levels in BMS patients. Regarding salivary flow rate (SFR), five articles indicated that BMS patients have less unstimulated SFR (uSRF)Two articles indicate that stimulated SFR (sSRF) is lower in BMS patients nevertheless, but eight did not show differences. Sialochemical analysis revealed that sodium (Na), chloride (Cl), potassium (K), sodium (Na), and calcium (Ca), showed higher levels in BMS patients according to three studies, but two studies did not establish any differences. Two study established that BMS patients have lower Mg salivary levels. CONCLUSIONS Qualitative salivary characteristics suggest that BMS has neuropathic, inflammatory, emotional, immune, and hormonal involvements. BMS can be associated with changes in salivary biomarkers of inflammation and oxidative stress, is related to anxiety and degree of pain.
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Affiliation(s)
- Juan Aitken-Saavedra
- Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Sandra B Tarquinio
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil
| | - Matheus Kinalski
- Faculty of Dentistry, Community University of Chapecó, Chapecó, Brazil
| | - Daniela Haubman
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Ana C Vasconcelos
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil -
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Orliaguet M, Misery L. Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review. Biomolecules 2021; 11:biom11081237. [PMID: 34439903 PMCID: PMC8393188 DOI: 10.3390/biom11081237] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/27/2022] Open
Abstract
The pathophysiology of primary burning mouth syndrome (BMS) has been extensively debated but is poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. The aim of the present work was to systematically review papers that could provide arguments in favour of the neuropathic and psychogenic components of primary BMS for a better understanding of the disease. This systematic review (SR) was registered in PROSPERO (CRD42021224160). The search was limited to articles in English or French from 1990 to 01 December 2020. A total of 113 articles were considered for data extraction. We divided them into four subgroups: pharmacological and nonpharmacological management studies (n = 23); neurophysiological studies (n = 35); biohistopathological studies (n = 25); and questionnaire-based studies (n = 30). Several of these studies have shown neuropathic involvement at various levels of the neuraxis in BMS with the contribution of quantitative sensory testing (QST), functional brain imaging, and biohistopathological or pharmacologic studies. On the other hand, the role of psychological factors in BMS has also been the focus of several studies and has shown a link with psychiatric disorders such as anxiety and/or depression symptoms. Depending on the patient, the neuropathic and psychogenic components may exist simultaneously, with a preponderance of one or the other, or exist individually. These two components cannot be dissociated to define BMS. Consequently, BMS may be considered nociplastic pain.
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Affiliation(s)
- Marie Orliaguet
- LIEN, Department of Oral Surgery, University of Western Brittany, F-29200 Brest, France;
| | - Laurent Misery
- LIEN, Department of Dermatology, University of Western Brittany, F-29200 Brest, France
- Correspondence: ; Tel.: +33-2-9888-3527
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Pal D, Saha S. Chondroitin: a natural biomarker with immense biomedical applications. RSC Adv 2019; 9:28061-28077. [PMID: 35530463 PMCID: PMC9071010 DOI: 10.1039/c9ra05546k] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 08/10/2019] [Indexed: 12/24/2022] Open
Abstract
Naturally extracted glycosaminoglycan chondroitin sulphate is the reactive product of N-acetylgalactosamine and d-glucuronic acid. Chondroitin sulfate (CS) extracted from Scophthalmus maximus, H. scabra, E. fraudatrix, M. magnum, and H. mexicana has shown remarkable anticoagulant, articular cartilage repair, corneal lesion healing, antidiabetic, and antiproliferative effects. Also, platinum and strontium nanoparticles of chondroitin sulfate are effective in osteoarthritis and exert anti-HSV2 and anti-angiogenic properties. A combination of chondroitin sulfate and RNA lipolexes demonstrates gene silencing effects in liver fibrosis. Chondroitin sulfate has also been used as a carrier for loxoprofen hydrogel preparation. Oligosaccharides of chondroitin sulfate showed effective inhibition of bovine testicular hyaluronidase enzyme as an antibacterial agent during pregnancy. Monoclonal antibody-recognized chondroitin sulfate A was effectively used to treat ameloblastoma. Selenium-chondroitin sulfate nanoparticles demonstrated positive effects in therapy of Kashin-Beck disease (KBD) and osteoarthritis.
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Affiliation(s)
- Dilipkumar Pal
- Department of Pharmaceutical Sciences, Guru Ghasidas Vishwavidyalaya (A Central University) Bilaspur-495009 C.G. India +91-7389263761
| | - Supriyo Saha
- School of Pharmaceutical Sciences and Technology, Sardar Bhagwan Singh University Dehradun-248161 Uttarakhand India
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Ji EH, Diep C, Liu T, Li H, Merrill R, Messadi D, Hu S. Potential protein biomarkers for burning mouth syndrome discovered by quantitative proteomics. Mol Pain 2017; 13:1744806916686796. [PMID: 28326926 PMCID: PMC5302177 DOI: 10.1177/1744806916686796] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Burning mouth syndrome (BMS) is a chronic pain disorder characterized by severe burning sensation in normal looking oral mucosa. Diagnosis of BMS remains to be a challenge to oral healthcare professionals because the method for definite diagnosis is still uncertain. In this study, a quantitative saliva proteomic analysis was performed in order to identify target proteins in BMS patients’ saliva that may be used as biomarkers for simple, non-invasive detection of the disease. By using isobaric tags for relative and absolute quantitation labeling and liquid chromatography-tandem mass spectrometry to quantify 1130 saliva proteins between BMS patients and healthy control subjects, we found that 50 proteins were significantly changed in the BMS patients when compared to the healthy control subjects (p ≤ 0.05, 39 up-regulated and 11 down-regulated). Four candidates, alpha-enolase, interleukin-18 (IL-18), kallikrein-13 (KLK13), and cathepsin G, were selected for further validation. Based on enzyme-linked immunosorbent assay measurements, three potential biomarkers, alpha-enolase, IL-18, and KLK13, were successfully validated. The fold changes for alpha-enolase, IL-18, and KLK13 were determined as 3.6, 2.9, and 2.2 (burning mouth syndrome vs. control), and corresponding receiver operating characteristic values were determined as 0.78, 0.83, and 0.68, respectively. Our findings indicate that testing of the identified protein biomarkers in saliva might be a valuable clinical tool for BMS detection. Further validation studies of the identified biomarkers or additional candidate biomarkers are needed to achieve a multi-marker prediction model for improved detection of BMS with high sensitivity and specificity.
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Affiliation(s)
- Eoon Hye Ji
- 1 School of Dentistry, University of California, Los Angeles, CA, USA
| | - Cynthia Diep
- 1 School of Dentistry, University of California, Los Angeles, CA, USA
| | - Tong Liu
- 2 Center for Advanced Proteomics Research, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Hong Li
- 2 Center for Advanced Proteomics Research, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Robert Merrill
- 1 School of Dentistry, University of California, Los Angeles, CA, USA
| | - Diana Messadi
- 1 School of Dentistry, University of California, Los Angeles, CA, USA
| | - Shen Hu
- 1 School of Dentistry, University of California, Los Angeles, CA, USA
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Kaczor-Urbanowicz KE, Martin Carreras-Presas C, Aro K, Tu M, Garcia-Godoy F, Wong DT. Saliva diagnostics - Current views and directions. Exp Biol Med (Maywood) 2016; 242:459-472. [PMID: 27903834 DOI: 10.1177/1535370216681550] [Citation(s) in RCA: 226] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In this review, we provide an update on the current and future applications of saliva for diagnostic purposes. There are many advantages of using saliva as a biofluid. Its collection is fast, easy, inexpensive, and non-invasive. In addition, saliva, as a "mirror of the body," can reflect the physiological and pathological state of the body. Therefore, it serves as a diagnostic and monitoring tool in many fields of science such as medicine, dentistry, and pharmacotherapy. Introduced in 2008, the term "Salivaomics" aimed to highlight the rapid development of knowledge about various "omics" constituents of saliva, including: proteome, transcriptome, micro-RNA, metabolome, and microbiome. In the last few years, researchers have developed new technologies and validated a wide range of salivary biomarkers that will soon make the use of saliva a clinical reality. However, a great need still exists for convenient and accurate point-of-care devices that can serve as a non-invasive diagnostic tool. In addition, there is an urgent need to decipher the scientific rationale and mechanisms that convey systemic diseases to saliva. Another promising technology called liquid biopsy enables detection of circulating tumor cells (CTCs) and fragments of tumor DNA in saliva, thus enabling non-invasive early detection of various cancers. The newly developed technology-electric field-induced release and measurement (EFIRM) provides near perfect detection of actionable mutations in lung cancer patients. These recent advances widened the salivary diagnostic approach from the oral cavity to the whole physiological system, and thus point towards a promising future of salivary diagnostics for personalized individual medicine applications including clinical decisions and post-treatment outcome predictions. Impact statement The purpose of this mini-review is to make an update about the present and future applications of saliva as a diagnostic biofluid in many fields of science such as dentistry, medicine and pharmacotherapy. Using saliva as a fluid for diagnostic purposes would be a huge breakthrough for both patients and healthcare providers since saliva collection is easy, non-invasive and inexpensive. We will go through the current main diagnostic applications of saliva, and provide a highlight on the emerging, newly developing technologies and tools for cancer screening, detection and monitoring.
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Affiliation(s)
| | | | - Katri Aro
- 1 School of Dentistry, Center for Oral/Head & Neck Oncology Research, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Michael Tu
- 1 School of Dentistry, Center for Oral/Head & Neck Oncology Research, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Franklin Garcia-Godoy
- 3 College of Dentistry, University of Tennessee Health Science Center, Bioscience Research Center, Memphis, TN 38163, USA
| | - David Tw Wong
- 1 School of Dentistry, Center for Oral/Head & Neck Oncology Research, University of California at Los Angeles, Los Angeles, CA 90095, USA
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9
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Nukatsuka I, Yamane H. Adsorption of Chondroitin Sulphate a onto Zirconia Nanoparticles. ADSORPT SCI TECHNOL 2011. [DOI: 10.1260/0263-6174.29.10.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Isoshi Nukatsuka
- Department of Frontier Materials Chemistry, Graduate School of Science and Technology, Hirosaki University, Hirosaki 036-8561, Japan
| | - Hirotatsu Yamane
- Department of Frontier Materials Chemistry, Graduate School of Science and Technology, Hirosaki University, Hirosaki 036-8561, Japan
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de Souza FTA, Amaral TMP, dos Santos TPM, Abdo EN, Aguiar MCF, Teixeira AL, Kummer AM, Abreu MHNG, Silva TA. Burning Mouth Syndrome: A Therapeutic Approach Involving Mechanical Salivary Stimulation. Headache 2011; 52:1026-34. [DOI: 10.1111/j.1526-4610.2011.02037.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Andrade D, Assis DM, Santos JA, Alves FM, Hirata IY, Araujo MS, Blaber SI, Blaber M, Juliano MA, Juliano L. Substrate specificity of kallikrein-related peptidase 13 activated by salts or glycosaminoglycans and a search for natural substrate candidates. Biochimie 2011; 93:1701-9. [DOI: 10.1016/j.biochi.2011.05.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 05/31/2011] [Indexed: 10/18/2022]
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12
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Loo JA, Yan W, Ramachandran P, Wong DT. Comparative human salivary and plasma proteomes. J Dent Res 2010; 89:1016-23. [PMID: 20739693 DOI: 10.1177/0022034510380414] [Citation(s) in RCA: 242] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The protein compositions, or the proteomes, found in human salivary and plasma fluids are compared. From recent experimental work by many laboratories, a catalogue of 2290 proteins found in whole saliva has been compiled. This list of salivary proteins is compared with the 2698 proteins found in plasma. Approximately 27% of the whole-saliva proteins are found in plasma. However, despite this apparent low degree of overlap, the distribution found across Gene Ontological categories, such as molecular function, biological processes, and cellular components, shows significant similarities. Moreover, nearly 40% of the proteins that have been suggested to be candidate markers for diseases such as cancer, cardiovascular disease, and stroke can be found in whole saliva. These comparisons and correlations should encourage researchers to consider the use of saliva to discover new protein markers of disease and as a diagnostic non-proximal fluid to detect early signs of disease throughout the body.
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Affiliation(s)
- J A Loo
- Department of Chemistry and Biochemistry, University of California-Los Angeles, Los Angeles, CA, USA
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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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