An advanced design of the Carlson-Crittenden cup for collection of parotid fluid

Proteomic profiling of whole-saliva reveals correlation between Burning Mouth Syndrome and the neurotrophin signaling pathway

Burning mouth syndrome (BMS) is characterized by a spontaneous and chronic sensation of burning in the oral mucosa, with no apparent signs. The underlying pathophysiological and neuropathic mechanisms remain unclear. Here, we attempt to elucidate some of these mechanisms using proteomic profiling and bioinformatic analyses of whole-saliva (WS) from BMS patients compared to WS from healthy individuals. Qualitative and quantitative proteomic profiling was performed using two dimensional gel electrophoresis (2-DE) and quantitative mass spectrometry (q-MS). In order to improve protein visibility, 21 high abundance proteins were depleted before proteomic profiling. Quantitative proteomic analysis revealed 100 BMS specific proteins and an additional 158 proteins up-regulated by more than threefold in those with BMS. Bioinformatic analyses of the altered protein expression profile of BMS group indicated high correlations to three cellular mechanisms including the neurotrophin signaling pathway. Based on this finding, we suggest that neurotrophin signaling pathway is involved in the pathophysiology of BMS by amplifying P75NTR activity, which in turn increases neural apoptosis thereby reducing sub-papillary nerve fiber density in the oral mucosa.

Protein-Based Salivary Profiles as Novel Biomarkers for Oral Diseases

The Global Burden of Oral Diseases affects 3.5 billion people worldwide, representing the number of people affected by the burden of untreated dental caries, severe periodontal disease, and edentulism. Thus, much more efforts in terms of diagnostics and treatments must be provided in the fight of these outcomes. In this sense, recently, the study of saliva as biological matrix has been identified as a new landmark initiative in the search of novel and useful biomarkers to prevent and diagnose these conditions. Specifically, saliva is a rich reservoir of different proteins and peptides and accessible due to recent advances in molecular biology and specially in targeted and unbiased proteomics technologies. Nonetheless, emerging barriers are an obstacle to the study of the salivary proteome in an effective way. This review aims at giving an overall perspective of salivary biomarkers identified in several oral diseases by means of molecular biology approaches.

Response of lingual ascorbic acid test and salivary ascorbate levels to changes in ascorbic acid intake

This study sought to determine whether the lingual ascorbic acid test (LAAT) and measurement of salivary ascorbate reflect plasma and leukocyte ascorbate levels during controlled periods of ascorbic acid depletion and supplementation. Eleven healthy non-smoking men, aged 19-28 years, ate a diet that was repeated every seven days and was adequate in all nutrients except ascorbic acid (AA). This basal diet, which provided less than 5 mg of AA per day, was supplemented with 60 mg of AA per day for two weeks, 0 mg (placebo) per day for four weeks, 600 mg per day for three weeks, and 0 mg per day for four weeks. Oral examinations, the lingual ascorbic acid test, and measurement of salivary, plasma, and leukocyte ascorbate concentrations were conducted throughout the study. Ascorbic acid concentrations in plasma and leukocytes responded rapidly to changes in vitamin C intake. LAAT-derived ascorbate values were unrelated to ascorbic acid intake and plasma and leukocyte ascorbate concentrations. Salivary ascorbate levels approached the lower limits of detection of the assay and remained constant throughout the investigation. Oral hygiene was consistently excellent, and no severe mucosal or periodontal changes were observed. It was concluded that lingual ascorbic acid test values and salivary ascorbate levels are not related to changes in ascorbic acid intake and are not consistent with plasma or leukocyte ascorbate concentrations.

Effect of decreased salivation and pH on the adherence of Klebsiella species to human buccal epithelial cells

To assess the role of reduced salivary flow and intraoral pH on gram-negative bacterial colonization of the oropharynx, we studied in vitro Klebsiella adherence to normal human buccal epithelial cells at various pH values and to buccal cells from patients with pathological xerostomia (decreased saliva flow). Reduced pH significantly increased adherence of Klebsiella pneumoniae 84 to normal buccal epithelial cells (P less than 0.001). In contrast, two clinical isolates of K. oxytoca showed no significant pH-dependent change in adherence. A corollary of this was that patients with pathological xerostomia had significantly increased adherence of K. pneumoniae 84 to their buccal epithelial cells as compared with normal controls (P less than 0.01). These results suggest that reduced salivary flow and the concomitant reduction of intraoral pH may predispose patients to bacterial colonization with K. pneumoniae.

An evaluation of salivary scintigraphy in Sjögren's syndrome

Sequential salivary scintigraphy, labial salivary gland biopsy, and measurement of stimulated parotid flow rate were performed in 50 patients suspected of having Sjögren's syndrome. The value of these tests in the diagnosis of this disease was compared. Salivary scintigraphy and labial salivary gland biopsy can be used together to diagnose the oral component of Sjögren's syndrome. Abnormal salivary scintigraphy correlated with both of the other tests and may be considered optional in the diagnostic evaluation.

Relationshipp of HLA-Dw3 and HLA-B8 to Sjögren's syndrome

Nineteen patients with Sjögren's syndrome were evaluated for the presence of HLA-B8 and HLA-Dw3. HLA-B8 was found in 57.8% of patients and 20.1% of 96 controls (P less than 0.001). HLA-Dw3 was detected in 73.7% of the patients and 24.0% of controls (P less than 0.0001). Statistical evaluation of the association of both antigens with Sjögren's syndrome revealed that the primary association was with HLA-Dw3 (P less than 0.005). Patients with HLA-Dw3 had a lower mean parotid salivary flow rate (0.8 +/- 0.3 ml/10 minutes/gland versus 5.6 +/- 1.2 ml/10 minutes/gland, P less than 0.0004) and a more intense lymphocytic infiltration into labial salivary glands (focus score 7.2 +/- 0.9 versus 3.4 +/- 0.9, P less than 0.04) than did patients without HLA-Dw3. The difference in the intensity of the lymphocytic infiltration was even more significant when patients with both HLA-Dw3 and HLA-B8 were compared with patients with neither antigen (focus score 7.5 +/- 1.0 versus 2.8 +/- 0.8, P less than 0.02). In addition, all patients with severe keratoconjunctivitis sicca had both antigens. Our observations suggest that a number of genes may interact to determine susceptibility and severity in Sjögren's syndrome.

Association of Sjögren's syndrome with HLA-B8

HLA antigens were examined by microdroplet lymphocyte cytotoxicity in 31 patients with Sjögrens syndrome. Fifty percent of 22 Causcasian patients (7 of 17 females and 4 of 5 males) had HLA-B8, as compared to 21% of 1205 controls (P=0.002). The presence of HLA-B8 was not correlated with parotid salivary flow, keratoconjunctivitis sicca, or focus score. Because of its association with a number of autoimmune diseases, including Sjögren's syndrome, it is suggested that HLA-B8 is genetically liked to an immune response gene(s) that predisposes the individual to autoimmune phenomena. The expression of autoimmunity may be determined by infectious or environmental factors.

The oral component of Sjögren's syndrome

This study reports the results of an interdisciplinary approach to the diagnosis of Sjögren's syndrome in 100 patients. Ocular and systemic diagnoses and oral features from the history and physical examination are correlated with measurements of stimulated parotid flow rate and labial salivary gland histopathology. A new diagnostic criterion is introduced whereby labial salivary gland focus scores are used to establish the presence of the oral component of Sjögren's syndrome in place of the subjective evaluation of xerostomia. The differential diagnosis of the oral clinical features of Sjögren's syndrome and the clinical management of the oral component of this disease are discussed.