A COMPREHENSIVE examination of the composition of the separately collected parotid and submaxillary secretions affords a convenient means of studying exocrine gland function in cystic fibrosis of the pancreas. Deviations in composition could arise from alterations in gland structure (hypertrophy, hyperplasia), function (metabolism, protein synthesis, ion transport, cell permeability), neural regulation, or combinations thereof. Elucidation of the aberrant mechanisms responsible for salivary gland abnormality could provide meaningful clues to the basic pathogenesis of cystic fibrosis.Studies on parotid saliva have yielded conflicting results. Several investigators have reported elevations in sodium, chloride, and flow rate in cystic fibrosis patients.1-5 Previous reports from this laboratory on parotid saliva indicated that although "there was a tendency for electrolyte values to be higher in a group of patients with cystic fibrosis of the pancreas, only in the case of inorganic phosphorus, however, was this elevation statistically significant."6 Parotid glycoproteins were not found to be significantly altered in amount or proportion.6 The parot¬ id secretion rate was not significantly ele¬ vated.7 Based on the parameters studied, the parotid gland was considered to be "only slightly affected in cystic fibrosis of the pan¬ creas."6 In the present investigation addi¬ tional parotid components were examined: The enzymes, amylase and lysozyme and the organic nonelectrolytes, urea and uric acid.These enzymes have been examined in pa¬ rotid saliva in only one study; and this phase was rather preliminary in nature.1There have been no reports on urea and uric acid.In contradistinction to the rather equivo¬ cal results with parotid saliva, very sig¬ nificant deviations in the character and chemistry of submaxillary saliva have been reported. The group studying the submaxil¬ lary secretion noted that with reflex stimu¬ lation, cystic fibrosis patients exhibited tur¬ bidity, elevated nitrogen levels, calcium, fucose, amylase, and ribonuclease.810 These findings seemed worth corroborating in an¬ other and larger group of patients, using (in some instances) different analytic tech¬ niques. Salivary components not previously examined were also investigated. In the present study electrolytes, organic nonelec¬ trolytes, total protein, protein-bound carbo¬ hydrates, amylase, and lysozyme were as¬ sayed. In addition, polyacrylamide gel "disc electrophoresis" was employed as a means of comparing the pattern of submaxillary protein fractions from patients with cystic fibrosis of the pancreas with a control group of children. MethodsThe cystic fibrosis patients studied in the present investigations were selected from an outpatient group regularly attending the Vanderbilt Clinic of the Columbia-Presbyterian Mediceli Center. Selection was based on the availability of an individual at the time of the study. Severity of the disease was not a factor in patient selection. Control individuals, similar in age and sex distribution to the cyst...

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The provocative finding of higher than normal levels of submaxillary calcium and phosphorus in asthmatic children, and the repeated demonstration of abnormally elevated levels in cystic fibrosis, suggest a potentiany important line of investigation into the basic pathogenesis of these diseases.