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SummaryIn health, mucosal inflammation is prevented by tightly regulated responses via Toll-like receptors (TLR) that interact with specific microbe associated molecular patterns. Currently, 13 TLRs have been identified. Based on the specificity of ligand recognition, TLR-2 and TLR-4 can recognize most oral commensal microorganisms. Recent identification of some soluble TLRs (sTLRs) suggests additional regulatory roles for these receptors. We report here the presence of sTLR-4 polypeptides in adult human saliva. Functionally, the salivary sTLR-4 suppressed cytokine secretion by activated macrophages. The sTLR-4 levels were elevated significantly in oral lichen planus (OLP), a chronic inflammatory condition of the oral mucosa characterized by clinical persistence. In contrast, the epithelial cells in the saliva of OLP subjects expressed significantly reduced TLR-2 and TLR-4 mRNA that correlated with fewer bacteria/salivary epithelial cells. Investigating the soluble and cellular components of saliva is useful in identifying potential biomarkers for oral mucosal lesions.

Objective. To evaluate the efficacy and safety of an intraoral electrostimulation device, consisting of stimulating electrodes, an electronic circuit, and a power source, in treating xerostomia. The device delivers electrostimulation through the oral mucosa to the lingual nerve in order to enhance the salivary reflex.Methods. The device was tested on a sample of patients with xerostomia due to Sjögren's syndrome and other sicca conditions in a 2-stage prospective, randomized, multicenter trial. Stage I was a double-blind, crossover stage designed to compare the effects of the electrically active device with the sham device, each used for 1 month, and stage II was a 3-month open-label stage designed to assess the long-term effects of the active device. Improvement in xerostomia severity from baseline was the primary outcome measure.Results. A total of 114 patients were randomized. In stage I, the active device performed better than the ClinicalTrials.gov identifier: NCT00509808. Drs.

Medicine, Indianapolis, Indiana, USA and a unifying hypothesis of pathogenesis Chaiyarit P, Kafrawy AH, Miles DA, Zunt, SL, Van Dis ML, Gregory RL: Oral lichen planus: an immunohistochemical study of heat shock proteins (HSPs) and cytokeratins (CKs) and a unifying hypothesis of pathogenesis. J Oral Pathol Med 1999; 28: 210-5. C Munksgaard, 1999.The expression of heat shock proteins HSP60 and HSP70 and cytokeratins CK1/ 10 and CK7/18 were compared in epithelium of oral lichen planus (OLP) lesions and oral fibromas using an avidin-biotin-peroxidase complex (ABC) immunohistochemical method. An immunostaining intensity distribution (IID) index was developed to assess staining intensity and the proportion of positively stained Key words: avidin-biotin-peroxidase complex cells in different layers of the epithelium. The expression of HSP60 in the basal (ABC); cytokeratins (CKs); heat shock proteins (HSP); immunostaining intensity layer was significantly higher in OLP than in fibromas. No difference in HSP70 distribution (IID); oral lichen planus (OLP) expression was evident between OLP and fibromas. The expression of CK1/10 in the epithelial basal and suprabasal layers was significantly higher in OLP than in A. H. Kafrawy, Department of Oral Surgery, fibromas. There was no demonstrable staining for CK7/18 in either OLP or fibro-Medicine and Pathology, Indiana University School of Dentistry, 1121 West Michigan mas. A significant correlation was evident between the expression of HSP60 andStreet, Room 106, Indianapolis, Indiana CK1/10 in the basal epithelial cells in OLP. The findings support a role for HSP60 46202-5186, USA in the pathogenesis of OLP. A unifying hypothesis of the pathogenesis of OLP, involving two sequential immune reactions, is proposed.