Expression of salivary immunoglobulins and their association with analgesic neuropeptide opiorphin in anorexia nervosa during adolescence

Abstract

Background Patients who suffer from anorexia nervosa (AN) are characterized by exceedingly lower body weight, micro- and macro-nutrient deficiencies, and hyposalivation as compared to healthy subjects. In addition, AN may predispose to difficulties in oral health maintenance. However, little is known about the relationship between stress-dependent salivary neuro/immunopeptidergic biomarkers such as opiorphin and immunoglobulins (Ig) and AN.The aim of this case–control study was to evaluate salivary opiorphin and immunoglobulins in female children and adolescents diagnosed with AN compared to healthy controls. Methods Adolescent patients with clinically-confirmed severe restrictive subtype AN (Body Mass Index BMI < 15 kg/m2, mean age 15.0 ± 1.8, n = 83) were examined in the first week of hospital admission and compared to healthy matched controls (n = 79). Measurements of salivary opiorphin, IgA, IgG, IgM (ELISA technique), and oral hygiene levels (Plaque Control Record index—PCR) were performed. Results In the AN group, a significantly higher concentration of opiorphin was evidenced (3.1 ± 4.1 ng/ml) compared to the control group (1.1 ± 1.2 ng/ml), (p < 0.001), contrary to IgM, which was significantly lower (311.0 ± 185.3 ng/ml) than in the control group (421.2 ± 168.1 ng/ml), (p < 0.001). There were no significant differences in the levels of IgA and IgG, despite a higher concentration of IgA in the AN group vs. controls (p = 0.14). Spearman analysis revealed a correlation between opiorphin and age (p < 0.05), but also with all immunoglobulins IgA, IgG, IgM (p = 0.006, p < 0.001, p < 0.001). Similarly a correlation was found between PCR index and immunoglobulins IgG, IgM (respectively p = 0.028, p < 0.001), and between body mass, BMI, IBW% and IgA, IgM (all p < 0.05). Conclusions In the acute phase of AN, salivary changes in opiorphin and immunoglobulins related to dental plaque suggest an essential role in oral health balance. Changes related to AN may affect the anti-inflammatory and analgesic components of saliva and suggest their use as neurobiological markers in severe malnutrition.

Salivary opiorphin levels in denture‐related traumatic ulcers

“…In a recent study, Paszynska et al (2022) have reported an increase in salivary opiorphin levels and decrease in IgM in anorexia nervosa patients, while IgA and IgG levels did not change compared to healthy controls. Similarly, ulcers caused by denture‐related trauma may alter the overall composition of the saliva.…”

“…have reported increased salivary opiorphin levels in children with stressful experiences in the past.The perceived stress levels were not investigated in the current study. Since pain and stress are closely related, not evaluating the stress levels can be regarded as a limitation of this study.In a recent study,Paszynska et al (2022) have reported an increase in salivary opiorphin levels and decrease in IgM in anorexia nervosa patients, while IgA and IgG levels did not change compared to healthy controls. Similarly, ulcers caused by denture-related trauma may alter the overall composition of the saliva.…”

“…Similarly, the effect of age and gender on opiorphin levels is not clearly understood. Some studies report a correlation between opiorphin levels and age (Nejad et al, 2020;Paszynska et al, 2022) or gender (Dufour et al, 2013). However, most studies did not indicate correlation between opiorphin levels and age and gender (Boucher et al, 2017;Dalirsani et al, 2023;Ozdogan et al, 2019Ozdogan et al, , 2020Salarić et al, 2017).…”

Expression profile of genes regulating cellular response to cytokine stimulus in Sjögren’s syndrome

“…Inflammatory cytokines that maintain chronic inflammation and reflect activation of inflammatory cells are potential markers helpful in the diagnosis and monitoring of SS and associated comorbidities. Previous studies revealed changes in the inflammatory cytokine profile due to inflammation of the salivary glands in patients with eating disorders such as anorexia [3]. Apart from their traditional pro-inflammatory or anti-inflammatory function, cytokines play a multifactorial and complex role in other processes including the initiation of vascular endothelial damage, lipoprotein metabolism changes, inducing a proatherosclerotic profile and insulin resistance as well as the thrombosis promotion by the secretion of procoagulant factors [4].…”