Salivary Enhancement Therapies

Fox, Philip C.

doi:10.1159/000077761

Cited by 102 publications

(85 citation statements)

References 31 publications

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“…Muscarinic agonist medications such as pilocarpine and cevimeline induced salivary secretion from the residual functional tissue [47]. However, these medications provided temporary relief of symptoms and had a limited effect on the recovery of damaged tissues.…”

Section: Discussionmentioning

confidence: 99%

Involvement of autoimmunity to REG, a regeneration factor, in patients with primary Sjögren's syndrome

Yoshimoto

Fujimoto

Itaya‐Hironaka

et al. 2013

Clinical and Experimental Immunology

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SummaryThe regenerating gene (Reg) was isolated originally as a gene specifically over-expressed in regenerating pancreatic islets and constitute a growth factor family. Reg gene product (Reg) is important in the pathophysiology of various human inflammatory diseases. Recently, the possible involvement of human REG in the regeneration of salivary ductal epithelial cells of patients with primary Sjögren's syndrome (SS) was reported. However, the expression of the REG family genes in minor salivary glands (MSG) and the occurrence of anti-REG Iα autoantibodies in SS patients were obscured. In this study, we examined the expression of REG family genes in the MSG of SS and screened anti-REG Iα autoantibodies in SS. The mRNA levels of REG family genes in MSG were quantified using real-time reverse transcriptionpolymerase chain reaction (RT-PCR) and REG Iα expression in the MSG was analysed by immunohistochemistry. The mRNA level of REG Iα in the MSG of SS patients was significantly higher than that of control. REG Iα protein was expressed highly in SS ductal epithelial cells. Anti-REG Iα autoantibodies in the sera were found in 11% of SS. All the MSG in the anti-REG Iα autoantibody-positive group showed REG Iα expression, whereas only 40% showed REG Iα expression in the anti-REG Iα autoantibodynegative group. The anti-REG Iα autoantibody-positive group showed significantly lower saliva secretion and a higher ratio of grade 4 (by RubinHolt) in sialography. These data suggest strongly that autoimmunity to REG Iα might play a role in the degeneration of MSG ductal epithelial cells in primary SS.

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Section: Discussionmentioning

confidence: 99%

Involvement of autoimmunity to REG, a regeneration factor, in patients with primary Sjögren's syndrome

Yoshimoto

Fujimoto

Itaya‐Hironaka

et al. 2013

Clinical and Experimental Immunology

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“…In the 9 patients with secondary SS, 18 of the 62 salivary proteins analyzed (29%) were identifiable in a significantly lower percentage of secondary SS patients than in the controls, 2 (IB-1 and statherin) showed significantly lower levels than in the controls, and 3 (IB-6, P-B Des [1][2][3][4] , and ␤-defensin 2) were identifiable in a significantly higher percentage of secondary SS patients than in the controls.…”

Section: Frequencies and Levels Of Salivary Gland Proteins In Primarymentioning

confidence: 90%

Proteomic study of salivary peptides and proteins in patients with Sjögren's syndrome before and after pilocarpine treatment

Peluso¹,

Santis²,

Inzitari³

et al. 2007

Arthritis & Rheumatism

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Objective. To investigate the effect of pilocarpine on the salivary peptide and protein profile in patients with primary Sjögren's syndrome (SS) and to study the differences between patients with primary SS, patients with SS associated with other rheumatic diseases, and healthy control subjects.Methods. Saliva specimens were obtained from 9 primary SS patients, 9 secondary SS patients, and 10 healthy controls. Samples were analyzed for levels of 62 different salivary proteins using high-performance liquid chromatography coupled with mass spectrometry using a spectrometer equipped with an electrospray ionization source. In 6 of the primary SS patients, saliva was collected at 30 minutes, 60 minutes, and 24 hours after taking 5 mg of pilocarpine.Results. Before pilocarpine, ϳ60% of salivary proteins in samples from primary SS patients were not identifiable or showed lower levels than those in healthy controls. After 30-60 minutes following pilocarpine treatment, approximately one-third of the less represented proteins was found in a similar percentage of primary SS patients and controls. Almost all of the proteins that were detectable at lower levels in primary SS patients compared with controls reached levels similar to those in controls at 30-60 minutes after pilocarpine. The parotid gland proteins had the best response to pilocarpine. Primary SS patients were characterized by higher ␣-defensin 1 levels and by the presence of ␤-defensin 2. Secondary SS patients showed an intermediate protein profile between that of the primary SS patients and the controls. Conclusion. Pilocarpine partially restored the levels and numbers of identifiable proteins in saliva from patients with primary SS. Higher levels of ␣-defensin 1 and the presence of ␤-defensin 2 in the saliva of patients with primary SS could be markers of oral inflammation in this patient group.Saliva is a complex fluid composed of a variety of electrolytes, metabolites, nucleotides, polynucleotides, and proteins. This fluid plays an important role in the maintenance of oral health. The rate of salivary protein secretion is controlled mainly by noradrenaline, which is released from the sympathetic terminals and acts through the ␤-adrenergic receptors. The rate of fluid and electrolyte secretion is controlled by acetylcholine, which is released from the parasympathetic terminals and acts through the muscarinic cholinergic receptors.A large number of systemic agents have been proposed as secretagogues, but only a few have shown consistent salivary secretion-enhancing properties in well-designed trials. Among cholinergic agonists, studies in rats have shown that pilocarpine is the most effective for protein secretion (1) and has mild ␤-adrenergic stimulatory properties; however, few data in humans have been reported. Pilocarpine has been shown to improve symptoms of oral dryness and to increase salivary output in patients with primary Sjögren's syndrome (SS) (2), a chronic autoimmune disorder of the exocrine glands with associated lymphocytic infiltrates and con...

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“…Pilocarpine is unlikely to be effective in later stages of SS when the exocrine glands may be irreversibly damaged. 28 Cevimeline is a selective muscarinic agonist with similar mode of action and side effects to pilocarpine, however, it is not licensed for use in the UK. 27 The use of fluoride regimens, together with regular oral hygiene reinforcement and dietary advice are also useful measures for caries prevention (Fig.…”

Section: Oral Aspects Of Treatmentmentioning

confidence: 99%