The Use of Whole Saliva in the Differential Diagnosis of Sjögren's Syndrome

1996 ◽  
Vol 10 (1) ◽  
pp. 17-24 ◽  
Author(s):  
L.M. Sreebny ◽  
W.X. Zhu
Keyword(s):  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Autoimmune Disorder ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Screening Tests ◽  
Whole Saliva ◽  
Sjögren‘S Syndrome ◽  
Immunologic Test

Sjögren's Syndrome (SS) is a chronic, multisystem. autoimmune disorder. It is characterized by (1) generalized exocrine gland dysfunction, (2) serologic abnormalities, and (3) organ-system changes. Oral changes are a prominent feature of this disease. Among these are xerostomia and hypofunction of the salivary glands. Given the intimate relationship between SS and the salivary glands, it is reasonable to postulate that whole saliva (WS) contains the stigmata associated with the presence of this disease. But few studies have been conducted on this secretion. Indeed, WS has largely been neglected and ignored by physicians, dentists, and scientists. Objections to its use have included the fact that it is "impure", that it does not adequately represent what is present in the salivary glands, that no standards have been established for its rate of flow, and that findings based on it lack specificity. Yet, it is this secretion which coats and protects the hard and soft oral tissues, enables us to prepare our food for digestion, and assists our speech. This review will demonstrate that there is a uniqueness and constancy to whole saliva and that it may be used to diagnose the presence of SS. "Screening tests", which include several simple-to-perform sialometric, chemical, and microbiologic procedures, may be conducted in doctors' offices to establish the "profile" of an SS patient. Electrophoretic studies may be used to study the nature of the salivary proteins, and an immunologic test, which is performed on WS and utilizes Western Blot Autoantibody Strips (ImmunoVision. Springdale, AR). may be used to establish the definitive diagnosis of SS.

scholarly journals Characterization of Lipids in Saliva, Tears and Minor Salivary Glands of Sjögren’s Syndrome Patients Using an HPLC/MS-Based Approach

2021 ◽  
Vol 22 (16) ◽  
pp. 8997
Author(s):  
Fredrik Fineide ◽  
Xiangjun Chen ◽  
Thomas Bjellaas ◽  
Valeria Vitelli ◽  
Tor Paaske Utheim ◽  
...  
Keyword(s):  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Minor Salivary Glands ◽  
Lipidomic Analysis ◽  
Lipid Species ◽  
Whole Saliva ◽  
Sjögren‘S Syndrome

The diagnostic work-up of primary Sjögren’s syndrome (pSS) includes quantifying saliva and tear production, evaluation of autoantibodies in serum and histopathological analysis of minor salivary glands. Thus, the potential for further utilizing these fluids and tissues in the quest to find better diagnostic and therapeutic tools should be fully explored. Ten samples of saliva and tears from female patients diagnosed with pSS and ten samples of saliva and tears from healthy females were included for lipidomic analysis of tears and whole saliva using high-performance liquid chromatography coupled to time-of-flight mass spectrometry. In addition, lipidomic analysis was performed on minor salivary gland biopsies from three pSS and three non-SS females. We found significant differences in the lipidomic profiles of saliva and tears in pSS patients compared to healthy controls. Moreover, there were differences in individual lipid species in stimulated saliva that were comparable to those of glandular biopsies, representing an intriguing avenue for further research. We believe a comprehensive elucidation of the changes in lipid composition in saliva, tears and minor salivary glands in pSS patients may be the key to detecting pSS-related dry mouth and dry eyes at an early stage. The identified differences may illuminate the path towards future innovative diagnostic methodologies and treatment modalities for alleviating pSS-related sicca symptoms.

scholarly journals Sialendoscopy increases saliva secretion and reduces xerostomia up to 60 weeks in Sjögren’s syndrome patients: a randomized controlled study

Rheumatology ◽  
2020 ◽  
Author(s):  
K Hakki Karagozoglu ◽  
Arjan Vissink ◽  
Tim Forouzanfar ◽  
Jan G A M de Visscher ◽  
Floor Maarse ◽  
...  
Keyword(s):  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Salivary Flow ◽  
Sjogren's Syndrome ◽  
Major Salivary Glands ◽  
Whole Saliva ◽  
Saliva Flow ◽  
Sjögren‘S Syndrome

Abstract Objective To assess the effect of sialendoscopy of the major salivary glands on salivary flow and xerostomia in patients with Sjögren’s syndrome (SS). Methods Forty-five patients with SS were randomly assigned to a control group (no irrigation, control, n = 15), to irrigation of the major salivary glands with saline (saline, n = 15) or to irrigation with saline followed by corticosteroid application (triamcinolone acetonide in saline, saline/TA, n = 15). Unstimulated whole saliva flow (UWSF), chewing-stimulated whole saliva flow (SWSF), citric acid-stimulated parotid flow, Clinical Oral Dryness Score (CODS), Xerostomia Inventory (XI) and EULAR SS Patient Reported Index (ESSPRI) scores were obtained 1 week before (T0), and 1, 8, 16, 24, 36, 48 and 60 weeks after sialendoscopy. Data were analysed using linear mixed models. Results Irrespective of the irrigation protocol used, sialendoscopy resulted in an increased salivary flow during follow-up up to 60 weeks. Significant between-group differences in the longitudinal course of outcomes were found for UWSF, SWSF, XI and ESSPRI scores (P = 0.028, P = 0.001, P = 0.03, P = 0.021, respectively). UWSF at 60 weeks was higher compared with T0 in the saline group (median: 0.14 vs median: 0.10, P = 0.02) and in the saline/TA group (median: 0.20, vs 0.13, P = 0.035). In the saline/TA group SWSF at 48 weeks was higher compared with T0 (median: 0.74 vs 0.38, P = 0.004). Increase in unstimulated salivary flow was also reflected in improved CODS, XI and ESSPRI scores compared with baseline. Conclusion Irrigation of the major salivary glands in patients with SS increases salivary flow and reduces xerostomia.

scholarly journals Dysfunction of Lacrimal and Salivary Glands in Sjögren's Syndrome: Nonimmunologic Injury in Preinflammatory Phase and Mouse Model

2011 ◽  
Vol 2011 ◽  
pp. 1-15 ◽  
Author(s):  
Toshiharu Hayashi
Keyword(s):  
Mouse Model ◽  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Autoimmune Disorder ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Dry Eyes ◽  
Morphologic Changes ◽  
Sjögren‘S Syndrome

Sjögren's syndrome (SjS) is a chronic autoimmune disorder characterized by dry eyes and dry mouth due to dacryoadenitis and sialoadenitis with SS-A/Ro and/or SS-B/La autoantibodies in genetically predisposed individuals. Destruction of lacrimal and salivary glands by autoimmune reactions may lead to clinical manifestation. However, the mechanisms behind the decreased volume of secretions in tears and saliva are complex and are not fully understood. Exocrine gland dysfunction may precede autoimmunity (acquired immunity) or represent a process independent from inflammation in the pathogenesis of SjS. The preceded functional and morphologic changes of those tissues by nonimmunologic injury before the development of inflammation at the sites of target organs have been implicated. This paper focuses on the several factors and components relating to glandular dysfunction and morphologic changes by nonimmunologic injury during the preinflammatory phase in mouse model, including the factors which link between innate immunity and adaptive immunity.

scholarly journals Interferon gamma-inducible protein 16 (IFI16) and anti-IFI16 antibodies in primary Sjögren’s syndrome: findings in serum and minor salivary glands

Reumatismo ◽  
2016 ◽  
Vol 67 (3) ◽  
pp. 85 ◽  
Author(s):  
A. Alunno ◽  
V. Caneparo ◽  
F. Carubbi ◽  
O. Bistoni ◽  
S. Caterbi ◽  
...  
Keyword(s):  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Primary Sjögren’S Syndrome ◽  
Minor Salivary Glands ◽  
Primary Sjogren’S Syndrome ◽  
Primary Sjögren's Syndrome ◽  
Sjögren‘S Syndrome

The interferon (IFN) signature, namely the overexpression of IFN-inducible genes is a crucial aspect in the pathogenesis of primary Sjögren’s syndrome (pSS). The IFN-inducible IFI16 protein, normally expressed in cell nuclei, may be overexpressed, mislocalized in the cytoplasm and secreted in the extracellular milieu in several autoimmune disorders including pSS. This leads to tolerance breaking to this self-protein and development of anti-IFI16 antibodies. The aim of this study was to identify pathogenic and clinical significance of IFI16 and anti-IFI16 autoantibodies in pSS. IFI16 and anti-IFI16 were assessed in the serum of 30 pSS patients and one-hundred healthy donors (HD) by ELISA. IFI16 was also evaluated in 5 minor salivary glands (MSGs) of pSS patients and 5 MSGs of non-pSS patients with sicca symptoms by immunohistochemistry. Normal MSGs do not constitutively express IFI16. Conversely, in pSS-MSGs a marked expression and cytoplasmic mislocalization of IFI16 by epithelial cells was observed with infiltrations in lymphocytes and peri/ intra-lesional endothelium. pSS patients display higher serum levels of both IFI16 and anti-IFI16 autoantibodies compared to HD. Our data suggest that IFI16 protein may be involved in the initiation and perpetuation of glandular inflammation occurring in pSS.

Interdisciplinary approach to the management of a patient with Sjogren’s syndrome: a clinical case

2021 ◽  
Author(s):  
N. Y. Emelyanova ◽  
T. E. Kozyrieva ◽  
O. V. Stepanova ◽  
N. V. Zorenko
Keyword(s):  
Oral Cavity ◽  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Clinical Case ◽  
Sjögren's Syndrome ◽  
Interdisciplinary Approach ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Mucous Membranes ◽  
Sjögren‘S Syndrome

Dryness of the mucous membranes (in mouth, nose, genitals in women) and skin are the most common complaints of patients with Sjogren’s disease — a multisystem immune‑mediated disorder that causes anxiety and concern associated with the difficulties of initial diagnosis. The authors present a clinical case of a patient with primary Sjogren’s syndrome, a large number of symptoms of digestive diseases, complaints of dryness of mucous membranes, in particular the oral cavity. The diagnosis was confirmed by allied specialists such as ophthalmologist, gynecologist, rheumatologist, dentist. Detailed dental examination revealed the main dental complaints (constant dry mouth, galitos, changes in taste), clinical condition (dryness of the red border of the lips, swelling of the oral mucosa, changes in the relief of the gums), decreased secretory activity and significant reduction of unstimulated salivation with a moderate level of stimulated salivation. It is noted that a significant decrease in sialometry (0.01 ml per minute) and functional activity of the small salivary glands (up to 18) confirms the presence of true xerostomia. Micro‑crystallization of saliva revealed disorganization of irregularly shaped structures, as well as a significant number of organic inclusions, which indicates a violation of homeostasis in the oral cavity. Given the results of ultrasound examination of the large salivary glands and the absence of enlargement and swelling of the glands during clinical examination, we can assume that the destructive damage to the glands is not so pronounced, evacuation function of the gland is not reduced, but the amount of secretion is significantly reduced. To provide medical aid to patients with Sjogren’s syndrome, the accessibility of the qualified consultation is important and required, with conduction of comprehensive examinations by allied specialists, including a dentist.  

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