Robert O. Wolf

Sjögren-Type Syndrome After Allogeneic Bone-Marrow Transplantation

Four patients, treated for hematologic disorders with bone-marrow transplants from HLA-identical siblings, spontaneously complained of dry eyes 8 to 12 months after transplantation. Four allograft recipients and two recipients of autologous bone-marrow transplants were evaluated for xerophthalmia and xerostomia. Three allogeneic marrow recipients had evidence of keratoconjunctivitis sicca, and two had decreased parotid gland function. All four allograft recipients had minor salivary gland histopathology identical to that of Sjögrens syndrome. The severity of symptoms and histologic lesions corresponded with the severity of chronic graft-versus-host disease. In addition, one patient developed sclerodermatous skin changes, another had discoid lupus erythematosus, and two patients had laboratory evidence of cholestasis. None of the patients had autoantibodies but all had hypergammaglobulinemia. In contrast, none of the recipients of autologous bone marrow had clinical, laboratory, or histologic findings resembling Sjögrens syndrome.

Salivary gland immunoglobulin and rheumatoid factor synthesis in Sjögren's syndrome: Natural history and response to treatment

Abstract Labial salivary glands, like the major salivary glands, are infiltrated with lymphoid cells in Sjogrens syndrome (SS). Studies utilizing biopsy specimens from the lower lips of seventy-six patients, forty-one of whom had Sjogrens syndrome, demonstrated that local synthesis of large amounts of immunoglobulins (IgM and IgG) and rheumatoid factor in salivary glandular tissue is distinctive for Sjogrens syndrome. The presence of rheumatoid factor was demonstrated autoradiographically by interaction between anti-lgG:lgG complexes and labeled immunoglobulins. Rheumatoid factor in the lip was found in eighteen of forty-one (43 per cent) patients with Sjogrens syndrome and in only two of thirty-five (6 per cent) control patients. On repeat biopsy of the lip untreated patients showed progression of lymphoid infiltration and increased immunoglobulin synthesis, whereas two patients treated with cyclophosphamide showed improvement histologically and all treated patients had diminished immunoglobulin synthesis. Sicca symptoms diminished in five of ten patients who were treated with cyclophosphamide for serious complications or other associated diseases, but immunosuppressive therapy cannot yet be recommended for uncomplicated Sjogrens syndrome.

Lysozyme determination in parotid saliva from patients with Sjögren's syndrome.

Lysozyme and total protein concentrations in parotid saliva were measured in 17 patients with primary Sjögrens syndrome, in six patients with Sjögrens syndrome secondary to hyperlipoproteinemia and in 14 age- and sex-matched healthy control subjects. Increased lysozyme concentrations were found only in patients with primary Sjögrens syndrome and correlated well with the presence of parotid gland enlargement. The total protein concentration in the saliva of patients with Sjögrens syndrome was not different from that of the control subjects. Parotid saliva lysozyme determination may be useful as an early adjunctive diagnostic test of primary Sjögrens syndrome.

Characterization of salivary proteins in patients with Sjögren's syndrome

Abstract Parotid saliva of patients with Sjogrens syndrome was subjected to disc electrophoresis. The protein distribution in the saliva of the patients with Sjogrens syndrome was compared with the protein distribution in the saliva of a control group. More anode-migrating protein was found in the patients with Sjogrens syndrome, as well as less amylase, and these differences were possibly significant. There was no difference in the content of protein remaining near the cathode in the salivas of the two groups. Samples of parotid saliva from a group of patients with Sjogrens syndrome and from a control group were subjected to radial quantitative immunodiffusion. There was no significant difference in the amount of IgG, IgA, and IgM in the two groups.

Rat Parotid Saliva Collection Technic

A technic for the in vivo collection of the various segregated major salivary secretions in experimental animals without the necessity for exposure of the ducts would allow repeatable bloodand tissue fluidfree salivary sampling. Methods have already been described in which the salivary duct is surgically exposed (extraorally), allowing pilocarpine-stimulated saliva to flow either directly (H. D. HALL and C. A. SCUNEYER, Proc. Soc. exp. Biol. N.Y., 115:100-05, 1964) or through a cannula into a receptacle (D. E. DRuM, J. dent. Res., 42:892, 1963). The advantages of collecting the salivary secretions directly from the gland are obvious and have been discussed by Hall and Schneyer (ibid). Repeated saliva collections have been made on the same rat, using the technic to be described. The inhalation anesthetic procedure employed was essentially that of Hagen and Hagen (J. oral Therap., 1:187, 1964), using a methoxyfluranesaturated atmosphere. The anesthetized rats were then immobilized on a dissecting board. A paper clip mouth prop, engaging the incisors, was placed so that a maximum intermaxillary opening was achieved. A small cotton throat pack was placed in the oropharynx to prevent the pooling salivary secretion from entering the air way and to prevent mouth breathing. The Stensens duct was easily visualized when the commissure of the mouth was retracted with forceps. As soon as the opening was visualized, pilocarpine

Regulated Vacuum System for Collecting Submaxillary and Sublingual Saliva

A closed-circuit, negative-pressure system better insures a positive tissue seal of the three collection chambers of the modified Schneyer segregator (B. L. Henriquis and H. H. Chauncey, Oral Surg., 14:1124-29, 1961). Among the causes for a mixing of the submaxillary saliva with the sublingual saliva and vice versa are: (1) non-approximation of the tissues against the segregator because of muscular movement during swallowing, tongue movement, and abnormal soft tissue position at the final impression stage; (2) a submucosal anastomosing of sublingual and submaxillary ducts (H. Sicher, Oral Anatomy [2d ed. 19521, pp. 198-201), which cannot be predicted or controlled.

SALIVA AND TASTE DISORDERS

Publisher Summary This chapter reviews the role of saliva in taste perception. In one of the experiments described in the chapter, three women and six men between the ages of 16 and 51 abstained from eating or smoking for two hours. Each subject was then assessed by two tests within eight hours. One tester administered the HK test, while the other one administered the 3d-H test. Each subject was unaware of the others results. Separate series of sodium chloride and sucrose solutions were prepared from reagent grade chemicals with double-distilled (DD) water, stored at 4°C and brought to room temperature before use. Under the 3d-H method, three consecutive drops of approximately 0.06 ml each were delivered to the anterior 1/3 of the tongue. Under the staircase method, 11 CF subjects of 19 to 24 years of age were recruited from the NIH Normal Volunteer Program. Each CF subject was age- and sex-matched with a subject having seven or more carious or restored teeth.