Shuji Toya

Levels of the antimicrobial proteins lactoferrin and chromogranin in the saliva of individuals with oral dryness.

STATEMENT OF PROBLEM Many individuals in an aging society experience oral dryness. Maintaining the flow of saliva and the presence of antimicrobial substances is important to maintain oral health. The inhibition of the secretion of antimicrobial substances could lead to oral dryness. PURPOSE The purpose of this study was to evaluate the antimicrobial substances lactoferrin and chromogranin A in the saliva of elderly individuals with oral dryness. MATERIAL AND METHODS The study included 25 controls and 28 participants with subjective oral dryness. The levels of lactoferrin and chromogranin A were determined in unstimulated whole saliva with an enzyme-linked immunosorbent assay method. The differences in secretion of lactoferrin and chromogranin A between the controls and the participants with oral dryness were analyzed with the Mann-Whitney U test (α=.05). RESULTS The flow rate of lactoferrin and chromogranin A was lower in the group of participants with oral dryness (lactoferrin, 7.43 ±7.08 ng/min; chromogranin A, 0.24 ±0.24 ng/min) than in the control group (lactoferrin, 21.52 ±7.67 ng/min; chromogranin A, 0.97 ±0.69 ng/min) (P<.01). The ratio of both antimicrobial proteins to total protein was also lower in participants with oral dryness than in the controls. CONCLUSIONS The results of this study indicated that the levels of lactoferrin and chromogranin A were lower in those with oral dryness. A reduction in the secretion of these antimicrobial substances may be associated with oral dryness.

Clinical evaluation of urinary 6-hydroxymethylpterin (6-HMP) in patients with cancer of the digestive organs

The purpose of this study is to clarify the clinical significance of urinary 6-HMP in patients with cancer of the digestive organs. High-performance liquid chromatography (HPLC) was used to determine 6-HMP in first morning urine. Conclusions were as follows:1.Cut off level of urinary 6-HMP was defined as 0.079 μg/ml, from 87 normal subjects.2.The daily profile of urinary 6-HMP in normal subjects was highest in morning and lowest at bedtime and daily changes were continuously under the cut off level.3.Sensitivity, specificity and accuracy of urinary 6-HMP were 64.2%, 77.6% and 70.5% respectively.4.In patients with malignant diseases, the overall positive rate was 64.2% and was clearly higher than benign diseases.5.The positive rate of urinary 6-HMP levels in malignant diseases was highest in pancreatic cancer (75.0%) and lowest in hepatocellular carcinoma (55.8%).6.Urinary 6-HMP elevated several days after operation and returned within normal range after 2–3 weeks.7.Urinary 6-HMP concentration correlated to the therapeutic effects of anticancer drugs, and increased again in tumor recurrence.

Evaluation of oral wetness using an improved moisture-checking device for the diagnosis of dry mouth

Abstract Purpose In 2013, we reported the results of a third-generation oral moisture-checking device in a multicentre clinical study involving patients with dry mouth and healthy volunteers. Subsequently, several improvements have been made to the third-generation device, and a fourth-generation device is now commercially available. This study aimed to confirm the usefulness of this improved fourth-generation device in the diagnosis of dry mouth and to assess the physiological wetness of lingual mucosa by using this device. Materials and Method This multicentre study comprised subjects with dry mouth (dry mouth group) and those without dry mouth (healthy group). Results In this study, the degree of moisture was considerably different between the two groups. Receiver operating characteristic analysis revealed an area under the curve value of 0.831. Sensitivity and specificity values were close to 80% in cases where the degree of moisture ≥29.6 was defined as normal, ≤27.9 was defined as dry mouth, and 28.0–29.5 was defined as borderline dry mouth. Conclusions These results suggest that the improved fourth-generation moisture-checking device can be used for the diagnosis of oral dryness.

Salivary level of antimicrobial protein chromogranin A in relation to the salivary flow rate and swallowing function

Background: Dysphagia is one of the problems in elderly persons in this aging society. The inhibition of the secretion of the antimicrobial proteins could lead to oral dryness and oral dryness could lead to swallowing problems. The aim of this study was to examine salivary levels of antimicrobial protein in relation to the salivary flow rate and swallowing function.Methods: In all, 26 patients with subjective oral dryness taking some medicines were studied. The unstimulated salivary flow rate was examined by ejecting gathered saliva from the mouth into a test tube for 10 min. The chromogranin A level was determined by an enzyme-linked immunosorbent assay. Swallowing function was evaluated using the repetitive saliva-swallowing test. Correlations among the salivary chromogranin A level, salivary flow rate, and swallowing function were analyzed using Spearman’s correlation coefficient by rank.Results: Statistically significant correlations were found between the salivary chromogranin A level and the unstimulated salivary flow rate (r = 0.735, P < 0.01) and between the salivary chromogranin A level and swallowing function (r = 0.459, P < 0.05). There was also a correlation between the unstimulated salivary flow rate and swallowing function (r = 0.585, P < 0.01).Conclusion: The results of this study suggested that the salivary antimicrobial protein chromogranin A level was related to both the salivary flow rate and swallowing function. This result suggested that the inhibition of the secretion of the antimicrobial proteins could lead to oral dryness and oral dryness could lead to swallowing problems.

Influence of swallowing saliva repeatedly on oral moisture

PURPOSE The aim of this study was to examine the influence of repetitive saliva-swallowing for the level of oral moisture using an oral-moisture checking device. METHODS Subjects were 24 healthy adults (HA) and 20 patients with oral dryness, 10 of whom had Sjögren syndrome or who had undergone radiation therapy (ODSR) and 10 who had not experienced ODSR (ODNSR). Oral moisture was measured before swallowing saliva (B), and after swallowing saliva once (F), twice (S), and three times (T). Oral moisture was measured at the lingual mucosa using an oral-moisture checking device. Statistical analysis was performed using the Friedman test. RESULTS Oral moisture of the lingual mucosa of the HA differed significantly between B and T, and F and T, and the oral moisture level tended to be higher the more times saliva was swallowed. However, oral moisture of lingual mucosa in the ODSR was not different at the different times of measurement, but the level of oral moisture tended to be lower the more times saliva was swallowed. Oral moisture of the lingual mucosa in the ODNSR differed significantly between B and T. The trends for the changes of the oral moisture level in the ODNSR were similar to those in the HA. CONCLUSIONS The results of this study show that swallowing saliva repeatedly could lead the increase of oral moisture in HA and ODNSR not in ODSR.