Lipopolysaccharide induced-in vivo increases in beta-defensins of the rat parotid gland.

Antimicrobial beta-defensins are thought to protect epithelial surfaces. Their mobilization in response to inflammation was studied in the rat parotid gland using an ELISA assay. Bacterial lipopolysaccharide (LPS), injected into the parotid duct on one side, induced a marked local inflammatory response in the parotid gland as judged by several fold increases in myeloperoxidase activity and, in histological sections, infiltration of neutrophils. Three hours after the injection, beta-defensin 1 and 3 were increased (by 41% and 15%, respectively, P<0.01) as compared to the contralateral gland. Though still elevated 6h after the injection, the percentage figures for beta-defensin 1 were, at this time, somewhat lower (30%) compared to the situation at 3h, while those for defensin 3 were significantly higher 65% (P<0.01); neither at the early nor at the late time of observation were any changes in the level of beta-defensin 2 observed. The beta-defensins under study were not detected in submandibular and sublingual glands, neither were they detected in the inflamed submandibular gland, showing also here several fold increases in myeloperoxidase activity and, in addition, the presence of inflammatory cells, following ductal injection of LPS towards the gland.

Lactoferrin concentration in human parotid saliva as measured by an enzyme-linked immunosorbent assay (ELISA).

The enzyme-linked immunosorbent assay (ELISA) was found to be a reliable and accurate method for quantitating lactoferrin in parotid fluid. In saliva from normal glands, the concentration was usually below 1 mg% and was always higher in unstimulated than in stimulated secretion.

Alterations in lactoferrin in salivary gland disease.

During the active phase of chronic recurrent parotitis there is a marked elevation in the parotid concentration of lactoferrin (Lf), and iron-binding glycoprotein with antibacterial properties. The Lf concentration decreases during the recovery period, but still remains above normal levels. The changes of Lf in parotitis parallel recent findings in mastitis and pancreatitis. Elevations in Lf were also noted in five of six subjects with Sjögren's disease, but not in subjects with sarcoidosis, diabetes or "dry mouth" without sialographic changes. The source of the Lf has not been determined; it could arise in part from disrupting polymorphonuclear leucocytes and in part from epithelial cells that synthesize Lf in the salivary glands. Inflammatory stimulation of Lf synthesis would suggest a basic protective mechanism in exocrine glands and should be fully explored.

Quantitation of human salivary acidic proline-rich proteins in oral diseases.

Acidic proline-rich proteins (APRP) were quantitated immunochemically in salivary secretions from groups of: caries-resistant (CR) and caries-susceptible (CS) subjects; heavy- and light-calculus-formers; and patients with Sjögren's Syndrome, drug-induced xerostomia, and recurrent parotitis. In all groups except the parotitis patients, there were comparable levels of APRP, about 40-50 mg%, with similar values in parotid and submandibular saliva. In chronic recurrent parotitis, the values were somewhat higher (about 60 mg%). There were no differences in the proportion of APRP-A to C in a subset of CR and CS. Taken as a whole, the data support the view that the secretion of APRP is stable and that caries status and propensity to calculus formation are not associated with abnormal levels of these phosphoproteins.

Epstein-Barr virus status and the histopathological changes of parotid gland lymphoid infiltrates in HIV-positive children.

This study examined the EBV status and the morphology in parotid glands of a large cohort of HIV-positive pediatric patients. Nineteen children with vertically acquired HIV infection, ranging in age from three months to seven years and two months, were analyzed. Seventeen patients were assessed for serological evidence of EBV infection; nine showed evidence of past infection, one each re-activation and current infection and six did not have serological evidence of EBV. Immunohistochemistry and in situ hybridization for EBER 1 and 2 were performed on formalin-fixed, paraffin-embedded tissue. Fourteen of the 19 cases were classified as severe or established myoepithelial sialadenitis (MESA) and five were regarded as having mild MESA. The majority of intraepithelial lymphocytes were of B-cell lineage, while the pericystic infiltrate contained CD8-positive T-lymphocytes. p24 immunohistochemistry for HIV showed positive follicular dendritic cells, lymphoid cells and macrophages. Ten of 14 cases were positive for EBER 1 and 2. These included cases that were serologically negative for EBV. This study confirms that the morphology and immunophenotype of pediatric HIV-associated parotid lesions are similar to those seen in adults. Ten of 14 cases with evidence of EBV within the lymphoid infiltrate showed the same morphology and immunophenotype as cases in which EBV was not detected either by serology or by in situ hybridization. These findings indicate that EBV is not uniformly found in either the tissue or serum of these patients, and may not have a pathogenetic role in HIV-associated lymphoepithelial lesions in the pediatric age group.

Two-dimensional electrophoresis of human salivary proteins from patients with sialoadenopathy.

Unstimulated saliva was fractionated by micro two-dimensional gel electrophoresis, and the proteins visualized by silver staining and immunostaining. The subjects with Sjögren's syndrome exhibited both quantitative and qualitative alterations in the protein composition of the saliva not only from the parotid gland but also from the submandibular/sublingual glands.

Increased beta 2-microglobulin in both parotid and submandibular/sublingual saliva from patients with Sjögren's syndrome.

Samples of unstimulated saliva from patients with sialoadenopathy were collected by microcapillary tube (1 microliter), and their beta 2-microglobulin (B2-MG) content determined by a sandwich enzyme immunoassay. A higher than normal (control) concentration of the globulin was present in both parotid and submandibular/sublingual saliva from the patients with Sjögren's syndrome but not in the samples from the patients with sialoadenitis or diabetes mellitus. The increase in B2-MG in saliva from patients with Sjögren's syndrome may reflect that immunolopathological events are important in the degeneration of both glands in this disease. Therefore, the determination of B2-MG in saliva may be a simple, non-invasive technique for confirming the diagnosis of Sjögren's syndrome as an autoimmune disease.

Nodular fasciitis of the parotid gland. Report of a case with presentation in an unusual location and cytologic differential diagnosis.

The histomorphology of nodular fasciitis (NF), a benign proliferation of myofibroblasts, is well described in the surgical pathology literature. The cytomorphology, however, has been reported infrequently. Cytologic interpretation of this pseudosarcomatous lesion is subject to the same pitfalls so frequently reported for histologic material. NF arises most commonly in the extremities or trunk; occurrence in the parotid gland is relatively uncommon. We describe a case of NF arising in association with the parotid gland; review the clinical, cytologic, histologic and immunohistochemical features of NF; and offer a differential diagnosis, based on cytologic features, of other benign and malignant lesions likely to be encountered at this location.

Sialochemical examinations in non-tumorous parotid enlargements.

Secretion rates and the composition of isolated parotid saliva samples were samples were examined in 51 patients suffering from chronic recurrent parotitis, sialosis, or Sjögren's syndrome, and in 17 healthy controls. Evaluation of the results indicated that sialochemical examination may provide a valuable help in the differential diagnosis of parotid diseases characterized by swelling of the gland. Chronic parotitis is characterized by a significantly decreased flow rate, extremely high sodium and protein concentration and lack of secretory response to stimulation. In Sjögren's syndrome the low flow rate was found to be associated with a decreased potassium secretion rate as well as decreased flow rate and decreased sodium concentration after stimulation. In sialosis, where flow rates display a considerable individual variation, a significant increase in potassium secretion rate could be revealed.

Recurrent parotitis in children. A report of 102 cases.

This article presents 102 cases of recurrent parotitis in children with studies of clinical findings, sialographic manifestations, dynamic functions of the parotid gland examined with radionuclide, laboratory findings and follow-up studies of 28 cases with sialography. The following conclusions are reached: 1. Retrograde infection induced by the mumps virus and upper respiratory infection seem to play a major role in the etiology of recurrent parotitis. Familial abnormalities are potential factors. Incomplete immune functions of the children are factors related to the pathogenesis, and following growth and development of the immune system, this disease will undergo remission; 2. Sequential scintigraphy shows normal uptake and retarded excretion function of the parotid; 3. Long-term follow-up studies demonstrate that the patients are free from symptoms for many years, but the punctate dilatation in sialography may diminish, disappear, or be unchanged; and 4. If the disease is not cured in childhood, it may continue into adulthood and healing will take place eventually. Relationship with Sjogren's syndrome has not been revealed.

Salivary factors in children with recurrent parotitis. Part 2: Protein, albumin, amylase, IgA, lactoferrin lysozyme and kallikrein concentrations.

The concentrations of total protein, albumin, amylase, IgA, lactoferrin, lysozyme and kallikrein in parotid saliva from 17 children with juvenile recurrent parotitis (JRP) in a non-active phase of disease and in healthy controls of the same number, sex and age were analysed after gustatory stimulation with 1%, 2% and 6% citric acid. There was a great individual variation in all analysed variables, especially in saliva from the diseased glands. Significantly raised levels of albumin, IgA, lactoferrin and kallikrein were found in the saliva from the JRP-children compared with the controls (p < 0.01-0.001), while total protein and alpha-amylase did not differ significantly. The sialo-chemical findings are discussed in the light of histological and bacteriological findings and support the hypothesis that the etiology of juvenile recurrent parotitis is a combination of congenital malformation of portions of the salivary ducts and a set-in infection.

[Relapsing parotiditis: its etiopathology and treatment]. / La parotiditis recidivante. Su etiopatogenia y tratamiento.

In this paper 85 cases of relapsing Parotiditis are presented, with the aim to ascertain the degree of accuracy provided by treatments with vitamin B complex, anti-inflammatory drugs or catchers of free radicals. Perusal of the bibliography and proposal of considering the malady divided in two stages. The first one would be characterized for metabolic alterations of the saccharoid cycle with scarce yielding of energy (ATP). Therefore failure of the Na/L bomb, which phenomenon is linked to an enzymatic protein deficiency and/or coenzyme of the B complex vitamins, being this condition provoked for a dietetic deficiencies, intestinal malabsorption due to alcoholic oedema, excessive expenditure of energy among drug-addicts, anemia, diabetes, etc. From this moment on appears the second stage--the inflammatory--with the whole metabolic and biochemical courtship of structural and functional irreversible damages.

[The auto-oxidative system of the acinar cells in acute postoperative parotitis]. / Autookislitel'naia sistema atsinarnykh kletok pri ostrom posleoperatsionnom parotite.

The major constituents of acinar cell auto-oxidative system in acute postoperative parotitis were determined in experiments on 32 dogs. Two types of cellular reactions were identified: free-radical processes with increased levels of lipid peroxidation products and insufficiency of enzymatic and nonenzymatic glutathion antioxidants and reaction of defense metabolism inhibition. A conclusion is made about the necessity of altering the current methods for prevention and therapy of postoperative parotitis.

[The participation of prostaglandin F2 in the peroxidation damages and antiperoxidation protection of the parotid gland in acute nonepidemic parotitis]. / Uchastie prostaglandina F2 v perekisnykh povrezhdeniiakh i antiperekisnoi zashchite okoloushnoi sliunnoi zhelezy pri ostrom neépidemicheskom parotite.

Effects of prostaglandin F2 on the major components of the antioxidative system (levels of malonic dialdehyde and lipid peroxides, activities and content of glutathione enzymes and nonenzymes (glutathione peroxidase, glutathione reductase, and NADPH (NADH), oxidized and reduced glutathione) were studied in experiments with 60 dogs in which acute nonepidemic parotitis was modeled. A varying capacity of the cells of the parotid gland to resist the detrimental effects of the disease and specific features of prostaglandin F2 effect on this capacity were revealed: injection of prostaglandin F2 stimulated both lipid peroxidation and the activity of the antioxidative system and led to cellular injury in the presence of a relatively high level of cellular metabolism, preserving cellular viability on condition of inhibited rate of metabolic reactions, this being the principal factor for the parotid gland, among other factors determining the cytoprotective effect.

New models of experimental parotitis and parotid gland distension in rats.

A significant reduction of the escape threshold to mechanical stimulation of the lateral facial skin was observed bilaterally at days 2 and 3 after unilateral complete Freund's adjuvant (CFA) administration into parotid gland. A slight reduction of mechanical escape threshold was also observed in rats with saline administration. The parotid gland inflammation was verified and quantified by measuring the tissue Evans' blue dye extravasation. The Evans' blue concentration in the parotid gland tissues was significantly greater in the CFA-injected rats than that of the saline-injected rats at 72 h after treatment. On day 10 after CFA administration into the parotid gland, the Evans' blue concentration was recovered to the control level. The administration of capsaicin into the parotid gland did not alter neuronal activities in the transition zone between the trigeminal spinal subnucleus interpolaris and caudalis (Vi/Vc). In contrast, capsaicin administration induced significant increases in the receptive field size and mechanical and cold responses of neurons located in superficial laminae of the C1/C2. The subgroup of C1/C2 neurons responded to mechanical distension of the parotid gland, whereas no Vi/Vc neurons responded to parotid distension.

Molecular alterations of parotid saliva in infantile chronic recurrent parotitis.

Infantile chronic recurrent parotitis (ICRP) is an insidious disease whose etiopathogenesis remains an enigma. Alterations in the physical appearance of parotid saliva from ICRP patients have been frequently reported. However, sialochemical studies in regard to ICRP are very rare. The aim of this study was to determine whether saliva of ICRP patients presents major physicochemical and biochemical alterations compared with saliva from paired healthy controls. Parotid, whole, and submandibular/sublingual saliva was collected at an asymptomatic stage from 33 ICRP patients (5-16 y old, both sexes) and from 33 sex- and age-matched healthy controls. Saliva was analyzed for protein concentration, mode of protein diffusion on cellulose membranes, unidimensional sodium dodecylsulfate (SDS)-polyacrylamide gel electrophoresis protein profiles and zymographic profiles of metalloproteinase 2 (MMP-2) and metalloproteinase 9 (MMP-9). Parotid saliva of ICRP patients showed an increased protein concentration, altered mode of protein diffusion, a higher frequency of polypeptide bands of 43, 37, 33, 29, 26, 16, and 10 kD, higher asymmetry in the polypeptide profiles of both contralateral parotid saliva, and an increase in the frequency of MMP-2 and MMP-9. Parotid saliva of patients with ICRP is molecularly altered with respect to normal saliva. Some of the molecular differences could be related to the etiopathogenesis of the disease.