Elevation of Urate in Saliva and Serum of Patients with Knee Osteoarthritis.

BACKGROUND: Knee osteoarthritis (knee OA) is the most common joint disease and the leading cause of disability and has a considerable financial burden on the healthcare system. OBJECTIVE: The aim of the present study was to evaluate urate in saliva and serum of knee OA. METHODS: Serum and saliva urate levels of 30 knee OA and 30 healthy controls were evaluated in a cross-sectional study. Data were analysed by Student's t test, Pearson correlation test, and receiver operating characteristic. RESULTS: The mean serum and both stimulated and unstimulated saliva urate levels were higher in the knee OA than that of the healthy group. WOMAC score positively correlated with serum (r = 0.485; p = 0.004), unstimulated saliva (r = 0.575; p = 0.001) and stimulated saliva (r = 0.453; p = 0.009) levels of urate. The serum level of urate significantly correlated with unstimulated (r = 0.442; p < 0.001) and stimulated (r = 0.563; p < 0.001) saliva urate levels. Serum and saliva urate had significant cutoff values (6.4, 4.9, and 3.3 mg/dL in serum, stimulated, and unstimulated saliva, respectively). CONCLUSION: In this study, urate in serum and saliva was increased in patients with knee OA and positively correlated with WOMAC.

Muscarinic cholinergic receptors in minor salivary gland tissues of patients with oral lichen planus: A case-control study.

BACKGROUND: Oral lichen planus (OLP) is a common, chronic immunological and inflammatory condition. Many of the OLP patients complain of xerostomia. The M3 muscarinic cholinergic receptors (MR3) are the main receptors in the salivary glands responsible for water secretion into the saliva. This study aimed to assess the level of M3 muscarinic cholinergic receptors in minor salivary glands of OLP patients. METHODS: This case-control cross-sectional study evaluated 40 OLP patients and 22 controls. All participants completed two questionnaires (xerostomia and xerostomia inventory). Stimulated and unstimulated saliva samples were collected. The saliva flow rate was calculated by dividing the saliva volume (in milliliters) by time (in minutes). Six minor salivary glands were also surgically removed from the lower lip of patients and controls, and weighed using a digital scale with 10-4  g accuracy. They were then frozen at -80°C, and the level of M3 receptors of the glands was determined using the ELISA kit. RESULTS: The unstimulated and stimulated saliva flow rate was significantly lower in OLP patients. The xerostomia inventory score was significantly higher in the OLP group. The level of M3 muscarinic receptors in minor salivary glands of OLP patients was significantly higher than that in controls. CONCLUSIONS: It may be concluded that the reduction in saliva flow significantly increases the number of M3 receptors in an attempt to compensate for this shortage and prevent xerostomia (compensatory upregulation).

Serum and Saliva MMP-3 in Patients with OLP and Oral SCC.

BACKGROUND: Matrix metalloproteinase-3 (MMP-3) plays a key role in development of cancer. The purpose of this study was to assess MMP-3 in the serum and saliva of patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Thirty patients with OLP (8 reticular and 22 erosive forms), and 20 patients with OSCC (6 in low stage and 14 in advanced stage), were enrolled in this study, conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The serum and saliva MMP-3 was assayed by ELISA method. Statistical analysis of the Student's t-test, ANOVA and Pearson correlation coefficient was performed. The mean saliva and serum levels of MMP-3 were significantly higher in patients with OSCC compared with OLP. RESULTS: The serum and saliva MMP-3 concentrations increased from reticular form of OLP to erosive form of OLP, and increased further to low stage of OSCC and advanced stage of OSCC. Serum MMP-3 correlated significantly with unstimulated (r = 0.310, p = 0.038) and stimulated (r = 0.365, p < 0.026) saliva MMP-3. CONCLUSION: Serum and saliva MMP-3 levels appear associated with OLP and OSCC.

Unstimulated whole saliva cortisol levels during Ramadan in Iranian Muslims.

AIMS: Ramadan is a great opportunity for scientific research due to its peculiar nature. This study was designed to investigate whether morning saliva cortisol pick can change during and after Ramadan compared to before it. MATERIALS AND METHODS: A total of 30 healthy volunteer men (aged between 30 and 76 years) were asked to participate in a cross-sectional study between August 12 and September 10, 2010. Saliva was collected 2 weeks before the beginning of Ramadan (BR), during the first week (R1), middle (R2), the last week (R3) of Ramadan and 3 weeks after Ramadan (AR). Cortisol concentration was analyzed by ELISA. Statistical analysis of one-way repeated measures analysis of variance (ANOVA) was used. RESULTS: The mean unstimulated saliva cortisol concentration and its output were significantly higher in the BR than during and after Ramadan. CONCLUSION: Mean saliva cortisol concentration and its output tended to be lower during and 3 weeks after Ramadan. CLINICAL SIGNIFICANCE: Cortisol as a stress hormone seems to be low during Ramadan.

Stimulated saliva aminotransaminase alteration after experiencing acute hypoxia training.

OBJECTIVE: Acute cypobarih hypoxia is generally recognized to be the most serious single physiological hazard during flight at altitude. Simulation of acute hypoxia in an altitude chamber is used for the training of military aircrew. Acute hypobaric hypoxia affects critical organ systems in different manners. The purpose of this study was to investigate stimulated saliva glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminase (GOT) alteration after the hypobaric hypoxia process. METHODS: A cross-sectional study was performed in 44 normal healthy military aircrew conducted at the hypobaric chamber of physiology at the University of Medical Sciences, Tehran, Iran. The GPT and GOT activities were assayed in stimulated whole saliva before and after the experience of hypobaric hypoxia by the International Federation of Clinical Chemistry method. Statistical analysis of the Student t-test was performed. RESULTS: The mean stimulated saliva GPT activity was significantly higher after the experience of the hypobaric hypoxia process (2.83 ± 0.34 vs. 0.42 ± 0.029 U/L, respectively; P = .001). Saliva GOT activity was also increased after this process (3.32 ± 0.43 vs. 1.22 ± 0.18 U/L, respectively; P = .001). CONCLUSION: Results suggest that subsequent to the experience of the hypobaric hypoxia process, there is a rise in the salivary activities of aminotransferases.

Salivary troponin I as an indicator of myocardial infarction.

BACKGROUND & OBJECTIVES: Accurate and rapid diagnosis of acute myocardial infarction (MI) is of major clinical significance. The troponin is the biomarker of choice for detection of cardiac injury. The objective of this study was to identify salivary levels of cardiac troponin I (cTnI) in patients with acute MI. METHODS: Thirty patients with acute MI and 28 normal healthy individuals were included in the study. cTnI levels were assayed in serum and saliva 12 and 24 h of acute MI by ELISA method. RESULTS: In patients with acute MI, the serum and resting (unstimulated) saliva concentrations of cTnI, but not stimulated saliva cTnI, at both 12 and 24 h of onset of MI, were significantly higher than in controls. Resting saliva cTnI concentrations correlated significantly with serum cTnI levels (spearman rho = 0.34 and 0.45 in the total individuals and in the MI patients respectively). INTERPRETATION & CONCLUSIONS: The present results suggest that saliva can be an analytical matrix for measurement of cTnI in patients with acute MI. Further studies may reveal capability of salivary cTnI for being used for developing point-of-care testing for early detection of MI in pre-clinical settings.

Unstimulated whole saliva 25-hydroxycholecalciferol in patients with xerostomia in menopausal women.

BACKGROUND AND AIM: The aim of this study was to compare unstimulated whole saliva 25-hydroxycholecalciferol (25(OH)D) in menopausal women with and without oral dryness (OD) feeling, and evaluate the relationship between saliva 25(OH)D and severity of OD feeling. METHODS: A case-control study was carried out on 70 selected menopausal women aged 41-77 years with or without OD feeling (35 as case and 35 as control) conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Unstimulated saliva samples were obtained by expectoration. Xerostomia inventory (XI) score was used as an index of OD feeling severity. The saliva 25(OH)D concentration was measured by ELISA. Statistical analysis of Student's t test and Spearman correlation was used. RESULTS: The mean saliva 25(OH)D level was significantly higher in the case group (897.1 ± 128.9 pg/ml), compared with control (156.7 ± 43.4 pg/ml; P < 0.05). XI score correlated significantly with saliva 25(OH)D concentration (r = 0.457, P < 0.001). CONCLUSIONS: It seems that the level of salivary 25(OH)D concentration may be higher in menopausal women with OD feeling than in the control group, and there is a positive correlation between OD feeling severity and unstimulated whole saliva 25(OH)D.

p53 as a neoplastic biomarker in patients with erosive and plaque like forms of oral lichen planus.

AIM: Unstimulated whole salivary p53 was assessed in patients suffering from erosive and plaque-like form of oral lichen planus (OLP). MATERIALS AND METHODS: Eighteen patients with erosive form, 17 patients suffering from plaque-like form and 38 noninvolvement subjects were enrolled. The unstimulated whole saliva p53 level was assayed by ELISA. RESULTS: The mean concentration of salivary p53 was significantly higher in patients with plaque-like form compared to both patients with erosive form and the control group. CONCLUSION: We conclude that plaque like form of OLP is important in view of the potential for malignancy and is not safety form. CLINICAL SIGNIFICANCE: It seems that all forms of OLP must be considered accurately, should be followed up with biannual examinations, and if possible, assessment of salivary p53 every year.

The effects of phase III cardiac rehabilitation in serum and salivary Hs-CRP and anthropometric measurements in patients with coronary artery disease.

AIM: Cardiac rehabilitation is a key part in the treatment of coronary artery disease (CAD) by its anti-infammatory effects. However, the effect of exercise training programs on salivary concentrations of high-sensitivity C-reactive protein (hs-CRP) in patients with coronary artery disease has not been well studied. The objective of this study was to evaluate the effect of phase III cardiac rehabilitation on serum and salivary levels of hs-CRP, in relation to the anthropometric measurements of obesity and the relationship between salivary and serum levels of hs-CRP in CAD male patients. MATERIALS AND METHODS: Forty male volunteers (45-75 years) with CAD participated in 6 to 8 weeks of moderate intensity aerobic exercise training consisting of 45 minutes sessions of treadmill, stationary bicycle and arm ergometer. Anthropometric measurements of obesity, serum level of hs-CRP, stimulated and nonstimulated salivary level of hs-CRP were measured at the beginning, in the middle and at the end of exercise sessions. RESULTS: All anthropometric measurements increased (p < 0.05) following cardiac rehabilitation except waist-hip ratio. Serum hs-CRP level reduced by 36% independent to the anthropometric measurements changes. Stimulated and nonstimulated salivary hs-CRP level decreased 68 and 54%, respectively, after 24 sessions of cardiac rehabilitation. Nonstimulated salivary hs-CRP levels correlated to serum levels of hs-CRP at baseline and after 24 sessions (p < 0.05). CONCLUSION: Phase III cardiac rehabilitation seems to be effective to improve serum and salivary hs-CRP concentrations independent of anthropometric measurements. CLINICAL SIGNIFICANCE: Nonstimulated salivary hs-CRP measurement could be a surrogate for blood measurement of hs-CRP during cardiac rehabilitation in male patients with CAD.

Saliva Levels of Adrenergic Receptors in Relation to Psychological Factors in Patients with Oral Lichen Planus.

OBJECTIVE: To evaluate the saliva level of α1 and ß1 adrenergic receptors (ARs) in oral lichen planus (OLP) patients. METHODS: This case-control study included unstimulated saliva samples from 33 OLP patients (14 erosive, 19 non-erosive) and 33 healthy controls. All participants were evaluated on psychological conditions via the Depression, Anxiety and Stress Scale - 21 items (DASS 21). The saliva levels of α1 and ß1 ARs was measured by enzyme-linked immunosorbent assay (ELISA). Data were analysed with a t test using SPSS 25 (IBM, Armonk, NY, USA). RESULTS: The saliva levels of α1 and ß1 ARs of OLP patients (both erosive and non-erosive forms) were significantly higher than in healthy controls. Stress levels in patients with both forms of OLP were significantly higher than in the healthy group. There was a positive correlation between salivary α1 and ß1 ARs and stress, and this positive correlation was also seen for saliva ß1 ARs between anxiety or depression. The saliva level of α1 ARs was inversely correlated with unstimulated salivary flow rates (r = -0.246; P = 0.046). CONCLUSION: This study indicated that OLP patients with both erosive and non-erosive forms have higher psychological stress and saliva levels of α1 and ß1 ARs than healthy controls; however, the role of α1 and ß1 ARs as salivary markers with regard to the development, severity of symptoms and outcome of OLP needs further investigation.

Saliva and Serum Acetylcholinesterase Activity in Multiple Sclerosis.

Multiple sclerosis is mediated by the immune system that damages the myelin sheath. Most patients experience inflammation. Since one of the factors that have a role in reducing inflammation is acetylcholine, and according to the benefits of saliva, in this study, the level of salivary and serum cholinesterase activity in patients with multiple sclerosis and healthy were evaluated. Thirty women with multiple sclerosis who were hospitalized in the neurology ward of Imam Reza and Hazrat Rasoul Hospitals and 30 healthy females participated in the study. The severity of multiple sclerosis was calculated by expanded disability status scale (EDSS). Saliva and serum samples were collected in the morning. Cholinesterase activity was assessed by a photometric method. The mean cholinesterase activity in stimulated and unstimulated saliva and serum significantly reduced in the multiple sclerosis group. The cutoff for differentiation of multiple sclerosis patients from healthy individuals by assessing cholinesterase activity (IU/L) was 3577 in serum, 241 in unstimulated saliva, and 266 in stimulated saliva. It seems that cholinesterase activity decreases in patients with multiple sclerosis.

Oxidative stress status and DNA damage in saliva of human subjects with oral lichen planus and oral squamous cell carcinoma.

BACKGROUND: The aim of this study was to evaluate oxidative stress status in the saliva of patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). METHODS: Thirty-two patients with OLP, 26 patients with OSCC, and 30 non-involved subjects were enrolled in this study. The study was conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The unstimulated whole saliva malondialdehyde (MDA), as an indicator of lipid peroxidation, the total antioxidant capacity (TAC), and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were assayed by thiobarbituric acid, ferric reducing antioxidant potential (FRAP), and ELISA method, respectively. The TAC/MDA ratio was used as an index of oxidative stress status. Data were analyzed by ANOVA followed by the Tukey's post hoc test. RESULTS AND CONCLUSION: There were no significant differences in saliva TAC and MDA levels between OLP and control, and also between OLP and OSCC patients. MDA and 8-OHdG were significantly higher but TAC was lower in OSCC patients than control. TAC/MDA ratio was significantly lower in patients with OSCC than both OLP patients and control. TAC/MDA ratio was significantly lower but 8-OHdG was higher in patients with OLP compared to control. This suggests that patients with OLP and OSCC are more susceptible to an imbalance of antioxidant-oxidative stress status.

Unstimulated saliva 17ß-estradiol and xerostomia in menopause.

One of the most common oral manifestations of menopause is xerostomia. As gingival tissue is sensitive to changes in the female sex steroids; the aim of this study was to evaluate the relationship between saliva 17ß-estradiol and severity of xerostomia. A case-control study was carried out in 64 selected menopausal women aged 42-75 years with or without xerostomia (32 as case and 32 as control) conducted at the Clinic of Oral Medicine, Tehran university of medical sciences. Xerostomia inventory (XI) score was used as an index of xerostomia severity. The saliva 17ß-estradiol was measured by an enzyme immunoassay kit. The mean unstimulated saliva flow rate and concentration of 17ß-estradiol were significantly lower in case than control. There were significant negative correlation between XI score and unstimulated whole saliva flow rate and also concentration of 17ß-estradiol in menopausal women. It seems that there is a negative correlation between xerostomia severity and saliva 17ß-estradiol in menopausal women.

Saliva-based creatine kinase MB measurement as a potential point-of-care testing for detection of myocardial infarction.

Myocardial infarction (MI) is the main cause of death all over the world. Biomarkers of cardiac necrosis are of great importance in the diagnosis of MI. The aim of this study was to determine probable changes of creatine kinase MB isoform (CK-MB) levels in saliva of patients with acute MI. A case-control study was carried out on 30 patients with acute MI who were hospitalized in Kamkar-Arabnia Hospital of Qom City and 30 healthy control subjects. CK-MB levels were measured by immunoinhibition assay in saliva and serum of patients and healthy individuals. Statistical analysis of the Student's t test and Pearson correlation coefficient was used. CK-MB levels showed a significant elevation in saliva and serum of patients with acute MI compared to healthy controls. Furthermore, there was a strong correlation between salivary levels of CK-MB and its serum values. Subsequent to an acute MI, there is a rise in salivary levels of CK-MB just as what occurs in the serum. Moreover, salivary levels of CK-MB reflect well its serum values. It seems that cardiac biomarker CK-MB is measurable in the saliva of patients with acute MI. Salivary CK-MB may serve as an easy-to-use diagnostic tool for point-of-care testing of acute MI.

Relationship of stimulated whole saliva cortisol level with the severity of a feeling of dry mouth in menopausal women.

OBJECTIVES: To evaluate the relationship of stimulated whole saliva cortisol level with the severity of a feeling of dry mouth (DM) in menopausal women. BACKGROUND: A feel of DM is a major complaint for many elderly individuals and strongly associated with the menopause. The exact mechanisms that mediate sensation of DM in menopausal women have not been firmly established. METHODS: A case-control study was carried out on 104 selected menopausal women with/without a feeling of DM, conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Xerostomia Inventory (XI) score was used as an index of DM severity. Stimulated whole saliva cortisol concentration (stimulated by chewing standard-sized paraffin for 60 s) was measured by ELISA. Statistical analysis by Student's t-test and Spearman correlation was used. RESULTS: The mean cortisol concentration of saliva, but not saliva cortisol output, was significantly higher in the cases than in the controls. There was significant positive correlation between XI score and concentration (r = 0.357, p = 0.000) or output (r = 0.223, p = 0.017) of stimulated whole saliva cortisol. CONCLUSIONS: It appears that stimulated whole saliva cortisol is high in menopausal women with a feeling of DM.

Relationship of serum and saliva calcium, phosphorus and alkaline phosphatase with dry mouth feeling in menopause.

OBJECTIVES: The aim of this study was to compare serum and saliva calcium, phosphorus and alkaline phosphatase of menopausal women with/without dry mouth (DM) feeling. BACKGROUND: The composition of saliva in menopause women with/without DM feeling is different. Some of these differences are in hormones that are related to bone turnover. METHODS: A case-control study was carried out on 60 selected menopausal women aged 45-79 years with or without DM feeling (30 as case, 30 as control), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. The phosphorus concentration was measured by photometrical measurement of the blue colour formed after the addition of ammonium molybdate and stannous chloride; calcium was measured by Arsenazo reaction; and alkaline phosphatase by the pNPP-AMP method. Statistical analysis of Student's t-test was used. RESULTS: The mean serum phosphorus and alkaline phosphatase, stimulated and unstimulated saliva calcium and alkaline phosphatase levels were significantly higher in the menopausal women suffering from DM. There were no significant differences between groups regarding saliva phosphorus and serum calcium concentration. CONCLUSION: Calcium, phosphorus and alkaline phosphatase appear associated with DM feeling in menopause.

Stimulated and unstimulated saliva progesterone in menopausal women with oral dryness feeling.

The aim of this study was to investigate the stimulated and unstimulated salivary progesterone in menopausal women with oral dryness (OD) feeling. A case-control study was carried out on 70 selected menopausal women aged 42-78 years with or without OD feeling (35 as cases with xerostomia and 35 as control without xerostomia), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences (TUMS). Unstimulated and paraffin-stimulated saliva samples were obtained by expectoration. The salivary concentration of progesterone was determined with an enzyme immunoassay kit. Statistical analysis of the Student's t test was used. The mean stimulated and unstimulated whole saliva progesterone concentrations and unstimulated saliva flow, but not stimulated saliva flow rate, was significantly lower in the case than in the control. The results showed that subjects with dry mouth had decreased unstimulated saliva flow and salivary progesterone compared with those without dry mouth. Thus, salivary progesterone level appears associated with OD feeling in menopause.

Serum and saliva levels of cathepsin L in patients with acute coronary syndrome.

AIM: Coronary artery disease (CAD) is the major cause of death nearly all over the world, and accurate and rapid diagnosis of CAD is of major medical and economic importance. The aim of this study was to evaluate the serum and saliva levels of cathepsin L in patients with acute coronary syndrome (ACS). MATERIALS AND METHODS: In a cross-sectional study, 39 patients with ACS and 28 with controls were recruited to the study, and cathepsin L levels were measured in serum, resting saliva, and stimulated saliva obtained 12 and 24 h after the onset of ACS by ELISA method. Statistical analyses of Fisher's exact test, the Student's t-test or Kruskal-Wallis test were performed. RESULTS: Stimulated saliva cathepsin L levels in patients with ACS 12 hours but not 24 hours after admission showed significant decrease compared with that in control subjects. However, there were no significant differences in serum and unstimulated saliva cathepsin L levels between groups. CONCLUSION: Serum and saliva levels of cathepsin L remain unchanged in patients with ACS and hence may not be a promising factor in CAD risk assessment. CLINICAL SIGNIFICANCE: It seems that serum and saliva cathepsin L may not be a good biomarker for CHD. ABBREVIATIONS: CAD: Coronary artery disease, ACS: Acute coronary syndrome, CHD: Coronary heart disease, EU: Emergency unit, MI: Myocardial infarction. KEYWORDS: Cathepsin L, Acute coronary syndrome, Resting saliva, Stimulated saliva. How to cite this article: Mirzaii-Dizgah I, Riahi E. Serum and Saliva Levels of Cathepsin L in Patients with Acute Coronary Syndrome. J Contemp Dent Pract 2011;12(2):114-119.

Unstimulated whole saliva parathyroid hormone in postmenopausal women with xerostomia.

OBJECTIVE: The aim of this study was to evaluate the correlation of xerostomia severity with unstimulated saliva parathyroid hormone (PTH) and to compare unstimulated whole saliva PTH between postmenopausal women with/without xerostomia. METHODS: A case-control study was carried out in 60 (30 as case and 30 as control) selected postmenopausal women with/ without xerostomia conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Xerostomia inventory (XI) score was also used as an index of xerostomia severity. PTH concentration was analyzed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis of Student's t-test and Spearman correlation was used. RESULTS: The mean unstimulated saliva PTH concentration was significantly higher but flow rate was lower in the case group compared with control. XI score correlated significantly with saliva PTH (r = 0.688, p = 0.001) and flow rate (r = - 0.529, p = 0.001). CONCLUSION: Xerostomia severity correlated positively with unstimulated whole saliva PTH and negatively with saliva flow rate in this group of postmenopausal women. Thus, salivary flow rate and PTH levels appear associated with xerostomia and menopause. CLINICAL SIGNIFICANCE: Salivary PTH level appears to be associated with xerostomia and menopause.