Clinical factors influencing the resting and stimulated salivary flow
Shigeo Yamachika, Ken Yamamoto, Yoshiaki Nomura, Hiroyuki Yamada, Ichiro Saito, Yoichi Nakagawa
Department of Clinical Pathophysiology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Department of Geriatric Dentistry, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Department of Oral Medicine and Stomatology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Department of Pathology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Department of Translational Research, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
DOI: 10.4236/ojst.2012.22019   PDF   HTML     4,912 Downloads   8,028 Views   Citations


Objective: The objective of this study was to examine the clinical and immunological factors influ encing sialometry in xerostomia patients. Method: The association between sialometry and other clinical examinations were investigated in a cross-sectional study. A total of 179 dry mouth patients showing hyposalivation who underwent a clinical examination were enrolled in this study. Multiple regression analyses were employed to examine the relative con-tributions of clinical and immunological factors including age, gender, parotid sialography, labial Salivary gland biopsy, anti-Ro/SS-A antibodies, and anti-La/SS-B antibodies to the resting (RSF) or stimulated saliva flow rate (SSF). Results: An increase of the stage of sialography, the grade of a labial biopsy, and the presence of anti-La/SS-B antibody had a significant correlation with a decrease of sialometry. Results of the multiple regression analysis showed that age (standardized coefficient = -0.244), grade of lip biopsy (-0.189), and anti-SS-B antibody (-0.171), were significantly associated with the RSF. The stage of sialography (?0.423) and age (-0.169) were significantly related to the sialometry in the SSF according to a multiple regression analysis. Conclusion: The results of this study suggest that the measurement of RSF reflects the immunological factors and SSF reflects the damage to the parotid gland.

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Yamachika, S. , Yamamoto, K. , Nomura, Y. , Yamada, H. , Saito, I. and Nakagawa, Y. (2012) Clinical factors influencing the resting and stimulated salivary flow. Open Journal of Stomatology, 2, 103-109. doi: 10.4236/ojst.2012.22019.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Fox, R.I. (2005) Sjogren;s syndrome. Lancet, 366, 321- 331.doi:10.1016/S0140-6736(05)66990-5
[2] Kalk, W.W., Vissink, A., Spijkervet, F.K., Bootsma, H., Kallenberg, C.G. and Roodenburg, J.L. (2002). Parotid sialography for diagnosing Sjogren syndrome. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics, 94, 131-137.
[3] Fox, R.I. and Saito, I. (1994) Criteria for diagnosis of Sjogren’s syndrome. Rheumatic Disease Clinics of North America, 20, 391-407.
[4] Vitali, C., Bombardieri, S., Jonsson, R., Moutsopoulos, H.M., Alexander, E.L., Carsons, S.E., Daniels, T.E., Fox, P.C., Fox, R.I., Kassan, S.S., Pillemer, S.R., Talal, N. and Weisman, M.H. (2002) Classification criteria for Sj?gren’s syndrome: A revised version of the European criteria proposed by the American-European Consensus Group. Annals of the Rheumatic Diseases, 61, 554-558. doi:10.1136/ard.61.6.554
[5] Fujibayashi, T., Sugai, S., Miyasaka, N., Hayashi, Y. and Tsubota K. (2004) Revised Japanese criteria for Sj?grens syndrome: Availability and validity. Modern Rheumatology, 14, 425-434. doi:10.1007/s10165-004-0338-x
[6] Konttinen, Y.T., Hukkanen, M., Kemppinen, P., Segerberg, M., Sorsa, T., Malmstrom, M., Rose, S., Itescu, S. and Polak, J.M. (1992) Peptide-containing nerves in labial salivary glands in Sjogren’s syndrome. Arthritis & Rhe-umatism, 35, 815-820.doi:10.1002/art.1780350717
[7] Beroukas, D., Goodfellow, R., Hiscock, J., Jonsson, R., Gordon, T.P. and Waterman, S.A. (2002) Up-regulation of M3-muscarinic receptors in labial salivary gland acini in primary Sjogren’s syndrome. Laboratory Investigation, 82, 203-210.
[8] Robinson, C.P., Brayer, J., Yamachika, S., Esch, T.R., Peck, A.B., Stewart, C.A., Peen, E., Jonsson, R. and Humphreys-Beher, M.G. (1998) Transfer of human serum IgG to nonobese diabetic Igmu null mice reveals a role for autoantibodies in the loss of secretory function of exocrine tissues in Sjogren’s syndrome. Proceedings of the National Academy of Sciences of the USA, 95, 7538- 7543.doi:10.1073/pnas.95.13.7538
[9] Navazesh, M. and Christensen, C.M. (1982) A compareson of whole mouth resting and stimulated salivary measurement procedures. Journal of Dental Research, 61, 1158-1162. doi:10.1177/00220345820610100901
[10] Rubin, P. and Holt, J.F. (1957) Secretory sialography in diseases of the major salivary glands. American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine, 77, 575-598.
[11] Greenspan, J.S., Daniels, T.E., Talal, N. and Sylvester, R.A. (1974) The histopathology of Sjogren’s syndrome in labial salivary gland biopsies. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics, 37, 217-229.
[12] Baum, B.J. (1981) Evaluation of stimulated parotid saliva flow rate in different age groups. Journal of Dental Research, 60, 1292-1296. doi:10.1177/00220345810600070101
[13] Heft, M.W. and Baum, B.J. (1984) Unstimulated and stimulated parotid salivary flow rate in individuals of different ages. Journal of Dental Research, 63, 1182-1185. doi:10.1177/00220345840630100101
[14] Osterberg, T., Birkhed, D., Johansson, C. and Svanborg, A. (1992) Longitudinal study of stimulated whole saliva in an elderly population. Scandinavian Journal of Dental Research, 100, 340-345.
[15] Ship, J.A. and Baum, B.J. (1990) Is reduced salivary flow normal in old people? Lancet, 336, 1507. doi:10.1016/0140-6736(90)93212-8
[16] Wu, A.J., Atkinson, J.C., Fox, P.C., Baum, B.J. and Ship, J.A. (1993) Cross-sectional and longitudinal analyses of stimulated parotid salivary constituents in healthy, dif- ferent-aged subjects. Journals of Gerontology, 48, M219- M224.
[17] Scott, J., Flower, E.A. and Burns, J. (1987) A quantitative study of histological changes in the human parotid gland occurring with adult age. Journal of Oral Pathology, 16, 505-510.doi:10.1111/j.1600-0714.1987.tb00681.x
[18] Scott, J. (1977) Degenerative changes in the histology of the human submandibular salivary gland occurring with age. Journal de Biologie Buccale, 5, 311-319.
[19] Nagler, R.M. and Hershkovich, O. (2005) Relationships between age, drugs, oral sensorial complaints and Salivary profile. Archives of Oral Biolog, 50, 7-16. doi:10.1016/j.archoralbio.2004.07.012
[20] Pedersen, W., Schubert, M., Izutsu, K., Mersai, T. and Truelove, E. (1985) Age-dependent decreases in human submandibular gland flow rates as measured under resting and post-stimulation conditions. Journal of Dental Research, 64, 822-825. doi:10.1177/00220345850640050801
[21] Gresik, E.W. and Azmitia, E.C. (1980) Age related changes in NGF, EGF and protease in the granular convoluted tubules of the mouse submandibular gland. A morphological and immunocytochemical study. Journals of Gerontology, 35, 520-524.
[22] Gresik, E.W. (1989) Changes with senescence in the fine structure of the granular convoluted tubule of the sub- mandibular gland of the mouse. American Journal of Anatomy, 184, 147-156. doi:10.1002/aja.1001840206
[23] Ishikawa, Y., Gee, M.V., Ambudkar, I.S., Bodner, L., Baum, B.J. and Roth, G.S. (1988) Age-related impairment in rat parotid cell alpha 1-adrenergic action at the level of inositol trisphosphate responsiveness. Biochimica et Biophysica Acta, 968, 203-210. doi:10.1016/0167-4889(88)90009-2
[24] Hiratsuka, K., Kamino, Y., Nagata, T., Takahashi, Y., Asai, S., Ishikawa, K. and Abiko, Y. (2002) Microarray analysis of gene expression changes in aging in mouse submandibular gland. Journal of Dental Research, 81, 679-682. doi:10.1177/154405910208101005
[25] Houghton, K., Malleson, P., Cabral, D., Petty, R. and Tucker, L. (2005) Primary Sjogren’s syndrome in children and adolescents: Are proposed diagnostic criteria applicable? Journal of Rheumatology, 32, 2225-2232.
[26] Dawes, C. (1996) Factors influencing salivary flow rate and composition. In: Edgar, W.E., O’Mullane, D.M., Eds., Saliva and Oral Health, 2nd Edition, Brithsh Dental As- sociation, London, 27-41.
[27] Cha, S., Peck, A.B. and Humphreys-Beher, M.G. (2002) Progress in understanding autoimmune exocrinopathy using the non-obese diabetic mouse: An update. Critical Reviews in Oral Biology & Medicine, 13, 5-16. doi:10.1177/154411130201300103
[28] Haneji, N., Nakamura, T., Takio, K., Yanagi, K., Higashiyama, H., Saito, I., Noji, S., Sugino, H. and Hayashi, Y. (1997) Identification of alpha-fodrin as a candidate autoantigen in primary Sjogren’s syndrome. Science, 276, 604-607. doi:10.1126/science.276.5312.604
[29] Robinson, C.P., Yamachika, S., Alford, C.E., Cooper, C., Pichardo, E.L., Shah, N., Peck, A.B. and Humphreys-Beher, M.G. (1997) Elevated levels of cysteine protease activity in saliva and salivary glands of the nonobese diabetic (NOD) mouse model for Sjogren syndrome. Proceedings of the National Academy of Sciences of the USA, 94, 5767-5771. doi:10.1073/pnas.94.11.5767
[30] Robinson, C.P., Bounous, D.I., Alford, C.E., Nguyen, K.H., Nanni, J.M., Peck, A.B. and Humphreys-Beher, M.G. (1997) PSP expression in murine lacrimal glands and function as a bacteria binding protein in exocrine secretions. American Journal of Physiology, 272, G863- G871.
[31] Humphreys-Beher, M.G., Brinkley, L., Purushotham, K.R., Wang, P.L., Nakagawa, Y., Dusek, D., Kerr, M., Chegini, N. and Chan, E.K. (1993) Characterization of antinuclear autoantibodies present in the serum from nonobese diabetic (NOD) mice. Clinical Immunology & Immunopathology, 68, 350-356. doi:10.1006/clin.1993.1137
[32] Saito, T., Fukuda, H., Arisue, M., Matsuda, A., Shindoh, M., Amemiya, A. and Ohmori, K. (1991) Relationship between sialographic findings of parotid glands and histopathologic finding of labial glands in Sjogren’s syndrome. Relation to clinical and immunologic findings. Oral Surgery, Oral Medicine, Oral Pathology, 72, 675- 680.doi:10.1016/0030-4220(91)90009-2
[33] Matsumura, R., Umemiya, K., Kagami, M., Tomioka, H., Tanabe, E., Sugiyama, T., Sueishi, M., Nakajima, A., Azuma, M., Okumura, K. and Sumida, T. (1998) Glandular and extraglandular expression of the Fas-Fas ligand and apoptosis in patients with Sjogren’s syndrome. Clinical & Experimental Rheumatology, 16, 561-568.

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