Salivary IgG Research Articles

Immunophenotyping in Saliva as an Alternative Approach for Evaluation of Immunopathogenesis in Chronic Periodontitis

To date, flow cytometric immunophenotyping has not been used to investigate immune patterns in saliva samples from individuals with inflammatory processes in the oral cavity, such as chronic periodontitis (CP). Saliva analysis could be a non-invasive method for evaluating oral health. The objective of this study is to determine the phenotype of leukocytes and total immunoglobulin A (IgA), IgG, and IgM titers in the saliva of individuals with CP. Saliva samples were obtained from patients with CP (n = 12) and from a control group (n = 27) without oral diseases. Flow cytometry was performed to determine the frequency of T cells (CD4(+) and CD8(+)), B cells, and natural killer (NK) cells as well as the total leukocyte population. Immunoglobulin titers were determined by dot enzyme-linked immunosorbent assay. Cell immunophenotyping revealed that patients with CP had a higher frequency of total leukocytes (47.94% ± 5.1%; P < 0.001), B cells (43.93% ± 6.2%; P = 0.006), NK cells (0.16% ± 0.04%; P = 0.03), and CD4(+) T cells (38.99% ± 4.4%; P = 0.002) than individuals without oral pathologies (24.75% ± 2.2%, 20.60% ± 2.7%, 0.09% ± 0.03%, and 16.82% ± 3.5%, respectively). No significant differences in salivary total IgA, IgG, and IgM titers were found between the two cohorts studied. Nevertheless, higher total IgG levels were observed in patients with CP, which could indicate a possible correlation between clinical attachment level and salivary IgG (P = 0.07; r(2) = 0.08). These results show that cell phenotyping by flow cytometry could be an effective tool for determining leukocyte profiles in saliva samples from patients with CP and healthy individuals.

Evaluation of salivary and serum anti-Helicobacter pylori in Egyptian patients with H. pylori related gastric disorders.

Helicobacter pylori is a common and important transmissible bacterial human pathogen. Although several diagnostic tests are available for the detection of H. pylori infection, all of them have both advantages and disadvantages, and none can be considered as a single gold standard. Serological methods analyzing (serum and saliva) by using enzyme immunoassays, which are simple, reproducible and inexpensive, can detect either antigen or antibody. This study evaluated the frequency of anti- H. pylori serum and salivary antibodies positivity among Egyptian patients with gastric disorders and the validity of salivary, serum serological tests for diagnosis of H. pylori, comparing this with gold standard tests performed on endoscopy biopsy. This prospective, case-controlled study included 45 Egyptian patients who attended Ain Shams University Hospitals Cairo, Egypt between January 2013 and June 2013. There were 29 males &16 females their mean age was 51.78 +/- 7 (range 18-60). Among the ulcerogenic drugs, Aspirin was the most common drug (46.7%). The evidence revealed the sensitivity of Rapid Urease Test (RUT) was 100%, specificity was 71.4%, Positive Predictive value (PPV) was 88.6% and Negative Predictive value (NPV) was 100%. The sensitivity of serum IgG was 68.97% and specificity was 42.86%; while the sensitivity of serum IgA was 89.6% and the specificity was 50%. Correlating the salivary IgG results with H. pylori status diagnosed by culture, salivary IgG succeeded to diagnose 19 cases from the 31 positive H. pylori patients with a sensitivity of 63.33% & specificity of 92.86% whereas the results of salivary IgA showed a sensitivity of 80% and specificity of 92.86%.

Frequency of Salivary Human Cytomegalovirus in Iraqi Patients with Chronic Periodontitis

Background: Periodontitis is a chronic inflammatory disease which is initiated by an infection of the oral microorganisms and it involves the humoral and cellular characteristics of the host response. The periodontal disease is found to develop due to a series of interactions among the periodontotrophic herpes viruses, the periodontopathic bacteria and the host immune reactions.Recent studies have demonstrated that various human viruses, especially human cytomegalovirus seems to play a part in the pathogenesis of periodontitis. Periodontitis is an infectious disease involving specific bacteria and viruses.Objectives: The present study was initiated to evaluate the percentage of human cytomegalovirus in periodontitis patients and determine the correlation between levels of human cytomegalovirus IgG and each of plaque index, gingival index and oral hygiene.Subjects and Methods: Thirty five periodontitis patients and eighteen healthy control subjects were included in this study. Saliva samples were taken from all subjects (patients and healthy). Salivary IgG agianst human cytomegalovirus was estimated by using enzyme-linked immunosorbent assays.Results: The current study showed that the frequency of human cytomegalovirus in chronic periodontitis patients was significantly higher than in healthy control group p&lt;0.05. On the other hand the current study failed to observe any significant correlation between salivary IgG and each of plaque index and gingival index, whereas higher significant correlation was observed with oral hygiene, (P&lt;0.05).Conclusion: Findings of the present study suggest that the frequent present of human cytomegalovirus in saliva of chronic periodontitis patients could have a crucial role in development of this disease.

PLACEBO-DRIVEN CLINICAL TRIALS OF TRANSFER POINT GLUCAN #300 IN CHILDREN WITH CHRONIC RESPIRATORY PROBLEMS: ANTIBODY PRODUCTION

The role of glucan in stimulation of immune reactio ns has been well-established. In this report, we fo cused on the antibody production in glucan-supplemented children with chronic respiratory problems. We measured the levels of salivary IgA, IgM and IgG in 40 children aged 8-12 years and evaluated the effe cts of 100 mg d -1 oral dose of glucan. We found a significant increa se in production of all tested antibodies in the glucan-stimulated group, but a decrease of anti body production in the control group. A thirty-day oral application of yeast-based natural immunomodulator β-glucan strongly stimulated the mucosal immunity of children with chronic respiratory problems.

Evaluation of Serum and Salivary IgG in Head and Neck Squamous Cell Carcinoma

Aims: To evaluate salivary and serum IgG levels in patients with head and neck squamous cell carcinoma (HNSCC) and healthy control subjects and to assess the effect of treatment on IgG levels. Study Design: A cross sectional study.

Periodontal status, salivary immunoglobulin, and microbial counts after short exposure to an isolated environment

Salivary flow rate, immunoglobulin, and periodontal status were affected during a simulated Skylab mission. The effect is more prominent after long-duration space flights and can persist for several weeks after landing. The objective of this study was to determine the effect of a simulated Mars environment on periodontal status and levels of salivary microorganisms and immunoglobulins in the human oral cavity. Twelve healthy male volunteers were studied before, at 1 and 2 weeks, and after completion of a mission in an isolated, confined simulated Mars environment at the Mars Desert Research Station, USA. We conducted a current stress test, measured salivary immunoglobulin, cortisol, α-amylase, salivary flow rate, and levels of plaque and salivary microbes, and assessed clinical periodontal parameters (probing depth, bleeding on probing, and clinical loss of attachment). Salivary IgG levels and Streptococcus mutans activity were significantly higher at 1 week. Values for clinical periodontal parameters (probing depth, bleeding on probing, and clinical loss of attachment) significantly differed at 1 week. Stress might be caused by the difficulty of the mission rather than the isolated environment, as mission duration was quite short. Periodontal condition might worsen due to poor oral hygiene during the mission. The present findings show that all periodontal conditions and levels of oral bacteria and stress after completion of the simulated Mars mission differed from those at baseline. To verify the relationship between stress status and periodontal health in simulated Mars missions, future studies using larger patient samples and longer follow-up will be required.

Salivary Immune Responses to the 7-Valent Pneumococcal Conjugate Vaccine in the First 2 Years of Life

BackgroundThe CRM197-conjugated 7-valent pneumococcal vaccine (PCV7) is protective against vaccine serotype disease and nasopharyngeal carriage. Data on PCV7-induced mucosal antibodies in relation to systemic or natural anticapsular antibodies are scarce.MethodsIn a randomized controlled setting, children received PCV7 at age 2 and 4 months (2-dose group), at age 2, 4 and 11 months (2+1-dose group) or no PCV7 (control group). From 188 children paired saliva samples were collected at 12 and 24 months of age. From a subgroup of 15 immunized children also serum samples were collected. IgG and IgA antibody-levels were measured by multiplex immunoassay.ResultsAt 12 months, both vaccine groups showed higher serum and saliva IgG-levels against vaccine serotypes compared with controls which sustained until 24 months for most serotypes. Salivary IgG-levels were 10–20-fold lower compared to serum IgG, however, serum and saliva IgG-levels were highly correlated. Serum and salivary IgA-levels were higher in both vaccine groups at 12 months compared with controls, except for serotype 19F. Higher salivary IgA levels remained present for most serotypes in the 2+1-dose group until 24 months, but not in the 2-dose group. Salivary IgA more than IgG, increased after documented carriage of serotypes 6B, 19F and 23F In contrast to IgG, salivary IgA-levels were comparable with serum, suggesting local IgA-production.ConclusionsPCV7 vaccination results in significant increases in salivary IgG and IgA-levels, which are more pronounced for IgG when compared to controls. In contrast, salivary anticapsular IgA-levels seemed to respond more to natural boosting. Salivary IgG and IgA-levels correlate well with systemic antibodies, suggesting saliva might be useful as potential future surveillance tool.

Wound healing and mucosal immunity during short Mars analog environment mission: salivary biomarkers and its clinical implications.

Wound healing in an extreme environment with micro-gravity is not well characterized, despite the likelihood that the increasing use of manned spaceflight as a research and commercial enterprise raises the probability of traumatic injury in this state. Hence, this study was conducted to determine the impact of the isolated environment of the Mars Desert Research Station on mucosal immunity and wound healing. Two punch biopsy wounds were placed on the hard palate of two crewmembers. The first wound was made during summer vacation, whereas the second was placed on the contra-lateral side 3 days before the Mars analog mission began. Thus, each crewmember served as his/her own control. Two independent methods were used to assess healing. A ten-item perceived stress scale, salivary cortisol, Immunoglobulin A, IgG and IgM were measured. There were significant differences in the proportion of the wound size healed between vacation and the mission. Salivary IgA, IgM, IgG and cortisol levels showed significant differences between vacation and mission. These data suggest that stress can have significant consequences for wound healing. The effects of stress on wound repair could have important clinical implications, including for recovery from surgery.

Saliva and sera IgA and IgG in Egyptian Giardia-infected children

Giardiasis is a gastrointestinal infection of wide distribution that is more prevalent in childhood. Easy and rapid diagnosis of giardiasis is essential for reduction of this infection. This cross-sectional study included 62 children in which collection of saliva, stool and serum samples was performed. An enzyme-linked immunosorbent assay (ELISA) technique was evaluated to detect IgA and IgG responses in both saliva and serum samples. Twenty-two children were positive for Giardia duodenalis infection by direct examination of faecal specimens, 20 non-infected and 20 infected with other parasites. Salivary and serum IgA and IgG responses against G. duodenalis infection were significantly higher in Giardia parasitized than non-Giardia parasitized children (p < 0.001). This concludes that specific salivary IgA may serve as a diagnostic tool and specific salivary IgG as a screening tool in monitoring the exposure of various populations to Giardia duodenalis. The advantage of salivary assays over serum immunoglobulin assay is being easy and non-invasive in sampling technique which is important especially for young children.

Salivary IgA and IgG in oral lichen planus and oral lichenoid reactions diseases

Background:The objective of this study was to assess the level of salivary IgA and IgG in oral lichen planus (OLP) and oral lichenoid reactions (OLR) patients as diagnostic factors to the differential diagnosis of OLP, OLR diseases.Materials and Methods:Saliva sample were obtained from 50 OLP, 50 OLR patients and 50 healthy subjects between April 2010 and October 2011. The clinical relevant data taken into account were: Demographical data, previous medication, and level of salivary IgA and IgG. Each sample was assessed to determine the level of salivary IgA by ELISA test and salivary IgG by radial immune diffusion.Results:The mean of salivary IgA and IgG in patients were 119.01 ± 114.18 mic/ml and 3.25 ± 1.81 mic/ml, respectively. There were no significant differences for salivary IgA and IgG between OLP and OLR, but the mean of salivary IgA and IgG in OLP and OLR patients were significantly more than normal group (P-value < 0.05). The cut-off value was set at >72 mic/ml for salivary IgA in both OLP and OLR groups and set at >3.7 mic/ml for salivary IgG. On comparing the AUCs, there was no significant difference between AUCs for IgA (0.715 ± 0.05vs. 0.69 ± 0.5, for OLP and OLR patients, respectively,P-value = 0.7) and IgG (0.681 ± 0.05 vs. 0.548 ± 0.06, for OLP and OLR patients, respectively, P-value = 0.1).Conclusions:Our results showed that the level of salivary IgA and IgG in OLP and OLR patients is higher than healthy controls, but they cannot be used as diagnostic factors to the differential diagnosis of OLP and OLR.

Immunoglobulin Levels and Periodontal Diseases-A Clinical Immunological Study

There is little doubt that immunological mechanisms play an important role in the pathogenesis of periodontal diseases. Studies conducted so far have yielded contradicting results with regard to the immunoglobulin levels and also varying results after therapy. Hence, the present study was undertaken to study the levels of immunoglobulins-G, A and M in the serum and saliva of patients with periodontal disease. 40 systemically healthy subjects-10 cases of chronic periodontitis with 10 age and sex-matched controls and 10 cases of aggressive periodontitis with 10 age and sex-matched controls were included in the study. The serum and salivary Ig-G, A, and M levels were analyzed by immunoturbidimetry before and 6-8 weeks after Phase I therapy. In both the groups, there was increase in the immunoglobulin levels in cases compared to the controls, but individual variations were observed. There was a modest decline in the immunoglobulin levels after phase I therapy, but in some cases the levels increased after therapy. Therefore, further long-term studies with a larger sample population and with more definitive treatment procedures like periodontal surgery should be undertaken.

Diagnostic values of parasite-specific antibody detections in saliva and urine in comparison with serum in opisthorchiasis

Infection by the liver fluke ( Opisthorchis viverrini) causes hepatobiliary disease and bile duct cancer (cholangiocarcinoma, CCA) in endemic areas in Southeast Asia. Measurements of humoral immune response particularly parasite-specific antibodies are useful not only for serodiagnosis but they have been implicated as risk factors of CCA. In this study, we used indirect Enzyme Immunosorbent Assay (ELISA) to measure O. viverrini-specific immunoglobulins in serum, urine and saliva and assessed efficacies in diagnosis of opisthorchiasis and evaluated the relationship of antibodies among clinical specimens in a sample population in endemic areas in Khon Kaen, Thailand. By employing the Receiver Operation Characteristics (ROC) analysis, diagnostic efficacy based upon the area under the curve (AUC) revealed that serum, salivary IgG and IgA performed better than urine for diagnosis of opisthorchiasis. Seropositive cases were found in both parasite egg-negative as well as O. viverrini egg-positive groups. The levels of serum IgG correlated with intensity of O. viverrini infection ( P < 0.05). Diagnostic sensitivities based on serum and salivary IgG, IgA also positively associated with the intensity of infection. Correlations between serum antibodies and those in saliva were found to be greater in egg-negative than egg-positive individuals for O. viverrini. Our findings indicated a complex interrelation between antibody responses in different clinical specimens triggered by liver fluke infection. More comprehensive examinations are needed to determine the potential utility of salivary antibody detection which, in combination with the conventional fecal examination method, may better assist in the identification of individuals with opisthorchiasis. Furthermore, it may provide a better indicator of the risk of disease, particularly CCA.

REnolase Maternal Immunization Confers Caries Protection on Offspring

Therapeutic vaccination with Streptococcus sobrinus recombinant enolase (rEnolase) protects rats from dental caries. Here, we investigated the effect that maternal rEnolase vaccination before pregnancy had on the offspring’s immune response to S. sobrinus oral infection and dental caries progression. Female Wistar rats were immunized by intranasal and subcutaneous routes with rEnolase adsorbed onto aluminum hydroxide as adjuvant or similarly treated with the adjuvant alone (sham-immunized). Ten days after the last administration, the immunized females were paired with a male rat. The oral immune responses to S. sobrinus infection and dental caries in the offspring were evaluated. The results showed that pups born from rEnolase-immunized mothers had higher levels of rEnolase-specific salivary IgA and IgG antibodies (indicating a placental antibody transfer) and lower sulcal and proximal enamel caries scores than rats born from sham-immunized mothers. In conclusion, rEnolase maternal immunization before pregnancy provides offspring with protection against S. sobrinus-induced dental caries.

Characterization of Gingival Th1, Th2 and Th17 Cells in Murine Periodontitis Model

Cellular and molecular mechanisms of the immune system influencing oral bone metabolism remain to be elucidated. In this study, we characterize the mucosal cytokine production by CD4+ T cells in the inflamed gingiva of mice infected with Porphyromonas gingivalis (P. gingivalis). A murine periodontal disease model with alveolar bone loss showed significant levels of FimA-specific salivary secretory IgA and plasma IgG Ab responses. Further, IL-6 and TNF-α production was elevated when compared with sham-infected mice. The frequencies of Th1 (IFN-γ), Th2 (IL-4) and Th17 (IL-17) producing CD4+ T cells were also increased in P. gingivalis infected mice. Among these cytokines, a significantly higher frequency of IFN-γ producing CD4+ T cells was noted. The kinetics of intracellular cytokine analyses revealed a significantly increased frequency of IFN-γ-, IL-4- and IL-17-producing CD4+ T cells one day after infection. Further, the frequency of IFN-γ producing CD4+ T cells was maintained throughout the experimental period. Although IL-4 and IL-17 production was intact until 15 days after the infection, the numbers of CD4+ T cells producing these cytokines were reduced thereafter. These results indicate that Th1-type CD4+ T cells play distinct roles in the induction and regulation of periodontal disease when compared with Th2- and Th17-type cytokine-producing CD4+ T cells.

Development of a multiplex microsphere immunoassay for the quantitation of salivary antibody responses to selected waterborne pathogens

Saliva has an important advantage over serum as a medium for antibody detection due to non-invasive sampling, which is critical for community-based epidemiological surveys. The development of a Luminex multiplex immunoassay for measurement of salivary IgG and IgA responses to potentially waterborne pathogens, Helicobacter pylori, Toxoplasma gondii, Cryptosporidium, and four noroviruses, involved selection of antigens and optimization of antigen coupling to Luminex microspheres. Coupling confirmation was conducted using antigen specific antibody or control sera at serial dilutions. Dose–response curves corresponding to different coupling conditions were compared using statistical tests. Control proteins in the specific antibody assay and a separate duplex assay for total immunoglobulins G and A were employed to assess antibody cross-reactivity and variability in saliva composition. 200 saliva samples prospectively collected from 20 adult volunteers and 10 paired sera from a subset of these volunteers were used to test this method. For chronic infections, H. pylori and T. gondii, individuals who tested IgG seropositive using commercial diagnostic ELISA also had the strongest salivary antibody responses in salivary antibody tests. A steep increase in anti-norovirus salivary antibody response (immunoconversion) was observed after an episode of acute diarrhea and vomiting in a volunteer. The Luminex assay also detected seroconversions to Cryptosporidium using control sera from infected children. Ongoing efforts involve further verification of salivary antibody tests and their application in larger pilot community studies.

Anti-Influenza Serum and Mucosal Antibody Responses After Administration of Live Attenuated or Inactivated Influenza Vaccines to HIV-Infected Children

Live-attenuated influenza vaccine (LAIV) prevents more cases of influenza in immune-competent children than the trivalent inactivated vaccine (TIV). We compared the antibody responses to LAIV or TIV in HIV-infected children. Blood and saliva obtained at enrollment, 4 and 24 weeks postimmunization from 243 HIV-infected children randomly assigned to TIV or LAIV were analyzed. Both vaccines increased the anti-influenza neutralizing antibodies at 4 and 24 weeks postimmunization. At 4 weeks postimmunization, TIV recipients had 2-fold to 3-fold higher neutralizing antibody titers than LAIV recipients, but the proportions of subjects with protective titers (≥ 1:40) were similar between treatment groups (96%-100% for influenza A and 81%-88% for influenza B). Both vaccines increased salivary homotypic IgG antibodies, but not IgA antibodies. Both vaccines also increased serum heterosubtypic antibodies. Among HIV-specific characteristics, the baseline viral load correlated best with the antibody responses to either vaccine. We used LAIV-virus shedding as a surrogate of influenza infection. Influenza-specific humoral and mucosal antibody levels were significantly higher in nonshedders than in shedders. LAIV and TIV generated homotypic and heterosubtypic humoral and mucosal antibody responses in HIV-infected children. High titers of humoral or mucosal antibodies correlated with protection against viral shedding.

Detection of salivary antibodies to crude antigens of Opisthorchis viverrini in opisthorchiasis and cholangiocarcinoma patients

Opisthorchis viverrini (O. viverrini; known as human liver fluke) is a major health problem in the northeastern region of Thailand. Infection with O. viverrini is the cause of hepatobiliary disease and cholangiocarcinoma (CCA). Previous studies demonstrated specific antibodies to crude O. viverrini antigens in serum from O. viverrini-infected patients. However, no studies have measured specific antibodies to O. viverrini antigens in saliva from patients with opisthorchiasis and CCA. The objective of the study was to detect specific antibodies to crude O. viverrini antigens in saliva from patients with opisthorchiasis and CCA, and to evaluate their use for diagnosis of O. viverrini infection. Saliva samples from 23 control subjects, 30 opisthorchiasis patients, and 38 CCA patients were collected. ELISA was established for detection of salivary IgA and IgG to crude O. viverrini antigens. ANOVA was used to compare salivary IgA and IgG levels among groups. Salivary IgA to crude O. viverrini antigens in CCA patients was significantly higher than controls (p = 0.007). Salivary IgG in CCA patients was significantly higher than opisthorchiasis patients and controls (p = 0.010 and p < 0.001, respectively). The cut-off value from salivary IgG test demonstrated higher accuracy for positivity of O. viverrini infection than salivary IgA. In conclusion, specific antibodies to crude O. viverrini antigens were detected in saliva of patients with opisthorchiasis and CCA. Salivary antibodies reflect serum immune response to O. viverrini infection, and salivary IgG tends to be a good candidate for diagnosis of O. viverrini infection.

Recent Diarrhea is Associated with Elevated Salivary IgG Responses to Cryptosporidium in Residents of an Eastern Massachusetts Community

Serological data suggest that Cryptosporidium infections are common but underreported. The invasiveness of blood sampling limits the application of serology in epidemiological surveillance. We pilot-tested a non-invasive salivary anti-Cryptosporidium antibody assay in a community survey involving children and adults. Families with children were recruited in a Massachusetts community in July; symptoms data were collected at 3 monthly follow-up mail surveys. One saliva sample per person (n = 349) was collected via mail, with the last survey in October. Samples were analyzed for IgG and IgA responses to a recombinant C. hominis gp15 sporozoite protein using a time-resolved fluorometric immunoassay. Log-transformed assay results were regressed on age using penalized B-splines to account for the strong age-dependence of antibody reactions. Positive responses were defined as fluorescence values above the upper 99% prediction limit. Forty-seven (13.5%) individuals had diarrhea without concurrent respiratory symptoms during the 3-month-long follow-up; eight of them had these symptoms during the month prior to saliva sampling. Two individuals had positive IgG responses: an adult who had diarrhea during the prior month and a child who had episodes of diarrhea during each survey month (Fisher's exact test for an association between diarrhea and IgG response: p = 0.0005 for symptoms during the prior month and p = 0.02 for symptoms during the entire follow-up period). The child also had a positive IgA response, along with two asymptomatic individuals (an association between diarrhea and IgA was not significant). These results suggest that the salivary IgG specific to Cryptosporidium antigens warrants further evaluation as a potential indicator of recent infections.

Minor salivary gland immunohistology in the diagnosis of primary Sjögren’s syndrome

Focal lymphocytic infiltrates of minor salivary glands are considered target-organ related signs of Sjögren's syndrome. The percentages of plasma cells expressing IgA, IgG and IgM in minor salivary gland biopsies have also been suggested as useful in establishing a diagnosis of Sjögren's syndrome, and this study aimed at evaluating this method. All biopsies from patients under investigation for Sjögren's syndrome (n = 210) at our department during 4 years were analyzed for IgA, IgG and IgM producing cells by immunohistochemistry, and related to Sjögren classification parameters. A focus score >or=1 was observed in 67/210 patients and the frequency of IgA producing cells was <70% in 42/210 patients. Sufficient clinical data for classification of disease were available for 57/210 patients. Patients were classified as having primary Sjögren's syndrome (pSS) (n = 9), secondary Sjögren's syndrome (sSS) (n = 12) or non-Sjögren's syndrome (non-SS) (n = 36). IgA expressing cells were significantly decreased (P < 0.01) and IgG expressing cells significantly increased (P < 0.02) in patients with pSS compared to non-SS. Also, increased numbers of salivary gland IgG producing plasma cells correlated with increased IgG serum levels (P < 0.001). However, there was no significant difference between sSS and non-SS with regard to IgA, IgG or IgM expressing cells in the glands. Our results support previous reports indicating the relevance of quantitative evaluation of Ig isotype expression in plasma cells in the clinical investigation of Sjögren's syndrome and further indicate a difference in plasma cell populations between pSS and sSS.

Salivary immunoglobulin concentrations in patients with epilepsy treated with carbamazepine.

Various anti-epileptic drugs may affect the immune system. An IgA-depressing effect of carbamazepine has been proposed, but only serum concentrations have been studied. IgA constitutes a small fraction of the serum immunoglobulins, while it is the predominating one in external secretions. In the present study the concentrations of IgA, IgG and IgM in unstimulated saliva were determined by single radial immunodiffusion in 34 patients with partial epilepsy, and being treated with carbamazepine alone. Median salivary IgA concentration in the patients was 208 x 10(-3) g/l, compared to 150 x 10(3) g/l in 41 healthy controls. Salivary IgG and IgM concentrations were also somewhat higher in the patients than in the controls, while the albumin concentrations were similar in the two groups. However, the differences in the immunoglobulin concentrations between patients and controls were not significant at a 5% level. There was no significant correlation between the concentrations of IgA in saliva and serum.