Salivary Levels Research Articles

Oral Findings and Salivary Alpha-Amylase in Major Depressive Disorder Patients

Background: The increasing global prevalence of major depressive disorder (MDD) has become an important challenge, leading to a heightened demand for oral medicine in developed nations. This demand arises from the recognition of the association between psychiatric disorders and other conditions, including various orofacial pain disorders. Objective: This study are to evaluate oral conditions such as recurrent aphthous ulcers, burning mouth syndrome, and altered taste and to assess salivary alpha-amylase in individuals diagnosed with major depressive disorder. Methods: This research uses a cross-sectional study design that includes a sample of 49 patients who have been diagnosed with major depressive disorder and who have undergone treatment for at least two weeks. The control group consists of 34 healthy subjects with no signs or symptoms of systemic disease. The study group received the diagnosis in Najaf City according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). With respect to recurrent aphthous ulcers, the results of this study show the percentage of patients with oral ulcers is significantly higher than in the control group. Results: The results also show that the prevalence of burning mouth syndrome is significantly higher in patients with major depressive disorder than in healthy controls. A highly statistically significant difference was found between the study group and the control group regarding altered taste. There is also a significant difference in salivary alpha-amylase levels between the study and control groups (p = 0.009). Conclusion: Major depressive disorder patients have much higher incidences of reported recurrent aphthous ulcers, burning mouth syndrome, and altered taste than healthy subjects, indicating the importance of psychological factors in these conditions. Additionally, salivary alpha-amylase levels were higher in patients with major depressive disorder than in the control group.

Quantitative correlation of serum and salivary trace elements in oral squamous cell carcinoma and oral potentially malignant disorders: An institution-based biochemical analysis

Abstract Background: Trace elements are the important components that play a crucial role in various functions of the human body at cellular and molecular levels. Considering the role of the trace elements in precancerous and cancerous conditions, estimation of their levels in these conditions could aid in understanding the disease process and progression. The purpose of this study is to determine the alteration in salivary electrolyte concentration of oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) patients to correlate the variations with the severity and biological behaviour. Material and Method: A total of 70 subjects were included in this study, and they were divided into three groups: patients with OSCC (30), OPMDs (30) and apparently healthy individuals (10). An informed consent was obtained, following which blood and saliva samples were collected from the participants. Salivary and serum levels of copper, zinc, lead, cadmium, calcium and magnesium were measured and compared between the groups. Results: The levels of biochemical elements in both serum and saliva were in perfect correlation. The amount of all the estimated metallic ions was found to be significantly (P 0.001) increased in OSCC followed by OPMDs and normal mucosa. The levels of copper, cadmium and magnesium were gradually increased in increasing grades of OSCC (P 0.001). Conclusion: Salivary trace element levels could possibly have diagnostic significance in the early evaluation of OPMDs and OSCC as well. Increased levels of these elements might be used as a marker of disease progression and predictor of prognosis.

Saliva as a Diagnostic Biomarker in Postmenopausal Women: A Systematic Review

Abstract Background: The main health problems faced by postmenopausal women include osteoporosis, vasomotor symptoms, cardiovascular diseases, urogenital atrophy, cancer, psychiatric symptoms, and cognitive problems. These manifestations can lead to postmenopausal syndrome, and the management of these manifestations has become a prime area of investigation in recent times. Aim: The aim of this systematic review is to critically analyze the literature to identify the salivary markers that can be used to diagnose diseases in postmenopausal women. Materials and Methods: Articles related to saliva as a diagnostic tool in postmenopausal women were collected in databases like PubMed and Google Scholar. Keywords used in this systematic review are saliva, diagnosis, postmenopausal women and disease. Articles included were based on the PRISMA guidelines. Results: A total of 692 articles were screened, out of which 674 articles were excluded as they failed to meet the expected criteria. Eighteen articles were selected based on title and abstract. After excluding all the articles which did not meet the criteria, totally 12 articles were included for review. Conclusion: The efficacy of salivary calcium levels to detect early bone changes in postmenopausal women has been studied the most in the literature. Studies with larger sample size are needed for saliva used as a substitute to serum calcium to diagnose osteoporosis. More studies are needed to analyze the significance of salivary alkaline phosphatase, parathormone, cortisol, salivary c-terminal of type I collagen, osteocalcin, and osteopontin in postmenopausal women.

Evaluation and comparison of serum and salivary interleukin 9 levels among individuals with gingivitis and periodontitis and healthy controls: A cross-sectional study

Context: Although interleukin (IL)-9 has been understudied, some pleiotropic effects have been documented on lymphocytes and mast cells. It is a T-cell-derived cytokine. Aims: The aim of this study was to appraise the association of IL-9 in the serum and saliva of individuals with gingivitis, periodontitis, and healthy controls. Settings and Design: It is an observational cross-sectional type. Materials and Methods: This study was conducted on 90 subjects, including both males and females, divided into three groups: gingivitis (30), Parkinson’s disease (PD) (30), and healthy (30). Clinical parameters assessed were gingival bleeding index, Russell’s periodontal index (PI), probing pocket depth, and clinical attachment level. Serum and salivary IL-9 levels were weighed by enzyme-linked immunosorbent assay. Statistical Analysis Used: The Statistical Package for the Social Sciences version 22, (IBM, Chicago, IL, USA) was used for evaluation. The normality of the data was checked using the Shapiro–Wilks test. Analysis of variance test was used to compare the means of two or more independent (unrelated) groups, followed by Tukey’s post hoc analysis for pair-wise comparison. The analogy between IL-9 and clinical parameters was evaluated using Pearson’s correlation coefficient. The probability value was set at 0.05. Results: Statistically significant elevation of saliva and serum IL-9 levels occurred in subjects with gingivitis, followed by PD and health. Conclusions: This study concluded that IL-9 may be indicated as a biomarker in the early stages of periodontal diseases.

Impact of sleep deprivation on stress levels and cognitive performance in young and middle-aged adults at a Medical University in Ajman, UAE.

Inadequate sleep is a widespread public health concern, impacting physical and mental health, as well as cognitive well-being. This study explores the link between sleep quality, the inflammatory marker interleukin-6 (IL-6), and cognitive function in two age groups (18-25 years and 35 years and above) at Gulf Medical University. Sleep quality was assessed using the Pittsburgh questionnaire, and salivary IL-6 levels were measured. Cognitive function was evaluated using the National Aeronautics and Space Administration-Psychomotor Vigilance Test (NASA-PVT), focusing on mean reaction time (RT), lapses, fastest 10% RT, and slowest 10% RT. Descriptive and inferential statistics were used to analyze the data. The descriptive statistics used were frequency, percentage mean, and standard deviation (SD). The inferential statistics used was the unpaired t-test. The level of significance was taken as P ≤ 0.05. Statistical Package for the Social Sciences (SPSS) 28 was used to analyze the data. Approximately 75% of young adults and 80% of middle-aged adults reported good sleep quality. Sleep disturbances were reported by 65% of young adults and 95% of middle-aged adults. In both age groups, individuals with poor sleep exhibited higher IL-6 levels, but all IL-6 values remained within the reference range. NASA-PVT results indicated that individuals with poor sleep had higher mean RT and lapses compared to those with good sleep. In the older age group, both mean RT and lapses were higher than in the younger group, suggesting potential age-related effects on psychomotor vigilance. Our findings suggest a connection between poor sleep quality, elevated IL-6 levels, and impaired cognitive performance.

The Role of Ramadan Fasting on Secretory IgA and Statherin Levels in Individuals with Dental Caries

Background: Tooth decay happens when bacteria in the mouth create acid from carbohydrates that can be fermented. Along with factors related to the person (like genetics or oral hygiene habits) and saliva, this process leads to cavities. During Ramadan fasting, when eating habits change, there could be effects on health, particularly on the salivary biomarkers that are important for dental well-being. Objectives: This cross-sectional study aimed to detect the activity and concentrations of salivary levels of secretory immunoglobulin A and Statherin during and after Ramadan fasting and to evaluate the association between these biomarkers with dental caries. Methods: The study comprised 40 individuals, aged 20-25 years, diagnosed with dental caries. Participants were assessed for periodontal parameters using the Plaque Index and the Gingival Index. Saliva samples were collected during the fourth week of Ramadan fasting and two weeks after Ramadan fasting. The concentrations of both secretory IgA and Statherin were measured in salivary samples using Enzyme-Linked Immunosorbent Assay . Results: A significant decrease in the mean concentration of secretory immunoglobulin A was observed during Ramadan fasting (2.14±0.21 ng/L) compared to post-fasting (3.34±0.35 ng/L) (p=0.001). However, there was a non-significant difference (p=0.05) in statherin levels between the fasting state (2.25±0.18 ng/L) and the post-fasting state (2.85±0.22 ng/L). No statistically significant difference was found concerning both the Plaque Index and the Gingival Index within fasting and post-fasting state. Conclusion: Low concentration of sIgA and Statherin during Ramadan fasting may indicate altered salivary gland activity or systemic response to fasting, potentially affecting oral health.

Salivary Biophysical Properties in Relation to Dental Caries Severity Among Type 1 Diabetic Children

Diabetes Mellitus is a multifactorial metabolic disorder characterized by elevated blood glucose levels or hyperglycemia. Diabetes Mellitus may cause many oral problems as a result of both micro- and macrovascular complications. We aimed to assess the probable relationship between the severity of dental caries and the biophysical properties of saliva (flow rate, PH, and viscosity). Materials and Methods: A cross-sectional comparative study was conducted in Karbala City, in which a sample of 45 children with type 1 diabetes aged between 10-12 years was compared with a group of 45 non-diabetic children matched in age and gender. Dental caries severity and experience were recorded and diagnosed using Manji et al.'s criteria and the decayed, missing, and filling index (DMFS/dmfs). Unstimulated salivary specimens were collected to evaluate flow rate, pH, and viscosity. Pearson (r) correlation coefficient test and one-way ANOVA test were employed for data analysis using SPSS-22. Results: Salivary levels of viscosity and flow rate were not statistically significant (P > 0.05) predicators regarding the dental caries experience and severity among type1 diabetic children (controlled and uncontrolled) while pH level of saliva was a statistically significant predictor regarding dental caries experience (DS/ DMFT) among uncontrolled diabetic children. Conclusion: Compared to non-diabetic children, type 1 diabetic children exhibited pronounced changes in salivary biophysical properties but unpronounced changes in caries status.

Salivary Levels of Interleukin-23 in Iranian Patients with Systemic Sclerosis

Background: Systemic sclerosis (SSc) is a rare chronic inflammatory disorder characterized by diffuse fibrosis and vascular abnormalities in the skin and internal organs. Interleukin-23 (IL-23) is a pro-inflammatory cytokine that can enhance the expansion of T helper 17 (Th17) cells and thus plays a critical role in many inflammatory autoimmune diseases. This study aimed to assess the salivary IL-23 levels in Iranian patients with SSc compared to healthy individuals. Methods: In this cross-sectional study, unstimulated saliva samples (5 cc) were collected from 88 SSc patients and 88 age- and sex-matched healthy individuals. The salivary levels of IL-23 in the saliva samples were measured using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Results: The mean salivary levels of IL-23 in the patient group were significantly higher than in the control subjects (164.5±22.1 ng/L vs. 95.8±15.7 ng/L, P<0.0001). In SSc patients, the salivary IL-23 levels were significantly elevated in ACA-positive compared to ACA-negative participants (179.8±11.2 ng/L vs. 144.3±15.7 ng/L, P<0.0001). However, IL-23 was not associated with gender or age (P>0.05). Conclusion: The results suggest that IL-23 is associated with the pathogenesis of SSc; therefore, this pro-inflammatory cytokine is not only a valuable supportive biomarker for monitoring the disease progression but also blocking IL-23 could be considered a potential therapeutic target, especially in early SSc. Further comprehensive studies are needed to confirm our findings.

Assessment of Salivary Flow Rate, pH, and Calcium Level Following Ajwa Date (Phoenix dactylifera) Consumption in Caries and Caries-free Individuals

Assessment of Salivary Flow Rate, pH, and Calcium Level Following Ajwa Date (Phoenix dactylifera) Consumption in Caries and Caries-free Individuals

Salivary Histamine Levels in Patients with Oral Lichen Planus Lesions.

Background and Objectives: An oral lichen planus (OLP) chronic lesion refers to a group of oral potentially malignant disorders (OPMDs) that still lack a proper understanding from the point of view of relevant biomarkers for diagnostics and prognosis. The aim of the study was to assess the salivary histamine levels in patients with oral lichen planus lesions. Materials and Methods: The study included a group of 76 patients with oral lichen planus. General diseases and medication taken, smoking habits, severity of pain assessed using a visual analogue scale (VAS), oral hygiene status, and duration of OLP were evaluated. ELISA diagnostics for histamines in saliva levels were assessed. Results: The histamine levels in the OLP group were higher (0.468) in comparison with the control group (0.056), without a statistically significant value p = 0.090 (Mann-Whitney U Test). The median age of 76 OLP patients was 63 years (min 22.0-max. 81), with the biological sex being 80.3% females and 15 19.7% males. The average duration of OLP lesion presence was 29.4 months (SD 37.1) and the median value was 14.5 months. The median of the VAS was 3.0. OLP assessment in accordance with the Malhotra methodology showed the highest frequency-30.3% for only two of the point areas involved and 17.1% for three points. Clinical assessment of the different OLP grades, severity, and oral site involvement and the VAS in correlation with histamine salivary levels showed a lack of statistical significance in the investigated population. Conclusions: Undertaking further research could provide further possibilities for searching for general factors in OLP development.

The Correlation of Insomnia to Hyposalivation and Xerostomia in the Elderly: A Single Centre Study

Background: The ageing process declines body functions and disrupts circadian rhythms, resulting in insomnia. The salivary gland's functions are affected by insomnia as well. Disorders of salivary secretion, such as xerostomia and hyposalivation, are associated with low salivary function levels. Objective: This study investigates the relationship between xerostomia, hyposalivation, and insomnia in the elderly. Method: This study is analytical observational research using a cross-sectional approach. A total of ninety-one residents of Cipayung's Tresna Werdha Budi Mulia 1 nursing home were the subjects of the study. The Summated-Xerostomia Inventory (SXI-id) questionnaire was utilised to measure xerostomia, the Insomnia Severity Index (ISI) was employed to measure insomnia, and the unstimulated salivary flow rate based on the spitting method was used to measure salivation. Data analysis was conducted using Spearman's correlation test. Result: A significant linear correlation was observed between the insomnia score and unstimulated salivary flow rate (r = -0.370; p = 0.001) and between the insomnia score and the xerostomia score (r = 0.682). Conclusion: In the elderly, salivary gland secretion might be impacted by insomnia.

The diagnostic value of salivary C-reactive protein in neonatal infections: a meta-analysis.

C-reactive protein (CRP), as an acute phase protein, is a sensitive indicator of neonatal bacterial infection. Some recent studies have shown that there is a correlation between CRP levels in serum and saliva, and using saliva to detect CRP levels is expected to be an ideal and non-invasive method to predict neonatal infection. The purpose of this Meta-analysis was to evaluate the diagnostic value of salivary CRP for neonatal infection. We searched PubMed, Embase, Web of Science, and Scopus databases in October 2023 and included observational studies that examined salivary CRP in newborns with bacterial infections. Data was extracted regarding the methodology, participant characteristics, and outcome measures. Nine articles were included, with a total of 696 newborns. Salivary CRP levels are significantly higher in neonates with infections compared to non-infected group (SMD = 0.58, 95%CI [0.40-0.76], P < 0.001). The accuracy for salivary CRP to predict serum CRP abnormality is high (sensitivity 86%, specificity 88%, area under the curve = 0.94). Our meta-analysis suggested that salivary CRP can be used as an alternative biomarker to serum CRP for detecting neonatal infection.

Non-Surgical Periodontal Therapy's Influence on Alpha-Synuclein and Inflammatory Marker Levels: A Pilot Study.

Background: Microbial dysbiosis may contribute to alpha-synuclein (α-Syn) homeostasis disruption, yet the burden of inflammatory periodontal infection and its treatment have never been studied in this regard. We aimed to compare the cytokine and α-Syn levels in the saliva and blood of patients with periodontitis who underwent non-surgical periodontal therapy (NSPT) and those of their healthy counterparts. Methods: Periodontal examination and saliva and blood sample collection were carried out in incoming patients at a university clinic. The periodontitis group (PG) received NSPT. The sample collection and periodontal observation were repeated 30 days after. IL-6, IL1-β and total α-Syn were quantified using immunoassay methods. The periodontal inflamed surface area (PISA) was calculated as a proxy for periodontal inflammation. Results: Eleven participants formed the PG, and there were fifteen healthy controls (HC). At baseline, no correlation between salivary and plasma α-Syn was found. The salivary α-Syn levels revealed a tendency to decrease 30 days after, particularly in the PD cases. The variation in PISA and α-Syn showed significant correlation. Salivary α-Syn correlated negatively with salivary IL-6 levels at both timepoints in the total sample (rho = -0.394 and rho = -0.451) and in the HC (rho = -0.632 and rho = -0.561). Variations in plasma IL-6 and α-Syn were negatively correlated (rho = -0.518) in the healthy participants. Baseline plasma IL1-β negatively correlated with plasmatic α-Syn at 30 days in the HC (rho = -0.581). Conclusions: Salivary and plasma α-Syn bioavailability operate independently, and periodontal diagnosis was not a confounding factor. Salivary α-Syn levels were significantly affected by NSPT, contrary to plasma levels. These results should be confirmed in future larger and prospective studies.

The Effect of Adult Smoking Behavior on Children's Exposure to Secondhand Smoke. An Analysis Based on Salivary Cotinine Levels Among Children in Dhaka and Karachi.

Exposure to secondhand smoke (SHS) risks children's health. However, biomarkers are rarely used to study SHS exposure among children in low- and middle-income countries. We analyzed cross-sectional data collected between March and November 2022 for a cluster-randomized controlled trial investigating a Smoke-Free Intervention in 2769 children aged 9-15 in 74 schools (34 in Dhaka, Bangladesh, and 40 in Karachi, Pakistan). Children's saliva was tested for the concentration of cotinine-a highly sensitive and specific biomarker for SHS exposure. Based on their reports, children's homes were categorized as Nonsmoking Homes (NSH) when residents were nonsmokers; Smoke-free Homes (SFH) when residents and visitors smoked outdoors only; and Smoke-permitted Homes (SPH) when either residents or visitors smoked indoors. We compared cotinine concentrations across these home types and the two cities using a proportional odds model. Overall, 95.7% of children (92% in Dhaka; and 99.4% in Karachi) had cotinine levels between 0.1 and 12 ng/mL, indicating SHS exposure. Median cotinine levels were higher in Karachi (0.58 ng/mL, IQR 0.37 to 0.93) than in Dhaka (0.27 ng/mL, IQR 0.16 to 0.49). Median cotinine concentration was also higher among children living in SPH than those in either NSH or SFH; with absolute differences of approximately 0.1-0.3 and 0.05 ng/mL, respectively. The level of SHS exposure in Dhaka and Karachi indicates widespread and unrestricted smoking. Smoking restrictions in households and enforcement of smoking bans are urgently needed. The high levels of SHS exposure in children living in SFH suggest parental behavior to hide their smoking and/or exposure in private vehicles or public spaces. It is important to advocate for SFH and cars to protect children from SHS exposure. However, these initiatives alone may not be enough. There is a need to enforce smoking bans in enclosed public places and transportation, as well as extend these bans to playgrounds, parks, fairgrounds, and other public spaces that children frequently visit. It is essential to complement smoking restrictions with tobacco cessation advice and support in these settings.

Artificial saliva plus beta-glucan for treatment of xerostomia in older adults: The clinical study of effectiveness and salivary total antioxidant capacity levels

To evaluate the effectiveness of 2 artificial saliva formulations, sodium carboxymethylcellulose artificial saliva spray and sodium carboxymethylcellulose artificial saliva spray plus β-glucan.: This study was a double-blind randomized controlled trial and involved older adults with xerostomia. The xerostomia inventory score, clinical oral dryness score, oral moisture degree, unstimulated salivary flow rate, and salivary total antioxidant capacity were measured prior to and after treatment. The results were evaluated 4 weeks after taking both products. : The study included 51 subjects in the control (n = 25) and BG (n = 26) groups. xerostomia inventory score and clinical oral dryness score were significantly lower in both groups after 4 weeks of treatment (p&amp;#60;0.00). Additionally, both groups had significantly greater oral moisture degree and unstimulated salivary flow rate than before treatment (p&amp;#60;0.05). Only the increase in oral moisture degree in the BG group was significantly greater than that in the control group (p=0.048). Both groups tended to have decreased salivary total antioxidant capacity, but only the control group had a significant difference at 4 weeks (p=0.004). There was no significant difference in satisfaction score between the two groups. No serious side effects were found in the study. : The clinical signs and symptoms of xerostomia were improved by both control and artificial BG saliva. BG improved oral moisture more than the control. Furthermore, BG was more likely to prevent a decrease in salivary total antioxidant capacity than was the control.

Sex differences in the effects of aromatherapy on anxiety and salivary oxytocin levels.

Aromatherapy is a holistic healing method to promote health and well-being by using natural plant extracts. However, its precise mechanism of action and influence on the endocrine system remains unclear. Since recent studies reported that a neuropeptide, oxytocin, can attenuate anxiety, we hypothesized that if oxytocin secretion is promoted through aromatherapy, it may improve mood and anxiety. The present study is aimed to investigate the relationship between oxytocin and the effects of aromatherapy with lavender oil on anxiety level, by measuring salivary oxytocin levels in healthy men and women. We conducted a randomized open crossover trial in 15 men and 10 women. Each participant received a placebo intervention (control group) and aromatherapy with lavender oil (aromatherapy group). For the aromatherapy group, each participant spent a 30-min session in a room with diffused lavender essential oil, followed by a 10-min hand massage using a carrier oil containing lavender oil. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) before the intervention, 30-min after the start of intervention, and after hand massage, in both groups. Saliva samples were collected at the same time points of the STAI. In women, either aromatherapy or hand massage was associated with a reduction in anxiety levels, independently. Moreover, salivary oxytocin levels were increased after aromatherapy. On the other hand, in men, anxiety levels were decreased after aromatherapy, as well as after hand massage, regardless of the use of lavender oil. However, there were no significant differences in changes of salivary oxytocin levels between the control and aromatherapy groups during the intervention period. Interestingly, there was a positive correlation between anxiety levels and salivary oxytocin levels before the intervention, but a negative correlation was observed after hand massage with lavender oil. The results of the present study indicate that in women, aromatherapy with lavender oil attenuated anxiety with increase in oxytocin level in women, whereas in men, there was no clear relationship of aromatherapy with anxiety or oxytocin levels but, there was a change in correlation between anxiety and oxytocin. The results of the present study suggest that the effect of aromatherapy can vary depending on sex.

SARS-CoV-2 Infection of Salivary Glands Compromises Oral Antifungal Innate Immunity and Predisposes to Oral Candidiasis.

Saliva contains antimicrobial peptides considered integral components of host innate immunity, and crucial for protection against colonizing microbial species. Most notable is histatin-5 which is exclusively produced in salivary glands with uniquely potent antifungal activity against the opportunistic pathogen Candida albicans. Recently, SARS-CoV-2 was shown to replicate in salivary gland acinar cells eliciting local immune cell activation. In this study, we performed mechanistic and clinical studies to investigate the implications of SARS-CoV-2 infection on salivary histatin-5 production and Candida colonization. Bulk RNA-sequencing of parotid salivary glands from COVID-19 autopsies demonstrated statistically significant decreased expression of histatin genes. In situ hybridization, coupled with immunofluorescence for co-localization of SARS-CoV-2 spike and histatin in salivary gland cells, showed that histatin was absent or minimally present in acinar cells with replicating viruses. To investigate the clinical implications of these findings, salivary histatin-5 levels and oral Candida burden in saliva samples from three independent cohorts of mild and severe COVID-19 patients and matched healthy controls were evaluated. Results revealed significantly reduced histatin-5 in SARS-CoV-2 infected subjects, concomitant with enhanced prevalence of C. albicans. Analysis of prospectively recovered samples indicated that the decrease in histatin-5 is likely reversible in mild-moderate disease as concentrations tended to increase during the post-acute phase. Importantly, salivary cytokine profiling demonstrated correlations between activation of the Th17 inflammatory pathway, changes in histatin-5 concentrations, and subsequent clearance of C. albicans in a heavily colonized subject. The importance of salivary histatin-5 in controlling the proliferation of C. albicans was demonstrated using an ex vivo assay where C. albicans was able to proliferate in COVID-19 saliva with low histatin-5, but not with high histatin-5. Taken together, the findings from this study provide direct evidence implicating SARS-CoV-2 infection of salivary glands with compromised oral innate immunity, and potential predisposition to oral candidiasis.

Evaluation of cytokine expressions in patients with recurrent aphthous stomatitis: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the expression levels of various T helper (Th) cell-secreted cytokines in recurrent aphthous stomatitis (RAS). Case-control studies comparing the serum or salivary levels of cytokines between RAS patients and healthy controls were searched in PubMed, EMBASE, Web of Science, and Google Scholar prior to September 30, 2023. Cytokines produced by Th1 (interleukin [IL]-1, IL-2, IL-8, IL-12, tumor necrosis factor alpha [TNF-α], interferon gamma [IFN-γ]), Th2 (IL-4, IL-5, IL-6, IL-10, IL-13), and Th17 (IL-17A) cells were investigated. The standard mean difference (SMD) with 95% confidence interval (CI) was calculated to detect the difference. A total of 20 studies comprising 1070 RAS patients and 536 healthy controls were included. RAS patients had significantly higher salivary levels of IL-2 (SMD = 4.15, 95%CI 0.83-7.48), IL-5 (SMD = 0.53, 95%CI 0.05-1.00), IL-6 (SMD = 0.48, 95%CI 0.12-0.84), IL-12 (SMD = 0.94, 95%CI 0.18-1.71), and TNF-α (SMD = 1.31, 95%CI 0.44-2.18) compared to healthy controls. Serum levels of IL-6 (SMD = 0.48, 95%CI 0.30-0.66), TNF-α (SMD = 0.70, 95%CI 0.22-1.17), and IFN-γ (SMD = 0.72, 95%CI 0.17-1.28) were significantly increased, while serum IL-10 levels (SMD = -2.25, 95%CI -3.99 to -0.52) were reduced in RAS patients. Patients diagnosed with major RAS had markedly elevated serum IL-8 levels (SMD = 0.39, 95%CI 0.07-0.71) and a trend toward higher serum IL-6 levels (SMD = 0.51, 95%CI -0.02 to 1.04) than those with minor RAS. In conclusion, Th1/Th2-related cytokines, especially IL-2, IL-6, and TNF-α, are involved in the pathogenesis of RAS development and progression and are potential therapeutic targets for RAS.

Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (The ACE Cohort)

PurposeAsymptomatic SARS-CoV-2 infections were widely reported during the COVID-19 pandemic, acting as a hidden source of infection. Many existing studies investigating asymptomatic immunity failed to recruit true asymptomatic individuals. Thus, we conducted a longitudinal cohort study to evaluate humoral- and cell-mediated responses to infection and vaccination in well-defined asymptomatic young adults (the Asymptomatic COVID-19 in Education [ACE] cohort).MethodsAsymptomatic testing services located at three UK universities identified asymptomatic young adults who were subsequently recruited with age- and sex-matched symptomatic and uninfected controls. Blood and saliva samples were collected after SARS-CoV-2 Wuhan infection, and again after vaccination. 51 participant’s anti-spike antibody titres, neutralizing antibodies, and spike-specific T-cell responses were measured, against both Wuhan and Omicron B.1.1.529.1.ResultsAsymptomatic participants exhibited reduced Wuhan-specific neutralization antibodies pre- and post-vaccination, as well as fewer Omicron-specific neutralization antibodies post-vaccination, compared to symptomatic participants. Lower Wuhan and Omicron-specific IgG titres in asymptomatic individuals were also observed pre- and post-vaccination, compared to symptomatic participants. There were no differences in salivary IgA levels. Conventional flow cytometry analysis and multi-dimensional clustering analysis indicated unvaccinated asymptomatic participants had significantly fewer Wuhan-specific IL-2 secreting CD4+ CD45RA+ T cells and activated CD8+ T cells than symptomatic participants, though these differences dissipated after vaccination.ConclusionsAsymptomatic infection results in decreased antibody and T cell responses to further exposure to SARS-CoV-2 variants, compared to symptomatic infection. Post-vaccination, antibody responses are still inferior, but T cell immunity increases to match symptomatic subjects, emphasising the importance of vaccination to help protect asymptomatic individuals against future variants.

Analysis of the Effects of Different Orthodontic Appliances on Salivary pH Levels: An In vitro Approach.

Orthodontic appliances can influence the oral environment, including salivary pH levels, which play a crucial role in maintaining oral health. Understanding how different orthodontic appliances affect salivary pH levels can help in improving treatment outcomes and minimizing potential side effects. In this in vitro study, we evaluated the effects of various orthodontic appliances on salivary pH levels using a simulated oral environment. Four different types of orthodontic appliances were tested: traditional metal braces, ceramic braces, lingual braces, and clear aligners. Saliva samples were collected and subjected to pH measurements using a standardized method. The pH measurements were recorded at three different time intervals: immediately after appliance placement, after 24 hours, and after 48 hours. The initial pH values varied among the different orthodontic appliances: metal braces (pH 7.2), ceramic braces (pH 7.4), lingual braces (pH 7.1), and clear aligners (pH 7.5). After 24 hours, there was a decrease in pH levels for all groups: metal braces (pH 6.8), ceramic braces (pH 7.0), lingual braces (pH 6.7), and clear aligners (pH 7.2). After 48 hours, the pH levels continued to decrease: metal braces (pH 6.5), ceramic braces (pH 6.8), lingual braces (pH 6.4), and clear aligners (pH 6.9). Our findings suggest that different orthodontic appliances have varying effects on salivary pH levels. Metal braces and lingual braces tend to cause a more pronounced decrease in salivary pH compared to ceramic braces and clear aligners. Monitoring salivary pH levels during orthodontic treatment may be beneficial in identifying potential risks to oral health and implementing appropriate interventions.