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Hypo-salivation, related to medical remedies, is an increasing clinical problem. Studies report a weak correlation between subjective mouth dryness and objective sialometry. This indicates that both quantity and quality of saliva are important for the surface-associated functions of saliva, such as lubrication and hydration, to be expressed. Film-forming properties and viscosities of three saliva substitutes were compared to human saliva. Adsorption to surfaces was measured by ellipsometry, infrared spectroscopy and drop-volume technique. Viscosity measurements were carried out using an oscillating rheometer. Saliva, with the lowest viscosity value and the highest protein content, presented superior film retention on both hydrophilic and hydrophobic surfaces. The carboxymethylcellulose-based MAS 84 showed intermediate values of viscosity, poorest ability to reduce surface tension, and negligible film-forming capacity. The porcine mucin-based Saliva Orthana showed about twice the viscosity of saliva and film-forming capability on preferably hydrophobic substrates. Salinum, a linseed extract, possessed the highest viscosity value and an initial surface tension close to that of saliva. The film retention on hydrophilic surfaces was not as effective as for saliva. The results indicate that the film-forming capacity of saliva substitutes is a property also to be considered in the exploration of clinically effective artificial salivas.
The effect of atropine-induced reductions in saliva flow rate on saliva phenytoin concentrations were evaluated in a randomised placebo-controlled crossover study in a group of epileptic patients stabilised on the drug. Pretreatment with atropine caused significant reductions in saliva flow rates during the first 4 h, compared to saline. The AUC0-4 h for saliva flow rate was significantly reduced by atropine (245 g vs 327 g) and the saliva phenytoin AUC0-4 h was significantly increased (5.6 micrograms.ml-1.h vs 4.5 micrograms.ml-1.h) without affecting plasma phenytoin concentrations. The saliva/plasma phenytoin AUC0-4 h ratio was therefore significantly increased by atropine (0.15 vs 0.12). However, there was a poor correlation between saliva/plasma phenytoin concentration ratios and saliva flow rates for the two treatments in the individual patients (correlation coefficient ranged from 0.25 to 0.65). These findings demonstrate that saliva phenytoin concentrations are increased by reductions in saliva flow rate. Caution is therefore required when saliva phenytoin concentrations are used for therapeutic monitoring in the presence of factors which may affect saliva flow rate.
UNLABELLED: Saliva is frequently used as a diagnostic fluid and several collection devices have been developed. OBJECTIVE: The aim of the present study was to investigate the validity and reliability of two types of Salivette collection kits (non-covered cotton roll and polypropylene covered polyether roll) relative to conventional collection of saliva using paraffin wax chewing stimulation. MATERIALS AND METHODS: Whole saliva samples were collected from 16 healthy volunteers. Following a cross-over design saliva was collected in a standardized way. The flow rate was determined and saliva samples were analyzed for pH, buffer capacity, electrolytes and protein/glycoprotein content. RESULTS: We find that Salivette methods do not allow evaluation of flow rate. pH was unaffected but buffer capacity was lower in Salivette collected than in paraffin wax-stimulated saliva. The non-covered cotton rolls reduced the content of Na+, K+, Cl-, as well as glycoprotein markers (hexosamines, fucose, sialic acid), lysozyme, lactoferrin, salivary- and myeloperoxidase but increased the concentrations of Ca2+, PO4(3)- and SCN-. Polypropylene covered polyether rolls affected saliva composition less than the non-covered cotton rolls. Thus, SCN- and sIgA concentrations were higher and lysozyme activity lower in the former (covered roll) saliva than in paraffin wax saliva. The reliability of the Salivette kits was good. CONCLUSION: We conclude that the Salivette method generates data significantly different from conventional paraffin wax-stimulated saliva such as buffer capacity and several electrolytes and organic components. Care should be taken in interpreting the results when such methods are employed.
Using a tensiometer in accordance with the drop volume principle, the surface tension decrease with time was determined for whole and for 2%, 10%, and 50% aqueous solutions of saliva from one healthy donor. The reduction of surface tension with time was also measured for 10% and 20% saliva solutions with added samples of Streptococcus salivarius KRF2, S. sanguis KRF3, and Actinomyces naeslundii 2t-55. The results show that 1) there is a time dependence of the surface tension reduction of both whole saliva and diluted saliva, 2) an increase of the concentration of whole saliva in salivary solutions gives rise to larger and more rapid surface tension reduction, 3) the proteinaceous components of saliva appear to have a dominant contribution on surface tension in whole saliva and diluted saliva, and 4) the surface-active proteinaceous components in saliva have the ability to dominate the air-saliva interface also in the presence of high concentrations of salivary bacteria.
Saliva and saliva-stained materials were examined as potential sources of deoxyribonucleic acid (DNA) for DNA analysis and identity testing. In this paper, the authors demonstrate that DNA was isolated and DNA banding patterns suitable for DNA typing were obtained from fresh saliva and various saliva-stained materials, such as envelopes, buccal swabs, gags, and cigarettes. Furthermore, DNA and DNA banding patterns were obtained from actual forensic evidentiary samples containing mixed saliva/semen stains. The DNA banding patterns obtained from saliva or saliva-stained material were indistinguishable from the patterns obtained from blood or hair from the same individual. Intact DNA was readily isolated and DNA banding patterns were obtained from saliva stored at -20 degrees C and dried saliva stains stored under varying conditions. We conclude that saliva and saliva-stained material can be good sources of DNA for analysis and for DNA typing in certain forensic settings.
The detection of A, B and H blood group substances (ABH-BGS) in saliva and in saliva stains has been investigated quantitatively by an indirect ELISA using a horseradish peroxidase conjugate in combination with the use of monoclonal antibodies. Through this method, the reaction specificity to BGS in the saliva was very high and its detection sensitivity was found to be approximately 1,000 times greater than has been achieved in a hemagglutination-inhibition test. The monoclonal anti-A and anti-B reagents reacting with both secretor and non-secretor saliva in a hemagglutination-inhibition test and in this ELISA method were selected from among commercial monoclonal antibodies. However, no monoclonal anti-H reagent was found to react with non-secretor saliva. The BGS level was determined by the use of calibration curves of A, B and H standard BGS from human gastric mucosa and was expressed in units, based on the inhibition titer of the standard BGS. In 230 saliva samples, ABH-BGS were detectable, except for H BGS in non-secretor saliva. The BGS levels in saliva stains experimentally prepared were found to be approximately proportional to the levels in the original saliva. As for actual and aged stains, it was possible to detect BGS in most cigarette butts and in aged stains, however, such detection proved impossible in saliva samples from postage stamp.
We describe a direct radioimmunoassay for cortisol in 10-microliter volumes of parotid saliva or whole saliva. Binding proteins are absent from these fluids, as demonstrated by the excellent correlation between results for samples assayed directly and by a comparison procedure involving extraction with 1,2-dichloroethane. The direct assay is specific, precise, and had a lower limit of sensitivity of 4 pg per assay tube. Comparison of cortisol concentrations in plasma, parotid saliva, and whole saliva in persons undergoing investigations for assessing adrenal function, including stimulation with cosyntropin (Synacthen) and suppression with dexamethasone, indicated that changes in plasma cortisol concentration were accurately and immediately reflected in saliva from either the parotidgland or whole saliva. A marked circadian rhythm has also been demonstrated for cortisol in parotid-gland saliva and whole saliva. We had to modify the 1,2-dichloroethane extraction procedure for accurate determination of cortisol in parotid saliva and whole saliva of patients undergoing treatment with metyrapone.
OBJECTIVE: To investigate saliva and plasma concentrations of penicillin after the intake of a conventional phenoxymethylpenicillin (PcV) tablet and a tablet with saliva-resistant coating (PcVsr), both containing 1 g penicillin. METHODS: The study had an open randomized crossover design and involved 24 healthy subjects. Saliva and blood were sampled intermittently for 6 h after tablet intake. RESULTS: Within the first 10 min after tablet intake penicillin was detected in saliva in ten subjects taking PcV and in none taking PcVsr (P < 0.001). These initial saliva concentrations were short-lasting, but in some subjects 50 to 100 times higher than those following the peak concentration in plasma, i.e. at 40 min or more after swallowing. From 40 min and onwards the saliva concentrations of penicillin were very similar for the two formulations. The elimination of high initial saliva concentrations may diminish ecological disturbances of the mouth flora as well as removing the unpleasant taste of penicillin. The plasma concentrations of penicillin were similar for the two formulations throughout the 6-h sampling period and the mean ratio of the area under the plasma concentration-time curve was 99% for PcVsr in relation to PcV, the 90% confidence interval being 86-115%. The corresponding values for the maximum plasma concentration were 108% and 93 127%. The time to maximum concentration was 45 min for PcVsr and 41 min for PcV. Thus, with regard to standard criteria which are based on systemic (plasma) concentrations, the formulations were bioequivalent despite the substantial difference in initial local (saliva) concentrations. CONCLUSION: Saliva-resistant coating of tablets can prevent oral release of penicillin without affecting the plasma concentrations. From a clinical point of view both local and systemic equivalence should be established before bioequivalence is assumed.
Potential drug users participated voluntarily in a Belgian study on the usefulness of the non-instrumental immunoassay Drugwipe (Securetec, Germany) for the screening of cocaine, opiates, amphetamine and cannabinoids in saliva and sweat. If one of the screening assays (urine, oral fluid, sweat) showed a positive result, blood and saliva were collected. The on-site Drugwipe results were correlated with the Drugwipe results for saliva in the laboratory and with the GC/MS results of the corresponding saliva, plasma and urine samples and pharmacological effects at the time of sampling. The Drugwipe assay proved to be sufficiently sensitive for the detection of recent cocaine (n = 6) and amphetamine (n = 15) abuse, whether the device was wiped on the tongue or on the surface of the body, or when a saliva sample was applied to the wiping part. In five of the six potential cocaine users, the saliva concentrations of cocaine exceeded 1,000 ng/ml. In the amphetamine group, the saliva concentrations of amphetamine, MDMA or both were high (> 1,000 ng/ml) in 13 subjects. For cocaine and amphetamine, the positive scores for Drugwipe matched the GC/MS results for the three body fluids. Recent heroin abuse (n = 5) could be demonstrated to some extent with Drugwipe on samples from the tongue but only the two subjects with the highest saliva concentrations of MAM (> 500 ng/ml) and morphine (> 500 ng/ml) were positive. If the legal cut-off value for driving under the influence of opiates in Belgium (20 ng/ml of free morphine in plasma) was taken into account, only three subjects would have been legally positive. For cannabinoids (n = 15), false negatives and even some false positives were observed. Saliva can be considered as a useful analytical matrix for the detection of drugs of abuse after recent abuse when analysed with GC/MS.
The various components of saliva, namely mixed saliva, parotid saliva, submandibular saliva, crevicular fluid and minor (labial) gland secretions, were collected from 63 known HIV antibody seropositive patients. A commercial test system, Wellcozyme HIV 1+2, and an antibody capture ELISA (GACELISA), were compared for sensitivity against all components. Sensitivity of the GACELISA system was 100% in 123 mixed saliva, 121 parotid saliva and 127 labial fluid samples, and 98% in 99 submandibular samples and 127 crevicular fluid samples. Respective figures for Wellcozyme 1+2 were 92%, 55%, 73%, 66% and 63%. Mixed saliva was most easily, conveniently and effectively collected using a plain Salivette. In 241 Salivette samples examined from the 63 patients, GACELISA proved 100% sensitive, and Wellcozyme 95% sensitive. Another form of Salivette impregnated with citric acid was unsuitable for GACELISA and gave a false negative value of 45%. In 197 samples from the gingival margin taken by a dry swab, GACELISA showed a sensitivity of 98% and Wellcozyme 81%. The most sensitive method for demonstrating anti-HIV antibody in saliva is to collect mixed saliva with the plain Salivette system and assay anti-HIV antibody levels by GACELISA.
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Cystatins are inhibitors of cysteine proteinases and could play a protective and regulatory role under inflammatory conditions. Since total cystatin activity of whole saliva was increased in periodontal patients (Henskens et al., 1993), we wanted to investigate the types or origins of cystatins involved in this increase. Distinct types of cystatins were identified by isoelectric focusing and immunoblotting with specific antibodies against one of the salivary acidic isoforms, cystatin S. and the widely distributed basic cystatin C. Clarified human whole saliva (CHWS) of healthy subjects contained cystatin S, whereas cystatin C was barely detectable. In contrast, in CHWS of gingivitis and periodontitis patients, both cystatin C and S levels were higher. The origin of cystatin activity was investigated by collecting submandibular (SM), sublingual (SL), and parotid (PAR) saliva from seven subjects with mild gingivitis. Total cystatin activity was about five times higher in SM saliva than in PAR saliva. In SM and SL saliva, both cystatins S and C were demonstrated. In contrast, in PAR samples, solely cystatin C was detectable. The introduction of experimental gingivitis in one periodontally healthy subject resulted in the appearance of a cystatin C band in PAR saliva and in an increase of cystatins S and C in SM saliva. We conclude that the previously observed increase of cystatin activity in whole saliva in inflammatory periodontal disease is, at least in part, due to an increased glandular output of both the isoform cystatin S (pI 4.7) and the basic cystatin C (pI 9.0).
Saliva is a mixture of secretions of both the large salivary glands (glandula sublingualis submandibularis and parotis) and the minor salivary glands of the palate, tongue, lips and cheeks. The rheological flow of the separate glandular salivas differs remarkably. Sublingual saliva is both more viscous and elastic than the other glandular salivas. The viscosity of parotid saliva, which is of importance during eating (digestion), is equal to the viscosity of water. Utilization of the combination of viscosity and elasticity may improve new saliva substitutes and of frequent applications of saliva substitutes by xerostomia patients may reduce. Besides, the utilization of correct visco-elastic properties of saliva substitutes may lead to better moistening and protective properties.
Three principally different antidepressant drugs--amitriptyline (with effects on both noradrenaline and serotonin reuptake), maprotiline (a selective inhibitor of reuptake of noradrenaline) and zimelidine (a selective inhibitor of reuptake of serotonin) were tested after a single dose and, as concerns maprotiline and zimelidine, after long-term use in healthy volunteers as regards the effects on saliva secretion rate and saliva composition. Amitriptyline gave a strong decrease in both unstimulated and stimulated saliva secretion rate, indicating a strong anticholinergic effect, and a strong increase in the activity of amylase and the content of protein, fucose and hexose in saliva, indicating a strong agonistic effect on noradrenaline transmission. Maprotiline gave an intermediate decrease in saliva secretion rate, and the effect remained after 14 days of treatment. Single doses gave increases in saliva amylase activity and protein content. After 14 days this effect was increased, and there was also a pronounced increase in fucose and hexose content indicating a strong agonistic effect on noradrenaline transmission. Zimelidine gave a low decrease in saliva secretion rate, indicating a mild anticholinergic effect. No certain effect on the saliva composition could be settled after a single dose, but after 14 days there were consistent increases in amylase activity and protein, fucose and hexose content, indicating a facilitation of noradrenaline transmission. Zimelidine as well as its active metabolite, norzimelidine, are selective inhibitors of serotonin reuptake. The action of zimelidine is discussed in view of recent hypotheses about a modulating serotoninergic influence on the noradrenergic system.
Increased awareness of the devastating effects of alcohol misuse on our highways, workplaces and families, as well as on the individual, has resulted in increased social pressure to enforce driving-while-intoxicated laws and to develop educational, prevention and treatment programs. One aspect of this movement is to develop improved sobriety testing to ensure that laws are properly and fairly enforced and that there is compliance with abstinence in treatment. Although sophisticated blood and breath testing devices are available, field tests suggest that saliva alcohol tests based on alcohol-oxidase methodology offer advantages in portability, ease of administration, and cost and time efficiency. We evaluated the validity and reliability of a simple saliva test, based on the enzymatic oxidation of alcohol by alcohol oxidase, for estimating blood alcohol concentration. Ten subjects consumed various doses of alcohol and multiple saliva samples were obtained using alcohol sensitive saliva strips that change color in proportion to the concentration of alcohol. The reflectance values of reacted saliva strips were read by meter and estimates of blood alcohol concentration in the range of 10-90 mg/dl were compared to simultaneous estimates obtained from breath analysis using a Breathalyzer Model 900A. We also examined how alcohol levels changed over time in alcohol reacted saliva strips. The results of regression analysis indicated that the saliva strips and the Breathalyzer gave reasonably close estimates (r = 0.89-.90) of blood alcohol concentration. Correlation coefficents for the values of saliva samples read by meter measured at 10 minutes and at 18 days after collection ranged from .90 to 1.00, showing high test-retest reliability despite storage.(ABSTRACT TRUNCATED AT 250 WORDS)
A rabbit anti-saliva hyperimmune serum was raised against pooled human saliva. After absorption with human serum and semen, the immune serum formed two or three distinct precipitation lines with human saliva by the Ouchterlony method. Based on the presence or absence of a precipitation line, close to the antigen well designated as Pl, all human saliva were divided into two groups; Pl+ and Pl-. The incidence of Pl+ saliva was 114 out of 154 samples (74%). By immunoelectrophoresis with anti-saliva serum preabsorbed with Pl- saliva, Pl+ saliva formed a precipitation line in cathodal area. No amylase activity was found in this precipitation line but it was stained with the Schiff's reagent. Pl protein was isolated by Sephadex G-100 and ion-exchange chromatography. Isoelectric focusing of the Pl protein in polyacrylamide slab gel containing urea revealed that the protein differed from any known parotid salivary proteins such as Pr, Db, Pa and Pm.