Etiological relationships of parotid saliva cyclic nucleotides in patients with taste and smell dysfunction

ObjectiveWe previously demonstrated that parotid saliva cAMP and cGMP were lower in patients with taste and smell dysfunction than in normal subjects. We subsequently demonstrated parotid saliva cAMP and cGMP were inversely correlated with smell loss degree such that as smell loss severity increased parotid saliva cAMP and cGMP decreased proportionately. To learn more about these relationships we studied parotid saliva cAMP and cGMP with respect to aetiology of sensory loss in these patients.DesignParotid saliva cAMP and cGMP in patients with smell loss (hyposmia) who participated in an open label fixed design controlled clinical trial with treatment with oral theophylline were evaluated with respect to their initial etiological diagnosis. Levels of cyclic nucleotides in each etiological category were compared to each other, to the entire patient group and to normal subjects.ResultsMean cAMP and cGMP in all patients combined were below those in normals, as previously described. However, categorized by aetiology, there was a stratification of levels of both cyclic nucleotides; some levels were below the normal mean and some were at or above the normal mean.ConclusionsParotid saliva cyclic nucleotides characterised in hyposmic patients by aetiology indicate (1) there are differential alterations in these nucleotides related to aetiology of sensory dysfunction and (2) these moieties measured prior to treatment indicate which patient groups may benefit from treatment with phosphodiesterase (PDE) inhibitors which increase levels of these moieties and thereby correct their sensory dysfunction.     

Alteration of cyclic nucleotides levels and oxidative stress in saliva of human subjects with periodontitis

Experimental findings suggest a protective role for cyclic nucleotides against induction of oxidative stress in saliva. Oxidative stress is a major contributor to the pathogenesis of inflammatory diseases. This study was conducted to evaluate salivary oxidative stress along with cGMP and cAMP levels in periodontitis subjects. cAMP and cGMP are second messengers that have important roles in salivary gland functions. Unstimulated whole saliva samples were obtained from periodontitis patients and age- and sex-matched healthy individuals. Saliva samples were analyzed for thiobarbituric reactive substances (TBARS) as a marker of lipid peroxidation, ferric reducing ability (total antioxidant power, TAP), and levels of cAMP and cGMP. Concentrations of cAMP and cGMP were reduced in the saliva of patients with moderate and severe periodontitis. Saliva of patients with severe periodontitis had higher TBARS and lower TAP than control subjects. The presence of oxidative stress and lower levels of salivary cGMP and cAMP in periodontitis are in association with disease severity.     

Depressed taste and smell in geriatric patients

BACKGROUND: Geriatric patients have a number of dental care problems that younger patients do not encounter. The oral changes associated with aging can have a significant effect on the efficacy of dental treatment. TYPES OF STUDIES REVIEWED: The authors reviewed studies dealing with the causes of depressed sense of taste and smell; the causes included aging, disease, medications and dental problems. Based on their findings, the authors described the location and anatomy of taste buds and receptor cells for smell and explored appetite, saliva, food seasonings, nutrition and dietary recommendations. They also discussed the relationship of smoking and tongue cleaning to taste sensations. RESULTS: The authors found that considerable differences exist between elderly people and young people in regards to sensory perception and pleasantness of food flavors. Salt and bitter taste acuity declines with age, but sweet and sour perceptivity does not. Olfactory acuity also declines with age. The authors found that most of the studies reviewed suggested that the sense of smell is more impaired by aging compared with the sense of taste. Smoking diminishes the taste of food and makes flavorful foods taste flat, while tongue brushing can increase taste sensation for geriatric patients. CLINICAL IMPLICATIONS: Food can become tasteless and unappetizing for geriatric patients as the result of declining taste and smell perception. Geriatric patients should be encouraged to add seasonings to their food instead of relying on excessive consumption of salt and sugar to give their food flavor. Adequate nutrition, tongue cleaning and smoking cessation are recommended for geriatric dental patients.     

Disturbances of smell and taste after high central midface fractures.

Estimation of the senses of smell and taste in patients who had suffered a high central midface fracture between 1979 and 1989 was carried out. 180 of these patients were operated on for repositioning and fixation of their fractures. A written questionnaire was sent to 165 living patients, 109 individuals responded, a response rate of 66%. Of these patients, 38% claimed to suffer impaired ability to smell and 23% not to taste well. 64% mentioned unconsciousness after the trauma. With rising seriousness of the trauma, more disturbances of smell are found: from 25% of the nasal fractures, to 80% of the fronto-nasal-Le Fort fractures. In more than half of the cases of disturbance of smell, a simultaneous impairment of taste was reported. It can be concluded that disturbance of smell most often appears after fronto-maxillary and fronto-nasal fractures. However, the higher and more extensive the fracture is, the more frequently is unconsciousness reported. Consequently, impairment of smell can be attributed to the fracture itself, but also to a cerebral lesion located more proximally.     

Association between underweight and taste sensitivity in middle‐ to old‐aged nursing home residents in Sri Lanka: a cross‐sectional study

Low taste sensitivity may be one factor related to undernutrition, which is a major problem in developing countries. The purpose of this cross‐sectional study was to examine the association between underweight, one indicator of undernutrition, and taste sensitivity in middle‐ to old‐aged Sri Lankan nursing home residents. Participants were 946 residents with BMI of <25·0 from 25 nursing homes. Data were obtained on height, weight, taste sensitivity, subjective taste ability, sex, age, ethnicity, number of years in nursing homes, activities of daily living (ADL), frequency of exercise, bowel movements, smoking status, drinking status, current number of chronic diseases, number and kinds of medications used, self‐reporting questionnaire 20 (SRQ20), subjective smell ability, number of teeth present, Eichner index and flow rate of saliva. Low sensitivity to bitter taste, being male, old age, low ADL, smoking experience, drinking experience, fewer medications used and no use of medication for hypertension and diabetes were each associated with underweight (P < 0·05). In a multilevel Poisson regression model adjusted for sex, age, ADL, smoking status, drinking status, number of medications used, use of medication for hypertension and diabetes and flow rate of saliva, subjects with low sensitivity (>0·003% quinine hydrochloride dihydrate) to bitter taste had a significant 1·70 times higher prevalence ratio (95% confident interval 1·04–2·80) for underweight compared with those with high sensitivity (0·0001% quinine hydrochloride dihydrate). These results suggest that low taste sensitivity to bitter taste may be one factor related to underweight.     

Clinical implications of taste thresholds in patients with odontogenic maxillary sinusitis

Patients with odontogenic maxillary sinusitis (OMS) often complain of reduced taste sensitivity as well as nasal obstruction. The filter paper disc method (the conventional gustatory test) was applied to nine patients who underwent sinus surgery to open the inferior nasal meatus and sinus drainage, on three different days: 1 day prior to surgery, 7 days postoperative, and 28 days postoperative. The same test was applied to nine non-clinical participants with or without clipping the nose to interfere with smooth nasal airflow on two different days. Acquired recognition thresholds for the four basic tastes of sweet, salty, sour, and bitter were assessed. In OMS patients, the recognition thresholds for all four tastes were markedly decreased at 7 and 28 days postoperative, and subjective taste sensitivity and the elimination of nasal obstruction was improved. The mean recognition threshold for the four tastes correlated negatively with taste satisfaction scores. Clipping the nose in non-clinical participants induced increases in gustatory detection and recognition thresholds. Despite the small sample size and different ages and sexes of the study subjects, it was demonstrated that nasal obstruction in OMS patients and nose clipping in non-clinical subjects reduce taste reactivity, and surgical intervention to promote nasal airflow recovers impaired taste reactivity.     

Oral manifestations and salivary flow rate, pH, and buffer capacity in patients with end-stage renal disease undergoing hemodialysis.

OBJECTIVE: The aim of this study was to investigate oral manifestations and salivary changes in patients with end-stage renal disease undergoing hemodialysis. STUDY DESIGN: Eighty-two patients undergoing hemodialysis for renal insufficiency were examined; 22 of these patients were randomly selected for salivary tests. Unstimulated whole saliva and stimulated parotid saliva were collected, and flow rate, pH, and buffer capacity were examined. Twenty-two healthy volunteers were included as controls. RESULTS: Uremic odor, dry mouth, and taste change were common symptoms. Petechia and/or ecchymosis and increase of tongue coating were major signs. The flow rates of unstimulated whole and stimulated parotid saliva were decreased in the patient group. The pH and buffer capacity of unstimulated whole saliva were increased in the patient group, but stimulated parotid saliva did not show any significant differences. CONCLUSIONS: Patients with end-stage renal disease undergoing hemodialysis showed apparent oral and salivary changes. The results help us understand the relationship between oral changes and renal insufficiency.     

Effects of cyclic nucleotide derivatives on acetylcholine-induced secretion from isolated, perfused rat submandibular salivary glands

The effects of dibutyryl cAMP, 8-bromo-cGMP, 3-isobutyl-1-methyl xanthine (MIX) and isoproterenol were examined. When administered simultaneously with acetylcholine (10(-6) M) in concentrations of 10(-5) M, both isoproterenol and cAMP reduced fluid secretion (16 and 31 per cent, respectively) and enhanced the decay in rate of flow with time, while cGMP and MIX increased salivary volumes (25 and 19 per cent, respectively). Isoproterenol-decreased Na and Cl and increased K and residual anion concentrations. These effects, except for increased K, were also observed with MIX, cAMP and cGMP did not significantly affect cation concentrations but reduced Cl and increased residual anion, although to a lesser extent than isoproterenol or MIX. The cyclic nucleotides did not affect the flow of saliva when added to the perfusate for 40 min after 40 min of acetylcholine stimulation. Prior exposure to cGMP increased the volume of saliva secreted after re-exposure to acetylcholine alone and both cGMP and cAMP increased the Na and reduced the K concentration of the stimulated secretion. These results suggest that cyclic nucleotides are involved in salivary fluid and electrolyte secretion and can modulate the effects of cholinergic stimuli. cGMP may be involved mainly in fluid secretion and, as salivary fluid originates almost exclusively in salivary acini, it may exert its action in acinar cells and activate specific components of the mechanism of primary secretion. cAMP may be primarily involved in transductal electrolyte transport, and may also inhibit certain parts of the fluid secretory mechanism, or reduce the effectiveness of cholinergic stimuli in activating them.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of a maxillary complete denture on taste perception Patients regularly report an alteration in taste perception after the insertion

Patients regularly report an alteration in taste perception after the insertion of a maxillary complete denture. It is generally accepted that changes in temperature and texture perception of the food induced by covering the hard palate are the principalfactors contributing to this alteration. Besides temperature and texture, other factors contributing to taste perception are smell, age and saliva composition.     

Evaluation of the xerostomia,taste and smell impairments after Covid-19

Background The purpose of this study was to explore the effects of coronavirus disease 19 (Covid-19) on the oral cavity by evaluating the oral findings in the patients who recovered after treatment.Material and Methods This study involved confirmed Covid-19 patients whose treatment completed at least two weeks ago. A questionnaire consist of eight parts was applied to explore the oral findings after Covid-19. Also stimulated salivary flow rate was evaluated with a salivary flow test.Results 177 patients reached and 107 of them participate in the study. Regarding gender significant differences were found in terms of the presence of taste impairment after treatment (p=0.007), the degree of taste (p=0.021) and smell (p=0.010) impairment. 18 % (5/27) of the patients evaluated were showed hyposalivation. No significant differences were observed regarding salivary flow between males (mean±SD: 1.14±0.65) and females (mean±SD: 1.12±0.43), (p=0.928); among the patients having treatment at home (mean±SD: 1.03±0.48) or hospital (mean±SD: 1.33±0.65), (p=0.187). In some of the patients’ taste [15], smell [23] impairment, and xerostomia [43] still observed at least two weeks after the treatment is completed.Conclusions The most frequent finding in patients after the treatment was xerostomia. Taste and smell impairments were more frequently observed in females. Key words:Saliva, oral findings, hyposalivation, Covid-19.     

Theophylline increases saliva sonic hedgehog and improves taste dysfunction

ObjectiveTo determine changes in saliva sonic hedgehog (Shh) and in taste dysfunction before and after oral theophylline treatment.DesignShh was measured in parotid saliva of both normal subjects and patients with taste dysfunction of multiple etiologies by use of a sensitive spectrophotometric ELISA assay. Taste dysfunction was defined clinically by both subjective inhibition of taste function (including acuity loss) and impaired gustometry.ResultsTheophylline treatment increased patient saliva Shh and improved taste dysfunction both subjectively and by gustometry.ConclusionsBy use of these systematic clinical measurements theophylline can be demonstrated to increase saliva Shh and improve taste dysfunction. These results are consistent with saliva Shh acting as a taste bud growth factor which stimulates stem cells of taste buds to initiate development and perpetuation of taste bud receptors. Measurements of saliva Shh provide an important marker for the presence of taste dysfunction and in the improvement by theophylline treatment.     

Detection and rapid increase of salivary antibodies to Staphylococcus lentus, an indigenous bacterium in rabbit saliva, through a single tonsillar application of bacterial cells

In rabbits, Staphylococcus lentus is one of the major bacteria in saliva and a minor bacteria in jejunum fluids and nasal wash. The presence and induction of naturally occurring antibodies reacting to rabbit indigenous bacteria were studied. In non-immune rabbits, the proportion of anti-S. lentus IgA antibodies to total IgA in the saliva was several times higher than that in the intestinal fluids and the nasal wash. The salivary antibodies were found to have increased 1 week after a single tonsillar application of isolated S. lentus cells but not after a single nasal application or a single intragastric instillation. In addition, the anti-S. lentus antibodies in the saliva highly increased with weekly tonsillar applications of isolated S. lentus but increased only one-fifth with weekly nasal applications of the same cells. These results strongly suggest that the palatine tonsils, which we believe had already been sensitized by S. lentus in the physiological condition, induced naturally occurring antibodies in rabbit saliva.     

Preferences and saliva stimulation of eight different chewing gums

OBJECTIVES: Chewing gums have been studied for clinical use to stimulate the salivary flow rate in healthy and diseased individuals. However, differences in preferences of chewing gums may influence patient compliance during long-term use. Therefore, we compared the effect of several chewing gums on the flow rate of whole saliva and pH, and investigated the preferences of these gums. METHODS: 83 healthy subjects participated in the first part of the study. Both parafilm-stimulated and chewing gum-stimulated whole saliva from 8 different chewing gums was collected and salivary flow rate and pH were determined. In another group of 112 healthy subjects, we investigated the preferences for the chewing gums with a 10-item questionnaire. RESULTS: All gums had comparable effects on salivary flow rate and pH. The average increase in flow rate was 187% during the first minute of chewing compared with parafilm stimulation. After 10 minutes of gum chewing, the amount of saliva was equal to parafilm stimulation. The questionnaire showed differences in preferences for the chewing gums, which were related to taste and gum shape. Gender interactions were observed for sparkling taste (p = 0.019), total judgement (p = 0.047) and the willingness to use the gum for several weeks (p = 0.037). CONCLUSIONS: Although all chewing gums stimulated the salivary flow rate equally, the observed differences in preferences may influence long-term compliance. Therefore, we recommend that chewing gums are tested before the start of clinical studies, to identify the most accepted chewing gum for specific groups of patients.     

Biochemical analysis of saliva and taste acuity evaluation in patients with burning mouth syndrome, xerostomia and/or gustatory disturbances

OBJECTIVE: In the current study, we performed taste and salivary analysis on patients suffering from burning mouth syndrome and xerostomia or taste disturbances. STUDY DESIGN: A total of 180 patients who complained of idiopathic burning mouth syndrome (BMS) and taste aberrations and/or xerostomia that may accompany BMS were evaluated. These patients were compared with 90 healthy, age- and sex-matched controls. Salivary flow rate, biochemical and immunological analysis and taste acuity by the forced-choice drop technique were performed for all subjects. These analyses were found to be conclusive in distinguishing controls from patients with complaints. RESULTS: The great similarity of both salivary and taste analysis in the BMS, taste aberration and xerostomia groups, which were significantly different from the results obtained in the control group, was found to be the most striking result. Higher salivary concentrations in the experimental group were consistent with a lower saliva (water) flow rate. CONCLUSION: An oral neuropathy and/or neurological transduction interruption induced by salivary compositional alterations is suggested as the possible aetiology for the complaints. This report may add an important objective diagnostic tool to the clinician treating these patients.     

Plasminogen in human saliva

Plasminogen has been demonstrated in human parotid submandibular and whole saliva both immunologically and functionally by activation with streptokinase. There was a significantly higher level of plasminogen in whole saliva than in either parotid or submandibular saliva, but these differences were largely eliminated after centrifugation. This was due to the tissue plasminogen content of leucocytes and epithelial cells which are present in whole saliva but which are removed by centrifugation. Plasminogen is therefore predominantly secreted in saliva. Since clinically fibrin clots seldom persist on the oral mucosa it is suggested that a potent plasminogen-assisted in vivo system of fibrinolysis may be operating in the oral mucosa.     

Prevalence of Anosmia or Ageusia in Patients With COVID-19 Among United Arab Emirates Population

ObjectiveThe aim of this research was to determine the relationship and prevalence of taste and smell dysfunction in patients with COVID-19 in the United Arab Emirates (UAE) population.MethodsEnrolled participants were interviewed online via a phone call after obtaining their informed consent. Quantification of smell, taste, and other sensations before, during, and after COVID-19 infection was correlated with the severity of COVID-19 symptoms.ResultsA total of 500 patients with (mild–severe) COVID-19 completed the survey. A total of 26.4% were asymptomatic, and 21.4% were classified as paucisymptomatic with less severe symptoms. Almost equal proportions of the studied population experienced extreme taste sensation reductions (43%) and loss of smell sensation (44%). Statistically significant drastic decreases in smell and taste senses were seen among younger individuals. The magnitude of reduction in both sense changes increased steeply from the asymptomatic group to the paucisymptomatic group to the symptomatic group.ConclusionsSudden anosmia or ageusia need to be recognised for early detection of COVID-19 infection to identify otherwise hidden carriers, thus favoring an early isolation strategy that will restrict the spread of the disease.     

口腔鳞癌患者免疫功能测定及其临床意义

本文从分子学水平和细胞学水平，对３０例口腔鳞癌患者，及相应的正常对照者，做血浆ｃＡＭＰ、ｃＧＭＰ含量及外周血Ｔ淋巴细胞亚群测定。血浆ｃＡＭＰ、ｃＧＭＰ含量测定发现，口腔鳞癌患者ｃＡＭＰ明显低于正常对照者（Ｐ＜０．０１），而ｃｏＭＰ和ｃＡＭＰ／ｃＧＭＰ无明显差异（Ｐ＞０．０５），提示口腔鳞癌患者ｃＡＭＰ抑制肿瘤细胞生长的能力低下，与全身其他部位癌症基本一致。Ｔ淋巴细胞亚群测定发现，口腔鳞癌患者与正常人存在明显差异，主要表现为口腔鳞癌患者ＣＤ３↓（Ｐ＜０．０５），ＣＤ８↑（Ｐ＜０．０１），ｃＤ４／ＣＤ８↓（ｐ＜０．０１），提示口腔鳞癌患者细胞免免疫功能紊乱，免疫平衡失调。     

Variations in the content of cyclic adenosine monophosphate in human mixed saliva during physiological stimulation.

The concentration and secretion rate of cyclic adenosine 3′,5′-monophosphate (cAMP) in human mixed saliva was studied in six normal persons before, during and after a meal. Both concentration and secretion rate of cAMP increased markedly after intake of food. Secretion rate varied from 8.3 ± 4.7 (mean ± S.D.) pmoles cAMP per min in the fasted state to 111.0 ± 40.9 pmoles per min during the meal and basal levels were reached one hour after it ended. The results indicate that determination of cAMP in saliva offers an opportunity to study the participation of hormones in the secretory response without trauma to the glands or interference with their secretion.     

Immunohistochemical evidence that electric currents increase periosteal cell cyclic nucleotide levels in feline alveolar bone in vivo

Applications of constant direct currents (15 ± 2 μA) to cat gingiva (non-invasively for 1–7 days) caused alterations in the immunohistochemical staining pattern of alveolar bone periosteal cells for cAMP and cGMP. In general, the staining intensity increased and the intracellular distribution pattern was changed. Additionally, exposure to electric currents produced increases in the number of cells intensely stained for cAMP and cGMP in the periosteum. It thus appears that the effect of electricity on bone cells in vivo is mediated by cyclic nucleotides.     

Cyclic nucleotides and growth regulation of the mandibular condylar cartilage of the rat in vitro

By exogenous interference in the intracellular level of cAMP and cGMP during growth in vitro without and with compression, an indication was obtained for the mediatorial involvement of these cyclic nucleotides in the major growth-processes in the mandibular condylar cartilage of 4-day-old rats. Raising the intracellular level of cAMP reduced proliferative activity in the prechondroblast zone, did not affect matrix synthesis by the functional chondroblasts and stimulated the process of hypertrophy. Intracellular elevation of cGMP had an antagonistic effect; it stimulated proliferation as well as matrix synthesis, but had no effect on hypertrophy. In this specific type of cartilage, cGMP can be considered as a major secondary intracellular messenger for proliferation-stimulating continuous biomechanical stimuli.