Salivary cortisol, 17β-estradiol, progesterone, dehydroepiandrosterone, and α-amylase in patients with burning mouth syndrome

Oral Diseases (2012) 18, 613–620 Objective: The aim of this study was to investigate salivary markers related with burning mouth syndrome (BMS). Materials and Methods: Thirty female patients with BMS and twenty female control subjects were included. Unstimulated (UWS) and stimulated whole saliva samples (SWS) were collected, and their flow rates were determined. Salivary levels of cortisol, 17β‐estradiol, progesterone, dehydroepiandrosterone (DHEA), and enzymatic activity of α‐amylase were determined. Salivary transferrin level was measured to determine the level of blood contamination in saliva samples. Results: The levels of all analytes in UWS were significantly correlated with those of SWS. The levels of 17β‐estradiol, progesterone, and DHEA in UWS were significantly correlated with age. Age‐matched comparisons revealed that the patient group had significantly higher levels of cortisol in UWS and of 17β‐estradiol in SWS. When the patients were divided into older (≥60 years) and younger (<60 years) groups, the older group showed a significantly lower level of progesterone in UWS. There were no significant relationships between treatment efficacy and levels of salivary analytes. Conclusions: In conclusion, patients with BMS showed significantly higher levels of cortisol in UWS and of 17β‐estradiol in SWS compared with controls.     

Oral mucosal epithelial cells express the membrane anchored mucin MUC1

ObjectiveThe presence of a stable salivary pellicle (SP) is essential to provide a wet surface for the oral mucosal epithelia. The oral mucosa is covered by the SP which is suggested to be a mixed film of both salivary and epithelial components. Our aim was to analyse the presence of membrane-anchored mucin MUC1 in the oral mucosal epithelia.DesingThe presence of MUC1 was studied by immunohistochemical and immunoelectron microscopical methods in 19 buccal mucosal specimens. The localization and intensity of the epithelial expression were analyzed.ResultsStrong staining of MUC1 was found in the epithelial cells of intermediate and superficial layers. Some basal cells were shown faint expression. In the intermediate and superficial layers, the MUC1 expression was seen mainly on the upper cell surface. Furthermore, the expression of MUC1 was noted in the cytoplasm near the nucleus and in the rough granules. By electron microscopy, extracellular domain of membrane-anchored molecules extruded about 15–30 nm above the cell surface in the apical cells of the oral epithelium. Immunoelectron microscopic examination shows that MUC1 is mainly localized in the plasma membrane of epithelial cells and also in small vesicles (75–100 nm) just below the plasma membrane.ConclusionThe membrane-anchored MUC1 is expressed in the superficial layer of the oral mucosal epithelium, especially on the upper surface of epithelial cells. MUCI may be the anchoring protein of the salivary pellicle stabilization.     

The membrane-associated MUC1 improves adhesion of salivary MUC5B on buccal cells. Application to development of an in vitro cellular model of oral epithelium

ObjectivesThe mucosal pellicle is a thin layer of salivary proteins, mostly MUC5B mucins, anchored to epithelial oral cells. This pellicle is involved in protection of oral mucosae against abrasion, pathogenic microorganisms or chemical xenobiotics. The present study aimed at studying the involvement of MUC1 in mucosal pellicle formation and more specifically in salivary MUC5B binding using a cell-based model of oral epithelium.DesignMUC1 mRNAs were not detected in TR146 cells, and therefore a stable cell line named TR146/MUC1 expressing this protein was developed by transfection. TR146 and TR146/MUC1 were incubated with human saliva in order to evaluate retention of MUC5B by epithelial cells.ResultsThe cell surface of both TR146 and TR146/MUC1 was typical of a squamous non-keratinized epithelium, with the presence of numerous microplicae. After incubation for 2 h with saliva diluted in culture medium (1:1) and two washes with PBS, saliva deposits on cells appeared as a loose filamentous thin network. MUC5B fluorescent immunostaining evidenced a heterogeneous lining of confluent cell cultures by this salivary mucin but with higher fluorescence on TR146/MUC1 cells. Semi-quantification of MUC5B bound to cells confirmed a better retention by TR146/MUC1, evaluated by Dot Blot (+34.1%, p < 0.05) or by immunocytochemistry (+44%, p < 0.001).ConclusionThe membrane-bound mucin MUC1 is a factor enhancing the formation of the mucosal pellicle by increasing the binding of salivary MUC5B to oral epithelial cells. An in vitro model suitable to study specifically the function and properties of the mucosal pellicle is proposed.     

Comparison between burning mouth syndrome patients with and without psychological problems

The purpose of this study was to compare clinical and socio-demographic characteristics between burning mouth syndrome (BMS) patients with and without psychological problems. Of 644 patients with symptoms of oral burning, 224 with primary BMS were selected on the basis of laboratory testing, medical history, and psychometric tests: 39 with psychological problems (age 62.5 ± 11.5 years) and 185 without psychological problems (age 58.4 ± 11.4 years). Comprehensive clinical and socio-demographic characteristics, including psychological profiles and salivary flow rates, were compared between the two groups. No significant difference in sex ratio, duration and diurnal pattern of symptoms, unstimulated whole saliva flow rate, or marital status was found between the groups. The patients with psychological problems had a significantly higher mean age, reduced stimulated whole saliva flow rate, and lower level of education than those without psychological problems. The patients with psychological problems also displayed higher rates and greater severity of various types of BMS-related symptom in most parts of the oral mucosa, higher rates of stress-related symptoms, and greater difficulties in daily activities. The severity of taste disturbance was the factor most significantly correlated with the level of psychometry. In conclusion, psychological problems in BMS patients are associated with an aggravation of BMS symptoms.     

The effect of clinical setting on the unstimulated salivary flow rate

ObjectiveUnstimulated whole saliva (UWS) sialometry uses the spitting method to assess occurrence of hyposalivation. This study compares the UWS flow rates in volunteers sitting in a laboratory or in a clinical setting, in order to evaluate the influence of environment on salivary secretion.Design25 healthy volunteers were recruited and divided into two groups to perform UWS sialometry under the two different settings (T1). Eleven weeks later, the participants repeated the same test (T2). At a unique time point and under the clinical setting, 18 patients complaining of xerostomia also performed the UWS sialometry; these values were used as control to corroborate findings.ResultsDifferent scenarios – laboratory one vs. clinical one – did not affect measurements of mean UWS flow rates. Both intra- and inter-individual variabilities, reported as standard error of the mean (SEM) and within-subject variance (WSV), resulted below the threshold of 0.1 g/min. A significant difference was found between UWS flow rates from healthy volunteers and those from patients with xerostomia (p < 0.05). Test/retest reliability showed a moderate correlation of datasets collected at the two time points from healthy volunteers (T1 vs. T2, 11 weeks later): under laboratory and clinical settings, Pearson’s coefficients of correlation were r = 0.62 and r = 0.32, respectively.ConclusionsType of environment did not influence UWS sialometry via spitting method, which appeared reliable for intra-day analysis of the salivary flow rate, although prone to physiological variations over time.     

Saliva flow rates and clinical characteristics of patients with burning mouth syndrome: A case–control study

Burning mouth syndrome (BMS) is a chronic pain condition that most commonly affects postmenopausal women older than 50 years of age. Xerostomia is a common complaint among BMS patients. However, previous studies showed inconsistent findings regarding saliva flow rate reduction. This study examined saliva flow rates, degree of mucosal hydration, xerostomia, and clinical characteristics in BMS patients compared with healthy controls. Unstimulated whole saliva (USWS) was collected through passive drooling; residual mucosal saliva (RMS) was collected using filter paper strips. Stimulated whole saliva (SWS) was collected while chewing on gum base. Oral exam and self-report data were collected. A total of 50 women (22 BMS cases and 28 healthy controls) aged 50 years or older were included in the analysis of this study. Mean age was 62 years for cases and 56 years for controls (P = 0.05). Compared with controls, cases had significantly lower USWS flow rates (P < 0.001) and had a higher prevalence of xerostomia (P = 0.001), gastrointestinal disease (P < 0.001), and vaginal dryness (P = 0.01). These data show that oral and vaginal dryness are common among BMS patients. Further studies are needed to investigate potential pathophysiological mechanisms related to the quality of saliva and mucosal barrier status among these patients.     

Probiotic intervention influences the salivary levels of Matrix Metalloproteinase (MMP)-9 and Tissue Inhibitor of metalloproteinases (TIMP)-1 in healthy adults

ObjectiveTo study the effect of orally administered Bifidobacterium animalis subsp. lactis BB-12 and Lactobacillus rhamnosus GG on the salivary levels of Matrix Metalloproteinases (MMP)-8, MMP-9 and of Tissue Inhibitor of Metalloproteinases (TIMP)-1 in healthy adults. Furthermore, the correlations between MMP-8, MMP-9 and TIMP-1 and plaque and gingival indices, salivary mutans streptococci and lactobacilli counts, and stimulated saliva secretion rate were analysed.DesignThe salivary samples originated from a randomized controlled trial where healthy student volunteers consumed probiotic or placebo lozenges twice a day for four weeks. The saliva samples were collected and clinical parameters measured at the baseline and at the end of the original study. For this study, the salivary levels of MMP-8, MMP-9 and TIMP-1 were analysed with immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA).ResultsIn the probiotic group (n = 29), salivary MMP-9 levels increased (p < 0.01) and TIMP-1 levels decreased (p < 0.01) significantly during the intervention. Furthermore, MMP-9/TIMP-1 ratio differed significantly from the baseline level (p < 0.01). These changes were not observed in the control group (n = 31). In the whole data, salivary MMP-9 and gingival index correlated (r = 0.260, p < 0.05 at baseline and r = 0.354, p < 0.01 at the end of the study). Intergroup differences or correlations with other clinical parameters were not found. Probiotic consumption did not affect the saliva flow rate.ConclusionsIncreased MMP-9 and decreased TIMP-1 levels in saliva may indicate that probiotics have immunomodulatory effects in the oral cavity. Furthermore, increased salivary MMP-9 levels may be an indication of the defensive potential of matrix metalloproteinases.     

Salivary levels of IL-1β, IL-6, IL-8, and TNF-α in patients with burning mouth syndrome

Objective

To compare salivary IL-1β, IL-6, IL-8, and TNF-α levels between patients with burning mouth syndrome (BMS) and controls.

Design

Forty female patients with BMS (mean age: 61.6 ± 10.1 years) and 20 female control subjects (mean age: 65.1 ± 9.0 years) were included in the study. Unstimulated (UWS) and stimulated whole saliva samples (SWS) were collected and their flow rates were determined. Salivary IL-1β, IL-6, IL-8, and TNF-α levels and total protein concentration were also determined. Salivary transferrin level was determined to investigate the level of blood contamination in saliva samples. Gingival index of the subjects was also examined. Student's t-test, Pearson's correlation analysis, and analysis of covariance were used.

Results

No significant differences were found in the salivary levels of IL-1β, IL-6, IL-8, and TNF-α in BMS patients compared with controls. Salivary flow rates and their total protein concentrations did not differ significantly between the groups. The levels of salivary cytokines and total protein concentration correlated significantly with the level of blood contamination in both UWS and SWS.

Conclusion

There were no differences in the salivary levels of IL-1β, IL-6, IL-8, and TNF-α in BMS patients compared with controls. Cytokine levels in whole saliva were affected mainly by the amount of blood contamination.     

Antimicrobial peptides in saliva of children with severe early childhood caries

ObjectiveControversies exist regarding the relationship between the concentrations of antimicrobial peptides (AMPs) and presence of dental caries in children. Thus, the aim of this study was to examine levels of AMPs in saliva of caries-free (CF), early childhood caries (ECC) and severe early childhood caries (S-ECC) children to determine if the levels of these salivary peptides individually or in combinations were related to caries severity and mutans streptococci levels.Design36 to 60 month-old children were selected to participate in this study. Children were grouped into CF group (n = 29), ECC group (n = 25) and S-ECC group (n = 29). Saliva was collected from children for microbiological analysis by culture. Salivary concentrations of cathelicidin LL-37, human β-defensin 2 (hBD-2), human β-defensin 3 (hBD-3) and histatin-5 (HTN-5) were determined by ELISA.ResultsSalivary concentrations of AMPs did not differ among CF, ECC and S-ECC groups. Data showed positive correlations between mutans streptococci levels and salivary hBD-2 or HTN-5. Positive correlations were found between hBD-2, hBD-3, LL-37 and HTN-5. Combinations among AMPs, mainly LL-37, were positively associated with caries levels.ConclusionsSalivary concentrations of AMPs individually were not associated with the severity of early childhood caries. The stimulus of caries appears to trigger a biological response, however, with a combination of these peptides.     

Relationship between the IgA antibody response against Streptococcus mutans GbpB and severity of dental caries in childhood

ObjectiveExplore the associations between the severity of dental caries in childhood, mutans streptococci (MS) levels and IgA antibody response against Streptococcus mutans GbpB. Moreover, other caries-related etiological factors were also investigated.Design36–60 month-old children were grouped into Caries-Free (CF, n = 19), Early Childhood Caries (ECC, n = 17) and Severe Early Childhood Caries (S-ECC, n = 21). Data from socio-economic-cultural status, oral hygiene habits and dietary patterns were obtained from a questionnaire and a food-frequency diary filled out by parents. Saliva was collected from children for microbiological analysis and detection of salivary IgA antibody reactive with S. mutans GbpB in western blot.ResultsS-ECC children had reduced family income compared to those with ECC and CF. There was difference between CF and caries groups (ECC and S-ECC) in MS counts. Positive correlations between salivary IgA antibody response against GbpB and MS counts were found when the entire population was evaluated. When children with high MS counts were compared, S-ECC group showed significantly lower IgA antibody levels to GbpB compared to CF group. This finding was not observed for the ECC group.ConclusionsThis study suggests that children with S-ECC have reduced salivary IgA immune responses to S. mutans GbpB, potentially compromising their ability to modify MS infection and its cariogenic potential. Furthermore, a reduced family income and high levels of MS were also associated with S-ECC.     

Increased melatonin in oral mucosal tissue of oral lichen planus (OLP) patients: A possible link between melatonin and its role in oral mucosal inflammation

ObjectiveThe existence of extra-pineal melatonin has been observed in various tissues. No prior studies of melatonin in human oral mucosal tissue under the condition of chronic inflammation have been reported. The aim of this study was to investigate the presence of melatonin in oral mucosal tissue of patients with oral lichen planus (OLP) which was considered as a chronic inflammatory immune-mediated disease causing oral mucosal damage and ulcerations.Materials and methodsSections from formalin-fixed and paraffin-embedded oral mucosal tissue of OLP patients (n = 30), and control subjects (n = 30) were used in this study. Immunohistochemical staining was performed and the semiquantitative scoring system was used to assess the levels of arylalkylamine-N-acetyltransferase (AANAT: a rate-limiting enzyme in the biosynthesis pathway of melatonin), melatonin, and melatonin receptor 1 (MT1) in oral mucosa of OLP patients and normal oral mucosa of control subjects.ResultsAANAT, melatonin, and MT1were detected in oral mucosal tissue of OLP patients and control subjects. Immunostaining scores of AANAT, melatonin, and MT1 in oral mucosal tissue of OLP patients were significantly higher than those in control subjects (p = 0.002, p < 0.001, and p = 0.031, respectively).ConclusionsIncreased levels of AANAT, melatonin, and MT1 in the inflamed oral mucosal tissue of OLP patients imply that chronic inflammation may induce the local biosynthesis of melatonin via AANAT, and may enhance the action of melatonin via MT1.     

Salivary antioxidants and oral health in children with autism

Individuals with autism vary widely in abilities, intelligence, and behaviours. Autistic children have preferences for soft and sweetened food making them susceptible to caries. A wide spectrum of medical and behavioural symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Mental retardation is evident in approximately 70% of individuals with autism and most psychiatric disorders including autism are associated with increased oxidative stress.ObjectivesTo evaluate the oral health status of children with autism and to determine the salivary pH and total salivary antioxidant concentration (TAC).Materials and methods101 subjects with autism between age group of 6 and 12 year were part of the study and 50 normal healthy siblings of same age group were taken as control group. Oral health status was analysed using oral hygiene index-simplified and dentition status index. The salivary total anti-oxidant level was estimated using phosphomolybdic acid using spectrophotometric method and the salivary pH using the pH indicating paper. The results were statistically analyzed using Mann–Whitney U test.ResultsA statistically very highly significant difference was seen in the mean oral hygiene index scores (autistic group – 1.2 and control group – 1, P < 0.001) and the mean salivary total antioxidant concentration (autistic group – 5.7 μg/ml and control group – 38 μg/ml, P < 0.001). No statistical significant difference was observed in the dental caries status and the salivary pH of autistic group and the control group.ConclusionsSimilar dental caries status was observed in children with autism and their healthy normal siblings. Oral hygiene was poor in children with autism whereas the Salivary TAC was significantly reduced in autistic children.     

Effect of interocclusal appliance on bite force,sleep quality,salivary cortisol levels and signs and symptoms of temporomandibular dysfunction in adults with sleep bruxism

ObjectiveThe purpose was to evaluate the effect interocclusal appliance therapy on bite force (BF), sleep quality and salivary cortisol levels in adults with SB diagnosed by polysomnography. As a secondary aim, signs and symptoms of temporomandibular dysfunction (TMD) were evaluated.DesignForty-three adults (19–30 y/o) were divided into two groups: experimental group (G_SB), composed of 28 subjects with SB, and control group (G_C), without SB and TMD (n = 15). G_SB was treated with stabilization interocclusal splint and evaluated at time intervals: before (baseline), one month (T1) and two months (T2) after therapy began, to collect data related to BF, sleep quality (Pittsburgh Sleep Quality Index), salivary cortisol levels and TMD. G_C was also examined three times and received no therapy. Data were analysed by means of normality tests, t-test/Mann-Whitney and One-way ANOVA repeated measures (Tukey post-test). Two-way ANOVA test for repeated measures was applied to verify the effect time*group interaction on the variance of each dependent variable (α = 0.05).ResultsG_SB showed an increase in BF and a positive effect on muscular symptomatology, range of mandibular movements and sleep quality; in G_C these parameters did not differ. Cortisol concentration decreased between baseline and T1 in G_SB (F_(1,31) = 4.46; test power = 62%; p = 0.017). The variance observed for BF, TMD and sleep quality among time points was dependent on the group (moderate effect size: partial Eta square >0.16; test power >80%).ConclusionsThe results suggested that short-term interocclusal appliance therapy had a positive effect on BF, temporomandibular symptomatology, sleep quality and salivary cortisol levels in adults with SB.     

Salivary levels of antimicrobial peptides Hnp 1-3, Ll-37 and S100 in Behcet's disease

BackgroundOral ulcer is the cardinal clinical sign and increased neutrophilic activity is a part of the pathogenesis in Behcet's disease (BD). Saliva, as a part of the innate immune response, contains antimicrobial peptides (AMPs) that are derived from both oral epithelial cells and neutrophils. The aim of this study was to investigate the associations between salivary levels of AMPs HNP 1-3, LL-37 and S100 and disease course in patients with Behcet's disease (BD).MethodsFifty-three patients with BD and 44 healthy controls (HC) were included in the study. Disease severity score reflecting organ involvement was calculated. Salivary HNP 1-3, LL-37 and S100 levels were measured in unstimulated saliva samples by ELISA.ResultsSalivary HNP 1-3 and S100 levels in BD patients (2715.2 ± 1333.4 μg/ml and 430.6 ± 203.9 ng/ml) were significantly higher compared to HC (1780.6 ± 933.2 μg/ml and 365.3 ± 84.7 ng/ml) (p = 0.000 and p = 0.004, respectively). Although LL-37 levels were also higher in BD than HC (190.9 ± 189.1 vs 143.1 ± 128.9 ng/ml), no significant difference was observed (p = 0.53). Salivary HNP 1-3 and LL-37 levels were associated with the severity of BD (mild disease: 1975.1 ± 1174.2 μg/ml and 115.9 ± 109.4 ng/ml vs severe disease: 2955.7 ± 1305.6 μg/ml and 215.3 ± 203.8 ng/ml, p = 0.020 and p = 0.031, respectively). Salivary LL-37 levels also correlated with the number of monthly oral ulcers (r = 0.5 p = 0.000).ConclusionAn increase in salivary HNP 1-3 and S100 levels might be associated with enhanced local and systemic innate responses in BD.     

The effect of dietary intervention on paraffin-stimulated saliva and dental health of children participating in a randomized controlled trial

ObjectivesThe aim was to study the impact of dietary intervention on the properties of paraffin-stimulated saliva, and on dental caries.Study designAt 7 months of age 1062 infants (540 intervention; 522 controls) started in the prospective, randomized Special Turku Intervention Project (STRIP) aimed at restricting the child's saturated fat and cholesterol intake to prevent atherosclerosis of adult age (www.clinicaltrials.gov NCT 00223600). At 3 years of age, every fifth child was invited to an oral sub-study, and 148 (78 boys) children attended. At 6, 9, 12 and 16 years of age 135, 127, 114 and 88 children were restudied, respectively. Dietary intakes of carbohydrates, protein, saturated fat, calcium, phosphate, and fibre were regularly recorded using 4-day food records. Height and weight were regularly monitored. Paraffin-stimulated saliva samples were collected at 6, 9, 12 and 16 years of age, and analyzed for flow rate, buffer capacity, calcium, phosphate and proteins. Dental health was recorded and expressed as d₃mft/D₃MFT, and as time of caries onset.ResultsDietary intakes of calcium, phosphate and fibre, and salivary flow rate increased with time in both groups (p < 0.001, GLM for repeated measures). Fibre intake and salivary flow rate were higher in the intervention than in the control group (p = 0.042 and p = 0.0394, respectively, GLM for repeated measures). There were no correlations between dietary intakes and salivary concentrations of calcium or phosphate. Children who did not have caries experience (d₃mft/D₃MFT = 0) during the entire follow-up had higher salivary calcium than those who had caries already at 3 years of age. The association between salivary calcium and caries onset was significant up to 12 years of age. Toothbrushing frequency was statistically significantly associated with caries-onset at ages 6 (gamma statistic 0.457, p = 0.046) and 12 years (gamma statistic 0.473, p = 0.019).ConclusionsThe current long-term dietary intervention increased children's paraffin-stimulated salivary flow rate. The concentration of salivary calcium was directly correlated to dental health. Higher salivary flow rate in the intervention group is believed to be due to higher fibre intake in the intervention group.     

Influence of motion and posture of the head on data obtained using the newly developed ultraminiature cordless bruxism measurement system

PurposeTo elucidate the influence of motion and posture of head on the newly developed ultraminiature cordless bruxism measurement system (BMS), we examined masseteric electromyographic (EMG) data of BMS during turning-over movements in bed in comparison with those of a conventional polygraph system (PG).MethodsTwelve healthy subjects lay on their back and then turned to the right (right turn, 90°) and then to the left (left turn, 180°). Maximum amplitudes and root mean square (RMS) values of EMG data were calculated during the phase of turning movements. The data were high-pass filtered at 10 Hz, 30 Hz, 50 Hz, and 100 Hz.ResultsArtifact signals were visibly observed in PG measurement for all subjects and in BMS measurement for three subjects. Maximum amplitudes during right turn measured by BMS were significantly smaller than those measured by PG, while there was no significant difference during left turn. During right turn, RMS values high-pass filtered at 10 Hz obtained by BMS were significantly smaller than those obtained by PG, while there was no significant difference between the data obtained by the two devices at the other cut-off frequencies. During left turn, there was no significant difference between RMS values obtained by the two devices.ConclusionsAlthough BMS data were slightly affected by motion and posture of head during simulated sleep-turning, it was suggested that motion artifact of signals during BMS measurements is equivalent to or less than that during PG measurements, and BMS is thought to be suitable to measure sleep bruxism.     

Sensory purinergic receptor P2X3 is elevated in burning mouth syndrome

Recent studies show that P2X₃ may play a role in neuropathic pain, including orofacial pain. Burning mouth syndrome (BMS) is a chronic neuropathic pain condition affecting 0.6–12% of post-menopausal women in the Western world. This study evaluates, for the first time, P2X₃ immunoreactivity levels in lingual mucosa in BMS patients. Patients diagnosed with BMS (n = 9) in accordance with International Association for the Study of Pain criteria and patients attending for wisdom tooth removal (n = 10, controls), were involved in this study. A pain history and score was recorded on a visual analogue scale (VAS) prior to obtaining a lingual biopsy. Immunohistochemistry and image analysis were used to quantify submucosal nerve fibres expressing P2X₃ and the structural marker neurofilaments. P2X₃ positive fibres were significantly increased in BMS compared with controls (p = 0.024). In contrast, neurofilament-staining fibres were reduced in BMS, and when expressed as a ratio of the neurofilament percentage area, there was a trend for an increase of P2X₃ positive fibres in the BMS group. Increased P2X₃ immunoreactivity in the trigeminal sensory system may play a role in the symptoms observed in BMS. P2X₃ may therefore be a therapeutic target for treating BMS and trigeminal neuropathic pain.     

Immunohistochemical expression of epithelial cell adhesion molecule (EpCAM) in mucoepidermoid carcinoma compared to normal salivary gland tissues

ObjectivesMucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor which displays biological, histological and clinical diversity thus representing a challenge for its diagnosis and management. Epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein identified as a tumor specific antigen due to its frequent overexpression in the majority of epithelial carcinomas and its correlation with prognosis. It is considered to be a promising biomarker used as a therapeutic target already in ongoing clinical trials. The purpose of this study was to investigate the pattern, cellular characterization and level of EpCAM expression in MEC and demonstrate its correlation with histologic grading which may benefit future clinical trials using EpCAM targeted therapy.Materials and methods48 specimens (12 normal salivary gland tissue and 36 MEC) were collected and EpCAM membranous expression was evaluated by immunohistochemistry. Total immunoscore (TIS) was evaluated, the term ‘EpCAM overexpression’ was given for tissues showing a total immunoscore >4.ResultsA highly significant difference was observed between TIS percent values in control and different grades of MEC (p < 0.001). High grade MEC (HG-MEC) was the highest EpCAM expressor. In addition, EpCAM expression pattern differed among the different grades.ConclusionEpCAM expression was detected in MEC, and its overexpression correlated with increasing the histological grade. The diffuse membranous expression in HG-MEC could be of diagnostic value in relation to the patchy expression observed in both low grade and intermediate grade MEC.     

DEFB1 polymorphisms and salivary hBD-1 concentration in Oral Lichen Planus patients and healthy subjects

ObjectivesThe aetiology of Oral Lichen Planus (OLP), a chronic inflammatory disease of oral mucosa, is not yet well understood. Since innate immunity may be hypothesized as involved in the susceptibility to OLP, we studied human beta defensin 1 (hBD-1) an antimicrobial peptide constitutively expressed in the saliva, looking at functional genetic variants possibly able to diminish hBD-1 production an consequently conferring major susceptibility to OLP.DesignWe analysed three DEFB1 polymorphisms at 5′ UTR, −52G > A (rs1799946), −44C > G (rs1800972), −20G > A (rs11362) and two DEFB1 polymorphisms at 3′UTR, c*5G > A (rs1047031), c*87A > G (rs1800971), with the aim of correlating these genetic variants and hBD-1 salivary level in a group of OLP patients and in healthy subjects. We also evaluated hBD-1 salivary concentrations, using ELISA, in OLP and healthy controls.ResultsWe compared hBD-1 concentrations in OLP and healthy subjects: hBD-1 concentration was significantly higher in OLP patients respect to control.When considering the correlation between DEFB1 polymorphisms genotypes and hBD-1 expression levels, significant results were obtained for SNPs −52G > A (p = 0.03 both in OLP patients and healthy individuals) and −44C > G (p = 0.02 in OLP patients).ConclusionshBD-1 production was different between OLP and healthy subjects (not age-matched with OLP). DEFB1 gene polymorphisms, −52G > A and −44C > G, correlated with hBD-1 salivary concentrations.