Changes in lactoferrin and other proteins in a case of chronic recurrent parotitis

Abstract Parotid fluid samples from an individual with chronic recurring parotitis were collected during acute exacerbation and then at various stages of recovery. The samples were serially examined for: (a) lactoferrin (Lf) and lysozyme concentration, (b) concentration of IgA, IgG, IgM, albumin and transferrin, (c) amylase activity and protein pattern on acrylamide disc gel electrophoresis, (d) myeloperoxidase (MPO). The most dramatic protein changes occurred during the initial exacerbation with a more than 20-fold increase in total protein, because of an influx of serum proteins, Lf, lysozyme and MPO. By 5 days following the exacerbation the protein concentration was only two times normal; serum proteins were still evident but intrinsic salivary proteins were the major components; Lf, and to a lesser extent lysozyme, were still elevated; MPO was no longer detected. By day 11, total protein concentration was nearly normal; only albumin and Lf were modestly elevated. The elevation in Lf concentration during this period was accompanied by a shift in its apparent molecular weight. A polymeric form of Lf, observed during the acute stage, changed to what appeared to be a dimeric and then a monomeric form as the inflammatory process subsided. At day 79, parotid fluid chemistry was normal in almost all respects; only a slight elevation in albumin suggested any residual pathology.     

The clinical and cytological characteristics of the oral mucosa in Sj?gren's disease and chronic parotitis]

Clinical stomatologic and cytologic studies were carried out in 31 patients with Sjogren's disease, 12 ones with chronic parotitis, and 5 normal subjects. Patients with Sjogren's disease, in contrast to those with chronic parotitis, develop clinically manifest signs of dry exfoliative cheilitis, xerostomia, atrophic changes in the buccal mucosa; this condition is associated with a very high caries intensity and no clinical manifestations of periodontitis or tartar. Elevated leukocyte levels in oral washings and oral fluid of patients with Sjogren's disease and chronic parotitis point to inflammations in the salivary glands, buccal mucosa, and periodontal tissues. Assessment of the leukocyte levels may be used for monitoring the disease course and treatment efficacy. A 3-5-fold enlargement of the deep-layer epitheliocytes, seen on the cytogram of oral washings, is characteristic of patients with Sjogren's disease, in contrast to those with chronic parotitis or normal subjects. A differentiated estimation of the epitheliocyte types in the cytogram of oral washings may be used in the diagnosis of Sjogren's disease along with the criteria suggested before.     

Variation in the amylase isoenzymes of human parotid saliva in health and disease

The mean values and ranges of the flow-rate, concentration of protein and amylase activity have been measured in the parotid saliva from 109 healthy subjects and in 71 patients suffering from parotitis. Significant variations in the amylase activity, protein and amylase secretion occur in chronic and recurrent diseases.The α-amylase may be separated by polyacrylamide-electrophoresis into four isoenzymes.The genetic variation of the distribution pattern is discussed. A quantitative evaluation relative to enzyme activity is described. The method shows variations in the ratio of the major isoenzymes I and II in samples from glands subject to certain diseases and after irradiation with ⁶⁰Co.     

Sequential quantitative scintigraphy of parotid glands with chronic inflammatory diseases]

Sequential quantitative scintigraphy of parotid glands was performed in 16 cases with recurrent parotitis in childhood, 33 with chronic obstructive parotitis, 37 with Sj?gren's syndrome, 4 with sialadenosis and 30 normal controls. Uptake function was normal, but excretion was retarded in recurrent parotitis in childhood. Chronic obstructive parotitis exhibited that excretion was obstructed and the uptake and excretion function between bilateral parotids was marked different. In Sj?gren's syndrome, uptake was very low and excretion was heavily delayed. Sialadenosis showed that excretion was retarded and uptake function was not definitely involved. The possible mechanism of the scintigraphical features were analyzed combined with the histopathological findings.     

Tuberculous parotitis: report of 3 cases.

Tuberculous parotitis, particularly the diffuse form, is rare. I describe here three patients with diffuse tuberculous parotitis, two of whom presented with unilateral parotid swelling while the third had swellings of both glands. All had discharging sinuses. In two of the patients, the parotitis was associated with active pulmonary tuberculosis. In the patient with bilateral parotitis, the disease seemed to be confined to the glands. The diagnosis of tuberculosis was confirmed by the finding of tubercle bacilli in the lesion or the sputum. They all responded well to standard antituberculous drugs.     

Recurrent swelling of parotid glands and Sjögren's syndrome

This study included 125 patients with chronic parotitis, and it presents, in particular, a long-term clinical, laboratory, and sialographic study of 22 patients who were diagnosed as having adult recurrent sialadenitis of the parotid glands (ARSPG). Twelve of the 22 patients with ARSPG were shown to have Sjogren's syndrome (SS). These patients had recurrent parotid gland swelling for 1.5–14 years (mean, 5.2 years) before xerostomia and keratoconjunctivitis sicca occurred. Ten of the 22 patients with ARSPG did not develop SS, but did experience recurrent parotitis which extended from childhood into adulthood. The ARSPG underwent remission in seven of these patients. It is suggested that patients with ARSPG, but without a history of parotid gland swellings in childhood, should be diagnosed provisionally as having subclinical SS (SCSS).     

The clinico-morphological characteristics of the regional blood circulation of the parotid glands in patients with chronic parenchymatous parotitis]

Regional circulation in the parotid glands was studied in 34 patients with chronic parenchymatous parotitis (CPP) with the use of clinical (rheography and coagulography) and morphologic methods. A relationship has been revealed between regional circulation changes and the inflammation severity, CPP stage, type of concomitant diseases.     

Epidermal growth factor concentration in hyperplastic and hypertrophic submandibular salivary glands of mice.

Submandibular salivary glands of mice contain high concentrations of epidermal growth factor (EGF). The EGF content of mouse submandibular salivary glands undergoing hyperplastic and hypertrophic changes was measured and compared to that in the glands of control mice. Salivary gland hyperplasia was induced by giving mice a single injection of isoprenaline and hypertrophy was produced either by repeated, daily injections of isoprenaline, repeated amputation of a lower incisor tooth or by removing the right submandibular salivary gland and thus producing a compensatory hypertrophy of the left submandibular gland. The EGF content of the hyperplastic submandibular salivary glands was not different from that of the control glands. While the EGF content of the hypertrophied glands resulting from either repeated isoprenaline injections or partial sialoadenectomy did not differ from that of the control glands, the concentration of EGF was significantly lower. This reduced concentration is probably a reflection of acinar hypertrophy with a resultant smaller proportionate contribution of the granular tubules to the mass of the gland. Incisor-amputation-induced hypertrophy did not result in a reduced concentration of EGF in the submandibular salivary glands, but the reason for the different response is unknown.The findings provide no evidence for the involvement of EGF in the induced changes of submandibular salivary gland hyperplasia or hypertrophy resulting from either isoprenaline treatment or partial sialoadenectomy. The reason for the higher concentration of EGF in hypertrophied submandibular salivary glands resulting from incisor amputation compared to that measured in hypertrophied glands resulting from the other stimuli used remains unresolved.     

Experimental Allergic Sialoadenitis

Abstract The right parotid duct of rats was instilled five to eight times with bovine serum albumin at daily intervals. Acute parotitis developed in non-sensitized animals, while chronic destructive sialoadenitis ensued in preimmunized rats. The morphological changes were reminiscent of those found in the salivary glands of patients with Sjögren's syndrome.     

唾液腺ECT在非肿瘤性唾液腺疾病中的诊断价值研究

目的 探讨唾液腺ECT在非肿瘤性唾液腺疾病中的诊断价值。方法 选取2010年12月至2013年12月来中国医科大学附属口腔医院口腔颌面外科就诊并接受治疗的非肿瘤性唾液腺疾病患者52例,其中慢性阻塞性腮腺炎30例,颌下腺结石15例,舍格伦综合征7例。所有患者常规检查及唾液腺ECT检查资料完整,回顾性分析检查结果,以明确唾液腺ECT在该类涎腺疾病诊断中的作用。结果 慢性阻塞性腮腺炎患者唾液腺ECT回报患侧腺体排泌功能不同程度降低,提示导管不同程度阻塞;涎石症患者唾液腺ECT回报患侧腺体排泌功能显著降低,提示导管重度阻塞,其中5例腺体摄取功能亦显著降低;舍格伦综合征患者ECT回报4个腺体（双侧腮腺和双侧颌下腺）摄取及排泌功能均有异常。结论 唾液腺ECT在非肿瘤性涎腺疾病中有一定的诊断和鉴别诊断价值,并能为临床治疗该类疾病提供有价值的依据。     

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??Abstract??Objective To evaluate the diagnostic value of ECT in patients with salivary gland diseases. Methods Totally 52 patients with salivary gland disease ??30 parotitis?? 15 submandibular gland calculi?? 7 Sjogren's syndrome??were selected to this retrospective study from Dec. 2010 to Dec. 2013. All the patients had ECT and other routine examinations before operation. Comparison was made among them to find out the diagnostic value of ECT. Results In parotitis??ECT revealed decrease in excretion with affected glands of different extent?? showing obstruction in the duct??in sialolithiasis??ECT revealed apparent decrease in excretion with affected glands?? and 5 patients' uptake also decreased??in Sjogren's syndrome?? ECT revealed abnormal uptake and excretion with the four glands. Conclusion ECT plays an important role in the diagnosis and differential diagnosis of salivary disease and provids a valuable basis in treating salivary gland diseases.     

The regional blood circulation of the parotid gland and the correction of its disorders in chronic interstitial parotitis]

Elevated vascular tone, lengthened time of intraglandular arterial bed filling, fibrinogenemia, elevated plasma tolerance to heparin were detected in 32 patients with chronic interstitial parotitis (CIP) during exacerbation and in a number of CIP patients with the remission of the disease. Correction of microcirculation disturbances is advisable during CIP exacerbation; in remission it may be effective in patients with the late stage of parotitis, in those with parotitis coursing along with diabetes mellitus, essential hypertension, or against the background of prolonged oral drug therapy (e. g. clofelin). Drugs correcting the microcirculatory disorders are conducive to a sooner alleviation of the inflammation and better and longer preservation of the function of the parotid glands.     

Magnetic resonance imaging-based differentiation between juvenile recurrent parotitis and juvenile Sjögren’s syndrome

Differentiation between juvenile recurrent parotitis and juvenile Sjögren’s syndrome may be difficult on the basis of clinical symptoms and imaging examinations, such as sialography and ultrasonography. Histological findings of the labial glands may also not be definitive for this purpose. Here, we report three cases of patients with juvenile recurrent parotitis who underwent magnetic resonance imaging examinations. The imaging results suggest that magnetic resonance imaging may be an effective tool for differentiating between these two distinct salivary gland diseases.     

The outcomes of chronic parenchymatous parotitis in children

Time course of the process was examined in 16 patients with chronic parenchymatous parotitis. The follow-up started in children and was proceeded in adults, thus permitting an answer to the problem of parenchymatous parotitis outcome. Dynamic sialographic studies have shown that the process in the gland may develop in three directions, i.e. improvement, deterioration, or stabilization. Positive changes were the most manifest in the initial stage of the disease and not manifest in the late one. The authors' findings help predict the course of parotitis and outcome of the changes in the parotid gland in children.     

Sialochemistry in chronic recurrent parotitis: electrolytes and glucose

The concentration of parotid fluid electrolytes and glucose was measured in: (a) a subject during an acute exacerbation of chronic recurrent parotitis and then at various stages of recovery following treatment with corticosteroids; (b) a group of seven patients seen during an acute exacertation and then when clinical symptoms had subsided; and (c) a group of 22 patients studied at various stages of parotitis. During acute exacerbations sodium and chloride concentrations were markedly elevated despite the very low flow rate and potassium was only half the normal salivary level. Phosphate concentration was also extremely low; glucose was very high. During recovery flow rate gradually increased while sodium, chloride and glucose levels fell. Potassium returned quickly to normal while the phosphate level rose very gruadually. The pattern of flow rate and sialochemistry during recovery was essentially the same for all patients. The pattern of flow rate and sialochemistry during recovery was essentially the same for all patients. In most subjects there was a residual effect, and elevated sodium and chloride and a decreased phosphate relative to flow rate. The degree of change from normal appeared to be a good indication of residual pathology within the gland. Sialochemistry should be useful to the clinician in the diagnosis and treatment of chronic recurrent parotitis.     

Gland atrophy following retrograde injection of methyl violet as a treatment in chronic obstructive parotitis

Objective. The purpose of this study was to evaluate the clinical effectiveness of retrograde injection of 1% methyl violet as a treatment for chronic obstructive parotitis.Study Design. Sixteen patients with chronic obstructive parotitis were treated with retrograde injection of 1% methyl violet. Pretreatment evaluation and assessment of the treatment effect were performed by clinical and imaging methods, including sialography and sonography of the treated glands.Results. Clinical symptoms following treatment included initial acute swelling and then a decrease in parotid swellings; the final outcome was a clinical cure of the affected glands characterized by disappearance of all symptoms, absence of secretion, and complete obliteration of the main duct orifice. Posttreatment imaging showed total atrophy of the diseased glands.Conclusion. Retrograde injection of 1% methyl violet caused total atrophy of the diseased glands and brought about complete relief in all 16 patients, with no detectable side effects.     

Immunohistochemical study of palatal salivary glands of denture wearing patients

The binding pattern of antibodies against different cytokeratin (CK) polypeptides, tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), lactoferrin (Lf), lysozyme (Ly) and secretory component (SC) in palatal glands (PSG) of long-term denture wearing patients has been studied to investigate immunohistochemically the localization of these marker proteins in normal PSG and in denture-induced sialadenitis of PSG. The study included palatal gland biopsies from 28 patients (15 f, 13 m; mean age 59 years), 17 of them with normal PSGs, 8 with focal obstructive sialadenitis, and 3 with diffuse sialadenitis. Presence of CK and TPA was found in all intra- and extraglandular salivary ducts, in the basophilic portions of acini, in some mucous acini, and in all atrophic acini. Increased expression of CEA and Lf was observed in inflammed areas of PSG which, on the other site, were devoid of Ly and SC. In the mucous acini of healthy PSG considerable basal Ly immunoreactivity was seen. SC was localized in almost all ductal cells and in some acinar cells. Appearance of Lf in the ductal cells of PSG indicates an early sign of palatal sialadenitis. Some distinctions in the expression pattern of the marker proteins between the mucous acini of major salivary glands and PSG point to differences in the functional activities of either group of salivary glands.     

Quantitation of human salivary acidic proline-rich proteins in oral diseases

Acidic proline-rich proteins (APRP) were quantitated immunochemically in salivary secretions from groups of: caries-resistant (CR) and caries-susceptible (CS) subjects; heavy- and light-calculus-formers; and patients with Sj?gren's Syndrome, drug-induced xerostomia, and recurrent parotitis. In all groups except the parotitis patients, there were comparable levels of APRP, about 40-50 mg%, with similar values in parotid and submandibular saliva. In chronic recurrent parotitis, the values were somewhat higher (about 60 mg%). There were no differences in the proportion of APRP-A to C in a subset of CR and CS. Taken as a whole, the data support the view that the secretion of APRP is stable and that caries status and propensity to calculus formation are not associated with abnormal levels of these phosphoproteins.     

Immunohistochemical study of palatal salivary glands of denture wearing patients

The binding pattern of antibodies against different cytokeratin (CK) polypeptides, tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), lactoferrin (Lf), lysozyme (Ly) and secretory component (SC) in palatal glands (PSG) of long-term denture wearing patients has been studied to investigate immunohistochemically the localization of these marker proteins in normal PSG and in denture-induced sialadenitis of PSG. The study included palatal gland biopsies from 28 patients (15 f, 13 m; mean age 59 years), 17 of them with normal PSGs, 8 with focal obstructive sialadenitis, and 3 with diffuse sialadenitis. Presence of CK and TPA was found in all intra- and extraglandular salivary ducts, in the basophilic portions of acini, in some mucous acini, and in all atrophic acini. Increased expression of CEA and Lf was observed in inflammed areas of PSG which, on the other site, were devoid of Ly and SC. In the mucous acini of healthy PSG considerable basal Ly immunoreactivity was seen. SC was localized in almost all ductal cells and in some acinar cells. Appearance of Lf in the ductal cells of PSG indicates an early sign of palatal sialadenitis. Some distinctions in the expression pattern of the marker proteins between the mucous acini of major salivary glands and PSG point to differences in the functional activities of either group of salivary glands.     

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??Abstract??Juvenile recurrent parotitis(JRP) is defined as recurrent episodes of inflammatory parotitis in children?? characterized by intermittent swelling?? pain and discomfort of one or both parotid glands. The aetiology is complicated and pathogenesis uncertain. With the development of microbiology?? clinical immunology and application of sialoendoscopic technique in recent decades?? it gives new ideas to the pathogenesis and therapy approach of JRP. Research and progress in aetiology and treatment of juvenile recurrent parotitis were reviewed in this article.