Relationship between saliva and plasma rufinamide concentrations in patients with epilepsy

The assay of saliva samples provides a valuable alternative to the use of blood samples for therapeutic drug monitoring (TDM), at least for certain categories of patients. To determine the feasibility of using saliva sampling for the TDM of rufinamide, we compared rufinamide concentrations in paired samples of saliva and plasma collected from 26 patients with epilepsy at steady state. Within-patient relationships between plasma rufinamide concentrations and dose, and the influence of comedication were also investigated. Assay results in the two tested fluids showed a good correlation (r² = .78, P < .0001), but concentrations in saliva were moderately lower than those in plasma (mean saliva to plasma ratio = 0.7 ± 0.2). In eight patients evaluated at three different dose levels, plasma rufinamide concentrations increased linearly with increasing dose. Patients receiving valproic acid comedication had higher dose-normalized plasma rufinamide levels than patients comedicated with drugs devoid of strong enzyme-inducing or enzyme-inhibiting activity. Overall, these findings indicate that use of saliva represents a feasible option for the application of TDM in patients treated with rufinamide. Because rufinamide concentrations are lower in saliva than in plasma, a correction factor is needed if measurements made in saliva are used as a surrogate for plasma concentrations.     

唾液细胞外囊泡miRNA-143/145与雌激素缺乏性骨质疏松相关性的临床研究

目的 研究唾液细胞外囊泡miRNA-143/145表达水平与女性绝经后骨质疏松的相关性,以探讨其对雌激素缺乏性骨质疏松的诊断价值。方法 选取在我院进行种植牙手术的绝经前后女性患者,采用CBCT对松质骨进行骨参数分析,测量患者骨密度差异;选择在我院进行住院手术的绝经期前后女性,分别收集血清、唾液样本,提取细胞外囊泡;透射电镜观察血清和唾液中细胞外囊泡形态;ELISA检测血清中雌激素表达水平;qRT-PCR检测血清和唾液细胞外囊泡中miRNA-143/145水平。结果 经分析发现,绝经后女性雌激素水平明显下降,并伴有骨密度的显著降低;经透射电镜观察,血清和唾液中细胞外囊泡为直径约100 nm的杯状双层膜样结构;和绝经前相比,绝经后女性血循环中miRNA-143/145的表达显著升高;进一步检测唾液中miRNA-143/145表达,呈现相似的趋势。结论 基于唾液细胞外囊泡中miRNA-143/145检测结果与血清检测相似,提示唾液检测作为一种无创性操作方式,更便于临床医生为女性绝经后骨质疏松状态做出诊断。     

唾液富组蛋白5抗白念珠菌作用实验性研究

目的探讨不同浓度的富组蛋白5（histidine rich protein5,HRPs5）在体外杀灭白念珠菌孢子、芽管的作用及抑制孢子形成芽管的作用。方法将一定数量的孢子和芽管分别与不同浓度的HRPs5混合培养后,置于400倍的倒置显微下观察菌落数,得出杀孢子率、杀芽管率和抑制孢子不形成芽管率。结果当25μml或更高浓度的HRPs5和白色念珠菌孢子作用后,可使90％以上的孢子丧失活力;100μml的HRPs5和白色念珠菌芽管作用后,可使90％以上的孢子丧失活力;400μg／ml的HRPs5和白色念珠菌孢子作用后,可使100％孢子受到抑制而不形成芽管。而50μg／ml的HRPs5对白色念珠菌孢子形成芽管仅有轻微的抑制作用。结论HRPs5在体外具有较强杀灭白念珠菌孢子、芽管的作用及抑制孢子形成芽管的作用,且随着HRPs5浓度的升高其作用愈强。     

Influence of mouse prolactin‐inducible protein in saliva on the aggregation of oral bacteria

Introduction: Mouse prolactin‐inducible protein (mPIP) is secreted in mouse saliva and has been found to bind oral bacteria, showing the highest affinity for streptococci. Comparisons between the oral flora of mPIP knockout mice and their wild‐type controls showed differences in the genera colonizing the two groups of mice. These findings suggested a role for mPIP in the colonization of the mouse oral cavity, possibly modulating the oral flora. In this in vitro study, we focused on the contribution of this protein to aggregation of oral bacteria, a process thought to promote the clearance of bacteria from the oral cavity, and one that could influence the composition of the oral bacterial community. Methods: The aggregation of selected human and mouse oral streptococci was measured spectrophotometrically. The aggregation of oral bacteria by saliva from mPIP knockout mice, which lack mPIP, was compared with that of saliva from wild‐type mice. Results: Both wild‐type saliva and mPIP knockout mouse saliva induced aggregation of human strain Streptococcus gordonii SK120 and mouse streptococci strains M105/6 and M106/2. Bacterial aggregation induced by the saliva of wild‐type mice was significantly higher than the aggregation induced by saliva from mPIP knockout mice for all the bacterial strains. Conclusion: In this study it was confirmed that mPIP plays a role in the aggregation of oral bacteria. The salivary components promoting aggregation of oral bacteria are considered to be part of the oral defense mechanisms so these findings provide insight into a possible function of mPIP in host defense by promoting aggregation of oral bacteria.     

高分子量唾液粘蛋白含量与乳牙患龋相关性的研究

目的:检测儿童唾液中高相对分子质量唾液粘蛋白(MG1)含量,探讨其与乳牙患龋状况之间的关系,为唾液粘蛋白的研究及龋病病因的探讨提供基础资料。方法:随机抽取长沙市两所幼儿园3～5岁305名幼儿进行口腔检查,根据检查结果分为3组,①无龋组:dmft=0;②低龋组:dmft=1～4;③高龋组:dmft≥5。随机抽取每组各20名儿童,用刃天青纸片法检测各组的龋活性,然后取所有儿童的非刺激性唾液,用ELISA试剂盒检测MG1的含量,对结果进行统计学分析。结果:①刃天青纸片法显示无龋组、低龋组、高龋组儿童的龋活性差异有统计学意义(P<0.05);②无龋组MG1平均含量为13.63 mg/L,低龋组MG1平均含量为12.96 mg/L,高龋组MG1平均含量为12.61 mg/L。经统计分析,无龋组与高龋组唾液MG1的含量差别有统计学意义(P<0.05),无龋组与低龋组、低龋组与高龋组唾液MG1的含量差异无统计学意义(P>0.05)。3～5岁儿童男女比较唾液中MG1含量差异无统计学意义(P>0.05),不同年龄组比较唾液中MG1含量差异无统计学意义(P>0.05)。结论:①dmft≥5的儿童龋活性高于dmft<5的儿童。②无龋组儿童唾液中MG1的含量高于高龋组,儿童唾液中MG1含量与性别和年龄无明显关系。     

Denture stomatitis and salivary Candida in Brazilian edentulous patients

Denture stomatitis (DS) is frequently associated with high levels of Candida in saliva and deficient denture hygiene. In order to analyse the incidence of DS and its pre-disposing factors, we evaluated 77 edentulous patients before and 6 months after the placement of new complete dentures. Denture stomatitis was observed in 50.6 and 18.2% of the patients at the first and second evaluation, respectively. Salivary flow, Candida counts in saliva and Candida species were similar in both evaluations. Denture stomatitis and Candida in saliva were more common in females. Our results showed that denture replacement and denture hygiene improvement were useful for DS resolution, particularly types I and II. However, oral and denture hygiene must be continuous, inasmuch as salivary Candida counts remained high and it is considered an important pre-disposing factor for DS.     

A Community Study of SARS-CoV-2 Detection by RT-PCR in Saliva: A Reliable and Effective Method

Efficient, wide-scale testing for SARS-CoV-2 is crucial for monitoring the incidence of the infection in the community. The gold standard for COVID-19 diagnosis is the molecular analysis of epithelial secretions from the upper respiratory system captured by nasopharyngeal (NP) or oropharyngeal swabs. Given the ease of collection, saliva has been proposed as a possible substitute to support testing at the population level. Here, we used a novel saliva collection device designed to favour the safe and correct acquisition of the sample, as well as the processivity of the downstream molecular analysis. We tested 1003 nasopharyngeal swabs and paired saliva samples self-collected by individuals recruited at a public drive-through testing facility. An overall moderate concordance (68%) between the two tests was found, with evidence that neither system can diagnose the infection in 100% of the cases. While the two methods performed equally well in symptomatic individuals, their discordance was mainly restricted to samples from convalescent subjects. The saliva test was at least as effective as NP swabs in asymptomatic individuals recruited for contact tracing. Our study describes a testing strategy of self-collected saliva samples, which is reliable for wide-scale COVID-19 screening in the community and is particularly effective for contact tracing.     

Influence of sucrose and xylitol on an early Streptococcus mutans biofilm in a dental simulator

ObjectivesIn vitro methods to study dental biofilms are useful in finding ways to support a healthy microbial balance in the oral cavity. The effects of sucrose, xylitol, and their combination on three strains of Streptococcus mutans and one strain of Streptococcus sobrinus were studied using a dental simulator.MethodsA simulator was used to mimic the oral cavity environment. It provided a continuous-flow system using artificial saliva (AS), constant temperature, mixing, and hydroxyapatite (HA) surface in which the influence of xylitol was studied. The quantities of planktonic and adhered bacteria were measured by real-time qPCR.ResultsCompared against the untreated AS, adding 1% sucrose increased the bacterial colonization of HA (p < 0.0001) whereas 2% xylitol decreased it (p < 0.05), with the exception of clinical S. mutans isolate 117. The combination of xylitol and sucrose decreased the bacterial quantities within the AS and the colonization on the HA by clinical S. mutans isolate 2366 was reduced (p < 0.05). Increasing the concentration (2%–5%) of xylitol caused a reduction in bacterial counts even in the presence of sucrose.ConclusionsThe continuous-culture biofilm model showed that within a young biofilm, sucrose significantly promotes whereas xylitol reduces bacterial colonization and proliferation. The results indicate that xylitol affects the ability of certain S. mutans strains to adhere to the HA. Clinical studies have also shown that xylitol consumption decreases caries incidence and reduces the amount of plaque. This study contributes to the understanding of the mechanism behind these clinical observations.