ABSTRACT
ABSTRACT Introduction: Alzheimer's disease is a neurodegenerative disorder characterized by the loss of cognitive functions. The prevalence of this disease worldwide is high, and therefore it is important to have a better understanding of the oral health needs and conditions of individuals with this disorder. The present study was carried out in a population with E280A mutation for Alzheimer's disease. The goal was to describe the salivary characteristics of persons with early familial Alzheimer's disease, in order to detect changes in the oral microbiome that can guide the dental management of these patients. Methods: transversal study in 37 participants living in the Metropolitan Area of the city of Medellín, aged 53 ± 6 years in average, in different stages of the disease: mild: 8, moderate: 7, and severe: 22, and evaluated by neuropsychological tests. Salivary samples were collected, evaluating saliva secretion rate and saliva buffer capacity, and conducting microbial analysis of the species most commonly found in the mouth. Results: 45.9% of participants showed a decreased rate of stimulated salivary secretion; salivary buffer capacity was decreased in 83.87% of participants, with average pH values of 3.449 ± 0.89 after the Ericsson test. Buffer capacity was altered in participants with decreased secretion rate and in those with no alteration in salivary secretion rate. High levels of microbial growth were observed, mainly for Streptococcus mutans and Candida albicans. Conclusions: This study suggests that other factors besides the pharmacological ones, like age and disease severity, may affect the salivary rate flow in patients with early familial Alzheimer's disease.
RESUMEN Introducción: la enfermedad de Alzheimer es una alteración neurodegenerativa caracterizada por la pérdida de funciones cognitivas. Existe una alta prevalencia de esta enfermedad a nivel mundial, por lo que resulta oportuno tener una mayor comprensión de las necesidades y condiciones de salud bucal de los sujetos con este desorden. El presente estudio se llevó a cabo en una población con mutación E280A para la enfermedad de Alzheimer. El objetivo consistió en describir las características salivares de las personas con enfermedad de Alzheimer familiar precoz, con el fin de detectar cambios en el microbioma bucal que puedan orientar el manejo odontológico de estos pacientes. Métodos: estudio transversal en 37 participantes que habitan el Área Metropolitana de la ciudad de Medellín, con una edad promedio de 53 ± 6 años, en diferentes estadios de la enfermedad: leve: 8, moderada: 7 y grave: 22, evaluados mediante pruebas neuropsicológicas. Se tomaron muestras salivares, se evaluó la tasa de secreción salivar y la capacidad buffer de la saliva y se efectuó un análisis microbiano de las principales especies presentes en boca. Resultados: el 45,9% de los participantes presentaron una tasa disminuida de secreción salivar estimulada; la capacidad buffer salivar estuvo disminuida en el 83,87% de los participantes, con valores promedios de pH luego de la prueba de Ericsson de 3,449 ± 0,89. La capacidad buffer se encontró alterada tanto en los participantes con tasa de secreción disminuida como en aquellos con tasa de secreción salivar no alterada. Se observó alto crecimiento microbiano, principalmente de Streptococcus mutans y Candida albicans. Conclusiones: este estudio sugiere que pueden existir otros factores, además de los farmacológicos, que afectan la tasa de flujo salivar en los pacientes con enfermedad de Alzheimer familiar precoz, como la edad y la severidad de la enfermedad.
Subject(s)
Saliva , Alzheimer DiseaseABSTRACT
The aim of the present study was to measure the amount of nerve growth factor (NGF) present in saliva, and investigate the relationship with aging, gender, and number of retained teeth. The subjects were 93 healthy volunteers (35 males and 58 females) aged 18-87 years. Stimulated saliva was collected during gum chewing, and saliva secretion per minute and NGF concentration per unit volume were measured by enzyme-linked immunosorbent assay. We found that NGF in saliva was measurable in all subjects. The mean NGF concentration in saliva was 55.70 ± 38.27 pg/ml, and no relationship was found between NGF concentration and aging, gender, and the number of retained teeth. The mean NGF amount in saliva was 84.38 ± 71.06 pg/min. The NGF amount in saliva decreased with age, especially for the group aged 70 years and older. It was higher in male than female subjects, and was significantly higher in the group without tooth loss compared to the edentulous group. In addition, regarding the relationship between the saliva flow rate per minute and NGF amount in saliva, the latter increased significantly with a rise in the former. These results indicate that the NGF amount in saliva is influenced by aging, masticatory function, and saliva amount. It is speculated that human salivary glands play an important role in the synthesis and expression of NGF.