Saliva as a potential tool for diagnosis of dry mouth including Sjögren's syndrome.

OBJECTIVES: Recently, the use of saliva as a diagnostic tool has gained considerable attention because it is non-invasive and easy to perform repeatedly. In this study, we focused on soluble molecules in saliva to establish a new diagnostic method for xerostomia. MATERIALS AND METHODS: Saliva was obtained from 90 patients with Sjögren's syndrome (SS), 22 patients with xerostomia associated with neurogenic/neuropsychiatric disorders and drugs (XND), 30 patients with radiation-induced xerostomia (RX), and 36 healthy controls. Concentrations of helper T (Th) cytokines in saliva were measured by flow cytometric analysis. Concentrations of secretory IgA (SIgA) and chromogranin A (CgA) were measured by ELISA. RESULTS: Unstimulated and stimulated whole saliva from patients with SS, XND, and RX was significantly reduced compared with controls. Th1 and Th2 cytokines from SS patients were significantly higher than controls. Furthermore, Th2 cytokines were closely associated with strong lymphocytic accumulation in salivary glands from SS patients, while Th1 and Th17 cytokines were negatively associated. SIgA levels were not significantly different between all patient groups and controls. CgA levels from XND patients were significantly higher than controls. CONCLUSIONS: The measurement of cytokines, CgA, and SIgA in saliva is suggested to be useful for the diagnosis of xerostomia and also to reveal disease status.

Clinical relevance of Küttner tumour and IgG4-related dacryoadenitis and sialoadenitis.

OBJECTIVES: Küttner tumour (KT), so-called chronic sclerosing sialoadenitis, is characterised by concomitant swelling of the submandibular glands secondary to strong lymphocytic infiltration and fibrosis independent of sialolith formation. However, recent studies have indicated that some patients with KT develop high serum levels of IgG4 and infiltration of IgG4-positive plasma cells, namely IgG4-related dacryoadenitis and sialoadenitis (IgG4-DS), so-called Mikulicz's disease. The aim of this study was to clarify the clinical and pathological associations between KT and IgG4-DS. MATERIALS AND METHODS: Fifty-four patients pathologically diagnosed with KT or chronic sialoadenitis were divided into two groups according to the presence or absence of sialolith (KT-S (+) or KT-S (-), respectively). RESULTS: There were no significant differences in the clinical findings, including the mean age, sex and disease duration, between the two groups. All patients in the KT-S (+) group showed unilateral swelling without infiltration of IgG4-positive plasma cells or a history of other IgG4-related diseases (IgG4-RD), while those in the KT-S (-) group showed bilateral swelling (37.5%), strong infiltration of IgG4-positive plasma cells (87.5%) and a history of other IgG4-RD (12.5%). CONCLUSIONS: These results suggest an association between the pathogeneses of KT-S (-) and IgG4-DS, but not KT-S (+).

[Skin surface lipids and sweat of hand in girl students who complained of impaired skin on the hand by using household detergents].

A questionnaire was presented to female university students concerning the relationship between the use of household detergent and the occurrence of impaired hands. In addition, in order to determine whether there was any relationship between the amounts and qualities of skin surface film and the incidence of impairments of hands, the following experiment was undertaken. From among the 1,861 female university students, 28 girls between the ages of 21-22 were chosen; 14 of whom had complained of impaired skin of hands (impairment group) attributable to household detergent during the past one year and 14 who had not experienced such disorders, either of the hands or elsewhere (non-impairment group) during the same period. The method of collecting skin surface lipids and sweat simultaneously is for the subjects to wear special gloves made of a given cotton fabric by the modified method of Straus & Pochi for a fixed of time. Then, the skin surface lipids and sweat were analyzed to determine the differences between the impairment group and the non-impairment group. The following results were obtained: 1) Of the 1,861 people surveyed, 496 or 26.7% of them stated that they had suffered from impaired skin due to the use of household detergents during the past one year. The most frequent site was the hands, including wrists, and the main symptom was dry skin. There were some seasonal changes in the occurrence of the impaired skin, with the highest occurrence in winter. There was a significant difference between the occurrence in winter, and that in spring, summer and autumn (p less than 0.01). 2) During the hot season, (average temperature 23-29 degrees C), the arithmetic averages and their standard deviation of the skin surface lipids of both the impairment group (N = 14) and the non-impairment group (N = 14) were 29.10 +/- 7.89 micrograms/cm2/8 hr and 45.98 +/- 23.29 micrograms/cm2/8 hr, respectively. In the cold season, (average temperature 5-13 degrees C), these become 31.95 +/- 16.69 micrograms/cm2/8 hr, and 53.45 +/- 24.16 micrograms/cm2/ 8 hr, respectively. In both these seasons, it was found that the amount of skin surface lipids of the impairment group was significantly less (hot season p less than 0.05, cold season p less than 0.01) than that of the non-impairment group.(ABSTRACT TRUNCATED AT 400 WORDS)