ascorbic-acid and Sjogren-s-Syndrome

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Common Cold; Depression; Guinea Pigs; Humans; Male; Miliaria; Nutritional Requirements; Scurvy; Sjogren's Syndrome; Skin Manifestations; Urinary Bladder Neoplasms

Thirty-six patients with primary Sjögren's syndrome participated in a randomised double-blind, cross-over, 3-week, study to compare the effect of Efamol (1500 mg X 2) with that of placebo. Efamol contains 9% of the prostaglandin-E1 precursor gamma-linolenic acid, which is presumed to occur in reduced levels in Sjögren's syndrome. Efamol treatment improved the Schirmer-I-test (P less than 0.03) while values of break-up time,-van Bijsterveld score, corneasensitivity, tear-lysozyme and nuclear chromatin in conjunctival epithelial cells did not reach the statistical 0.05 level.

Topics: Adult; Aged; Ascorbic Acid; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Fatty Acids, Essential; Fatty Acids, Unsaturated; Female; Flushing; gamma-Linolenic Acid; Humans; Linoleic Acids; Male; Middle Aged; Niacin; Oenothera biennis; Plant Oils; Pyridoxine; Sjogren's Syndrome; Zinc; Zinc Compounds

To update Schall's classification for Sjögren's syndrome (SS) by the new quantitative stimulation test with dynamic salivary glands scintigraphy (qsDSGS) and to standardize quantitative salivary gland scintigraphy.. The histopathology, oral, ocular, serological examination and qsDSGS of 268 consecutive patients with suggestive SS were evaluated in this retrospective cohort study. The serological examination included 15 autoantibodies, antinuclear antibodies (ANA) and so on. The diagnostic thresholds of the functional parameters were set by the quantitative method, and the modified Schall's classification is well established and verified.. Based on the quantitative analysis of qsDSGS, the peak uptake level (PUL) and stimulation excretion fraction (sEF) of each parotid gland were determined as the key imaging features, which had good diagnostic performance for SS. By the modified Schall's classification, all patients were classified into: Class 1 (normal; n = 44), Class 2 (mild to moderate involvement; n = 130), Class 3 (severe involvement; n = 56) and Class 4 (very severe involvement, non-function; n = 38). Using the threshold PUL ≤ 10 counts per sec/pixel as positivity, the modified Schall's classification could provide better diagnostic performance with 88.4% specificity, 71.3% sensitivity, 96.14% positive predictive value and 43.20% negative predictive value for SS (likelihood ratio 6.15). The trends of serologically positive frequencies against SSA/Ro, anti-SSB/La and ANA were significantly increased with the new classification.. The modified Schall's classification by the new stimulation test with dynamic scintigraphy is eligible to standardize quantitative salivary gland scintigraphy for SS, and may be more convenient and suitable in daily practice for clinical research and management of SS.

Topics: Adult; Aged; Aged, 80 and over; Ascorbic Acid; Autoantibodies; Biomarkers; Female; Humans; Male; Middle Aged; Parotid Gland; Predictive Value of Tests; Reproducibility of Results; Retrospective Studies; Salivation; Serologic Tests; Single Photon Emission Computed Tomography Computed Tomography; Sjogren's Syndrome; Time Factors; Young Adult

Beside many actual groups of classification criteria, uniform classification criteria for Sjögren's syndrome (SS) are still missing. The ophtalmic component of SS is well defined. Criteria for classifying its oral component remain controversial. The fifth item of the European Union and the United States of America (EU-US) revised diagnostic classification criteria in 2002, is an objective evidence of xerostomia, diagnosed by one of the tests: unstimulated whole sialometry (UWS), parotid sialography, and dynamic salivary gland scintigraphy (DSGS). The aim of this study was to evaluate senstitivity, specificity, positive and negative predictive value and accuracy of DSGS with ascorbic acid stimulation in detecting xerostomia in SS patients and to compare DSGS findings with UWS values.. Tests DSGS and UWS were done in 20 patients with SS and in 10 of the control subjects. The findings of DSGS were graded from 1 to 4 scintigraphie (SCT) grade 1--normal finding; SCT grade 2--moderate function damage; SCT grade 3--serious function damage, SCT grade 4--very serious function damage. UWS measured 1.5 hour after the breakfast lasted 15 minutes. UWS bellow 2.5 ml/15min min. considered pathological.. All SS patients had pathological SCT findings. Comparing SCT grade between the patients and the control group, high statistical significance was found (p < 0.001). The estimated sensitivity of DSGS was 100%, specificity 80%, positive predictive value 91%, negative predictive value 100% and accuracy 93%. The calculated sensitivity of UWS was 75%. Salivary function damage detected by scintigraphy was in positive correlation with UWS findings.. DSGS is a diagnostic test with high sensitivity, specificity, accuracy and positive and negative predictive values in detecting salivary function damage in SS patients. DSGS and UWS are very sensitive diagnostic tests for objective evidence of xerostomia, and have to be ones of the earliest investigations which shoud be performed in subjects suspected of SS. Test DSGS is more sensitive, and seems to better reflect symptoms of dry mouth than UWS.

Topics: Adult; Aged; Ascorbic Acid; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Saliva; Salivary Glands; Sensitivity and Specificity; Sjogren's Syndrome; Sodium Pertechnetate Tc 99m

Topics: Adolescent; Adult; Aged; Amyloidosis; Arthritis, Juvenile; Arthritis, Rheumatoid; Ascorbic Acid; Child; Child, Preschool; Dimethyl Sulfoxide; Drug Evaluation; Glomerular Filtration Rate; Humans; Kidney; Middle Aged; Proteinuria; Scleroderma, Systemic; Sjogren's Syndrome; Ultrasonics

Sjogren's Syndrome (S.S.) is characterized clinically by oral and ocular dryness and immunologically by its frequent association with autoimmune diseases and the presence of various circulating autoantibodies. Evidence has been presented suggesting that S.S. may be due to a relative deficiency of PGE1 and that elevating PGE1 levels may reduce oral and ocular dryness. In an attempt to increase PGE1 levels, precursors of PGE1 including di-homo-gamma linolenic acid, ascorbic acid and pyridoxine in the form of dietary supplements were administered to 10 patients with S.S. for 10 weeks. There was no significant improvement in any of the patients during the treatment period compared to assessments done pre and post treatment. Measurements of oral and ocular dryness of 6 patients on prostaglandin synthetase inhibiting anti-inflammatory medications were similar to the 4 patients on no medication.

Topics: Ascorbic Acid; Aspartate Aminotransferases; Aspirin; Fatty Acids, Essential; Female; Humans; Indomethacin; Pyridoxine; Sjogren's Syndrome

Topics: Adult; Aged; Ascorbic Acid; Dimethyl Sulfoxide; Drug Therapy, Combination; Female; Glucocorticoids; Heparin; Humans; Hydrocortisone; Male; Middle Aged; Sjogren's Syndrome

Topics: Ascorbic Acid; Fatty Acids, Essential; Humans; Lacrimal Apparatus Diseases; Pyridoxine; Salivary Gland Diseases; Sjogren's Syndrome; Syndrome

Lack of adequate synthesis of prostaglandin (PG) E1 may be the key factor in Sjogren's syndrome. PGE1 is important for lacrimal and salivary gland secretion and for T lymphocyte function: a deficiency could therefore account for the main features of Sjogren's syndrome and the sicca syndrome. PGE1 could also account for many of the other features often associated with these syndromes. These include the Raynaud's phenomenon, the abnormalities of renal function and the precipitation of the syndrome by vitamin C deficiency. Vitamin C is important in PGE1 biosynthesis. PGE1 treatment has been shown to correct the immunological abnormalities in the NZB/W mouse, the animal model of Sjogren's syndrome. An attempt to treat humans with Sjogren's syndrome by raising endogenous PGE1 production by administration of essential fatty acid PGE1 precursors, of pyridoxine and of vitamin C was successful in raising the rates of tear and saliva production.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Fatty Acids, Essential; Female; Humans; Lacrimal Apparatus Diseases; Middle Aged; Prostaglandins E; Pyridoxine; Salivary Gland Diseases; Sjogren's Syndrome; Syndrome

Vitamin C stimulates the formation of PGE1 in human platelets. The effect occurs over the physiologically relevant range of concentrations. PGE1 is required for T lymphocyte function and plays a major part in the regulation of immune responses. PGE1 is also important in the regulation of collagen and ground substance metabolism, in cholesterol metabolism and in regulation of responsiveness to insulin. It is proposed that defective formation of PGE1 could account for many of the features of scurvy and for many of the reported therapeutic effects of vitamin C. If correct, vitamin C will be of value only in conjunction with an adequate supply of dihomogammalinolenic acid, the precursor of PGE1. Essential fatty acids, pyridoxine and zinc are all required to achieve this.

Topics: Animals; Arachidonic Acids; Ascorbic Acid; Ascorbic Acid Deficiency; Blood Platelets; Cats; Cholesterol; Collagen; Dental Caries; Drug Therapy, Combination; Glycosaminoglycans; Humans; Linolenic Acids; Neoplasms; Platelet Aggregation; Prostaglandins E; Salivation; Scurvy; Sjogren's Syndrome; Stimulation, Chemical

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Dental Caries; Diet; Humans; Keratoconjunctivitis; Lacrimal Apparatus; Male; Middle Aged; Oral Manifestations; Salivary Gland Diseases; Scurvy; Sjogren's Syndrome; Skin Manifestations; Xerostomia