lactoferrin and Xerostomia

Innate human salivary defence proteins, lysozyme, lactoferrin and peroxidase, are known to exert a wide antimicrobial activity against a number of bacterial, viral and fungal pathogens in vitro. Therefore, these proteins, alone or in combinations, have been incorporated as preservatives in foods and pharmaceuticals as well as in oral health care products to restore salivas' own antimicrobial capacity in patients with dry mouth. These antimicrobials used in oral health care products, such as dentifrices, mouth-rinses, moisturizing gels and chewing gums, have been purified from bovine colostrum. In this review I critically evaluate the clinical efficacy and safety of this kind of preventive approach against various oral diseases and symptoms.

Topics: Animals; Anti-Infective Agents, Local; Bacteria; Cattle; Colostrum; Complex Mixtures; Dentifrices; Drug Combinations; Drug Design; Female; Glucose Oxidase; Humans; Lactoferrin; Lactoperoxidase; Mouthwashes; Muramidase; Polymers; Pregnancy; Proteins; Saliva, Artificial; Salivary Proteins and Peptides; Thiocyanates; Xerostomia

To evaluate the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lactoferrin and lysozyme, in a sample of elderly individuals with dry mouth.. Twenty elderly institutionalised subjects with dry mouth and with a certain degree of independence for daily life activities were included in this pilot study. A randomised, double blind and cross-over design was used. The study variables comprised subjective dry mouth sensation, the severity of discomfort assessed by means of a visual analogical scale (VAS), the Oral Health Impact Profile (OHIP), the presence of signs and symptoms of dry mouth, sialometry and Candida albicans culture. All the variables were recorded before and after each of the two periods of the study.. The 20 selected subjects we made up of 16 women and four men, with a mean age of 81.3 years. Improvement was observed on analysing the data between the first and second intervention period in terms of the OHIP values, the presence of dry mouth, and the need to drink fluids to swallow. However, the improvement in certain variables before and after treatment did not take a positive course in all cases, and some subjects even improved with placebo.. The evaluated mouthwash and oral gel improved some subjective and clinical aspects in elderly individuals with dry mouth, though a placebo effect cannot be entirely discarded.

Topics: Aged; Aged, 80 and over; Anti-Infective Agents; Cross-Over Studies; Dental Care for Aged; Double-Blind Method; Drug Combinations; Female; Glucose Oxidase; Humans; Lactoferrin; Lactoperoxidase; Male; Muramidase; Pilot Projects; Polymers; Quality of Life; Saliva, Artificial; Sickness Impact Profile; Xerostomia

This study evaluates the effects of two oral hygiene products containing nonimmunoglobulin antimicrobial agents on whole saliva and on subjective oral symptoms in patients with xerostomia. Twenty patients used a lactoperoxidase-system-containing toothpaste (Biotene) combined with the use of a mouthrinse (Biotene), comprising also lysozyme and lactoferrin, for 4 weeks. Saliva samples were collected at base line, after 4 weeks' use of the products, and at the end of a 4-week washout period. Samples were analyzed for selected biochemical and microbiologic factors. The effects on subjective oral symptoms were also recorded. A 4-week daily use of toothpaste and mouthrinse relieved the symptoms of oral dryness in 16 patients. The levels of salivary hypothiocyanite, lysozyme, lactoferrin, or myeloperoxidase activity did not change, but there was a significant decrease in salivary pH (P < 0.05), total peroxidase activity (P < 0.05), and total protein content (P = 0.01). In patients with the lowest salivary flow rates (n = 5) a significant (P > or = 0.04) increase was detected in salivary hypothiocyanite concentrations. No major changes occurred in salivary microflora. The products relieved subjective oral symptoms in most xerostomic patients, but this was not necessarily related to the presence of antimicrobial agents.

Topics: Adult; Aged; Anti-Infective Agents, Local; Bacteria, Anaerobic; Candida; Colony Count, Microbial; Dentifrices; Female; Humans; Hydrogen Peroxide; Hydrogen-Ion Concentration; Lactoferrin; Lactoperoxidase; Male; Middle Aged; Mouthwashes; Muramidase; Palliative Care; Peroxidases; Saliva; Salivary Proteins and Peptides; Thiocyanates; Xerostomia

We aimed to perform a longitudinal investigation of the effects of radiotherapy on salivary flow rate, pH, buffering capacity, and protein composition of saliva and on the quality of life of children with Hodgkin disease.. Ten children (6-16-year-old) with Hodgkin disease and 10 matched healthy children were investigated. Stimulated and non-stimulated saliva samples were collected at baseline, after 1080 and 2160cGy of radiation, and 1, 2, and 3 months post-radiotherapy. The salivary flow rate was expressed as mL/min. Buffer capacity was determined by titration. Amylase activity, immunoglobulin A, mucin, and lactoferrin concentrations were determined by ELISA. Quality of life was assessed by Quality of Life - Head and Neck module 35 questionnaire.. We found that radiotherapy caused hyposalivation at 1080cGy and 1 month after radiotherapy and reduced buffering capacity at 2160cGy. Mucin concentration and amylase activity in non-stimulated saliva increased 1 month after radiotherapy. Lactoferrin concentration increased during and after radiotherapy. Immunoglobulin A concentration increased at 1080cGy, 1 and 2 months, for non-stimulated saliva and at 2160cGy and 1 month for stimulated saliva. Children reported more pain after radiotherapy and more xerostomia during radiotherapy.. We concluded that the radiotherapy protocol affected the children's salivary properties and children's quality of life.

Topics: Adolescent; Case-Control Studies; Child; Enzyme-Linked Immunosorbent Assay; Female; Hodgkin Disease; Humans; Immunoglobulin A; Lactoferrin; Male; Mucins; Quality of Life; Saliva; Salivation; Xerostomia

Many individuals in an aging society experience oral dryness. Maintaining the flow of saliva and the presence of antimicrobial substances is important to maintain oral health. The inhibition of the secretion of antimicrobial substances could lead to oral dryness.. The purpose of this study was to evaluate the antimicrobial substances lactoferrin and chromogranin A in the saliva of elderly individuals with oral dryness.. The study included 25 controls and 28 participants with subjective oral dryness. The levels of lactoferrin and chromogranin A were determined in unstimulated whole saliva with an enzyme-linked immunosorbent assay method. The differences in secretion of lactoferrin and chromogranin A between the controls and the participants with oral dryness were analyzed with the Mann-Whitney U test (α=.05).. The flow rate of lactoferrin and chromogranin A was lower in the group of participants with oral dryness (lactoferrin, 7.43 ±7.08 ng/min; chromogranin A, 0.24 ±0.24 ng/min) than in the control group (lactoferrin, 21.52 ±7.67 ng/min; chromogranin A, 0.97 ±0.69 ng/min) (P<.01). The ratio of both antimicrobial proteins to total protein was also lower in participants with oral dryness than in the controls.. The results of this study indicated that the levels of lactoferrin and chromogranin A were lower in those with oral dryness. A reduction in the secretion of these antimicrobial substances may be associated with oral dryness.

Topics: Aged; Anti-Infective Agents; Chromogranin A; Female; Humans; Lactoferrin; Male; Middle Aged; Saliva; Salivary Proteins and Peptides; Secretory Rate; Xerostomia

The aim of this study was to assess the relationship between complaints of xerostomia in patients with rheumatoid arthritis (RA) with the total output of the salivary proteins of innate and adaptive immunity.. The salivary output and specific activity of peroxidase and specific contents of lysozyme, lactoferrin, and secretory immunoglobulin A (sIgA) were determined in xerostomic RA patients, nonxerostomic RA patients, and healthy control subjects.. Compared with nonxerostomic RA and healthy control groups, xerostomic RA patients had significantly decreased output of saliva and protein, decreased peroxidase activity, and a significantly lower specific content of peroxidase and sIgA. Compared with the RA control group, xerostomic RA patients had significantly lower specific content of all salivary proteins examined.. The results indicate that xerostomia in patients with RA may be a harbinger of diminished saliva production regarding quantity and quality, and may be indicative of impairment of the salivary immune system of the oral cavity in xerostomic RA patients.

Topics: Adaptive Immunity; Adult; Arthritis, Rheumatoid; Blood Sedimentation; C-Reactive Protein; Case-Control Studies; DMF Index; Female; Humans; Immunity, Innate; Immunoglobulin A, Secretory; Immunologic Factors; Lactoferrin; Middle Aged; Muramidase; Oral Hygiene Index; Periodontal Index; Peroxidases; Rheumatoid Factor; Saliva; Salivary Proteins and Peptides; Secretory Rate; Xerostomia

Xerostomia is a common complication of radiotherapy for head and neck cancer. Symptomatic treatment consists of stringent oral hygiene to prevent oral infections and saliva substitutes to increase comfort. The aim of the study was to evaluate the clinical effectiveness of the BioXtra (BX) dry mouth care system.. A xerostomia questionnaire consisting of 3 parts (xerostomia symptom score, quality of life (QoL) survey and visual analogue scale (VAS)) was completed by 34 patients suffering from radiation-induced xerostomia, before and after 4 weeks of treatment with the BioXtra moisturizing gel, toothpaste and mouthwash.. The BioXtra products significantly diminished the most common symptoms of xerostomia. Mean VAS score at the start of treatment was 59.8. After treatment, this decreased to 36.4 (p < 0.001). Twenty-six patients (77%) responded to treatment, 11 of these patients (32%) reported a major improvement. Quality of life significantly improved under treatment: mean QoL score at the start was 59.4; this increased to 70.5 (p < 0.001). None of the 34 patients reported any adverse effects and all but 1 patient found the BX dry mouth care system easy to use.. The results of this study suggest that the BioXtra dry mouth care system is effective in reducing the symptoms of radiation-induced xerostomia and improving the quality of life of xerostomia patients, even if a proportion of the benefit is due to a placebo effect. However, further research is necessary to evaluate the efficacy of BioXtra on oral health.

Topics: Aged; Aged, 80 and over; Complex Mixtures; Female; Head and Neck Neoplasms; Health Surveys; Humans; Lactoferrin; Lactoperoxidase; Male; Middle Aged; Muramidase; Pain Measurement; Proteins; Psychological Tests; Psychometrics; Quality of Life; Radiation Injuries; Radiation Oncology; Radiotherapy; Radiotherapy Dosage; Risk Factors; Saliva; Salivation; Surveys and Questionnaires; Xerostomia; Xylitol

In this study, the secretion rate and IgA, albumin and lactoferrin concentrations in minor labial and buccal gland saliva were investigated in individuals with hyposalivation due to primary Sjogren's syndrome (pSS; 10 subjects) or head and neck radiation therapy (RT; 10 subjects) and in their matched controls. Whole saliva was similarly examined. The minor gland saliva flow was measured using the Periotron method. IgA, albumin and lactoferrin concentrations were analysed by ELISA techniques. A general finding was that the flow rate and protein concentrations were lower in labial than in buccal gland saliva. In both hyposalivation groups, the labial minor gland saliva secretion rate was lowered compared to their respective controls. The buccal gland saliva flow rate was significantly reduced in the RT group only. IgA and albumin concentrations were not different from the controls in the labial secretions. The concentration of lactoferrin was increased in the RT group. In buccal saliva, the concentrations of all proteins examined but pSS IgA, were increased compared to the controls. Reduced flow rate and increased protein concentrations were seen for whole saliva where the lactoferrin concentration was higher in RT than in pSS subjects. Thus, our findings suggested that minor gland saliva flow rate and protein concentrations are affected in RT and pSS subjects and to highest extent in the former.

Topics: Adult; Aged; Albumins; Case-Control Studies; Cheek; Enzyme-Linked Immunosorbent Assay; Female; Head and Neck Neoplasms; Humans; Immunoglobulin A, Secretory; Lactoferrin; Lip; Male; Middle Aged; Radiation Injuries; Radiotherapy; Salivary Glands, Minor; Salivary Proteins and Peptides; Salivation; Sjogren's Syndrome; Xerostomia

There are several reasons for hyposalivation, each affecting the salivary composition in different ways. The aim of this study was to analyze and compare lactoferrin, amylase and mucin MUC5B in stimulated whole saliva collected from subjects with hyposalivation of different origins and to relate the results to the presence of some microbial species associated with oral disorders. Albumin was determined as a marker of serum leakage. The characteristic feature for subjects with radiation-induced hyposalivation was a large increase in lactoferrin, probably due to leakage through inflamed mucosal tissues, while it was a high albumin content for the group with primary Sjögren's syndrome, probably due to disruption of the fragile mucosa. The saliva composition in subjects with hyposalivation of unknown origin or due to medicines was close to that in the healthy controls. All three hyposalivation groups tended to display a decrease in the concentrations of MUC5B and amylase. None of the microbial species analyzed (streptococci, mutans streptococci, Lactobacillus spp., Fusobacterium nucleatum, Prevotella intermedia/Prevotella nigrescens, Candida albicans, Staphylococcus aureus and enterics) correlated with concentration of MUC5B in saliva. The RT group, having the highest concentration of lactoferrin, had the lowest median number of F. nucleatum and was the only group in which median number of P. intermedia/P. nigrescens was zero.

Topics: Adult; Aged; Amylases; Analysis of Variance; Candida albicans; Colony Count, Microbial; Enterobacteriaceae; Female; Fusobacterium nucleatum; Humans; Lactobacillus; Lactoferrin; Male; Middle Aged; Mucin-5B; Mucins; Prevotella; Prevotella intermedia; Radiotherapy; Saliva; Salivary Proteins and Peptides; Secretory Rate; Serum Albumin; Sjogren's Syndrome; Staphylococcus aureus; Statistics as Topic; Streptococcus; Streptococcus mutans; Xerostomia

Human parotid salivas were collected from patients with secondary Sjögren's syndrome and controls without disease or with drug-induced xerostomia. Parotid glycoproteins were separated by gradient sodium dodecyl sulphate gel electrophoresis (SDS-PAGE), electroblotted onto nitrocellulose membrane and probed with biotinylated lectins of characterised sugar specificities. The binding patterns of lectins from Maclura pomifera (MPA) and Arachis hypogaea (PNA) indicated that many parotid glycoproteins have sialylated O-linked glycans and that sialylation is not affected by disease. Binding by lectins from Ricinus communis (RCA-1), Limax flavus (LFA), Lotus tetragonolobus (LTA) and Ulex europaeus (UEA-1) appeared unaltered in secondary Sjögren's syndrome, suggesting no obvious change in N-glycosylation of parotid glycoproteins. Variations in binding patterns of most lectins was attributable to subject-to-subject variations in recognised polymorphic proteins. Dolichos biflorus agglutinin (DBA) consistently showed increased binding to a 75 kDa (Mr) protein in salivas from patients with secondary Sjögren's syndrome. The binding protein was identified as lactoferrin but found not to contain N-acetylgalactosamine, the sugar to which DBA binds. Binding of DBA to lactoferrin was dependent upon its saturation with iron, modified SDS-PAGE under nonreducing conditions resolved iron-free and iron-saturated lactoferrins and demonstrated increased levels of the iron-saturated form in secondary Sjögren's syndrome. Lectin binding studies of purified lactoferrins from saliva, milk, and polymorphonuclear neutrophils suggested that raised levels of lactoferrin in saliva originate from salivary cells and not from inflammatory cells. These results suggest that DBA binding provides greater specificity as an indicator of salivary gland disease than measurement of lactoferrin levels alone.

Topics: Biotinylation; Electrophoresis, Polyacrylamide Gel; Glycoproteins; Glycosylation; Humans; Iron; Lactoferrin; Lectins; N-Acetylneuraminic Acid; Parotid Gland; Peanut Agglutinin; Plant Lectins; Saliva; Sjogren's Syndrome; Xerostomia

During the active phase of chronic recurrent parotitis there is a marked elevation in the parotid concentration of lactoferrin (Lf), and iron-binding glycoprotein with antibacterial properties. The Lf concentration decreases during the recovery period, but still remains above normal levels. The changes of Lf in parotitis parallel recent findings in mastitis and pancreatitis. Elevations in Lf were also noted in five of six subjects with Sjögren's disease, but not in subjects with sarcoidosis, diabetes or "dry mouth" without sialographic changes. The source of the Lf has not been determined; it could arise in part from disrupting polymorphonuclear leucocytes and in part from epithelial cells that synthesize Lf in the salivary glands. Inflammatory stimulation of Lf synthesis would suggest a basic protective mechanism in exocrine glands and should be fully explored.

Topics: Albumins; Chronic Disease; Diabetes Mellitus; Humans; Lactoferrin; Lactoglobulins; Parotitis; Recurrence; Saliva; Sarcoidosis; Secretory Rate; Sjogren's Syndrome; Xerostomia