muramidase and Sjogren-s-Syndrome

Topics: Autoimmune Diseases; DNA, Viral; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Muramidase; Nucleic Acid Hybridization; RNA, Messenger; RNA, Viral; Salivary Glands; Sjogren's Syndrome

Diagnosis of a dry eye is facilitated by prompt recognition of pertinent signs and symptoms and by utilisation of those office and laboratory procedures which help to confirm the diagnosis. Prior knowledge of those systemic diseases associated with keratoconjunctivitis sicca (KCS) alert the practitioner to a possible dry eye state. Conversely, a diagnosis of KCS may prompt recognition of a hitherto unsuspected systemic disease. In this review, I will discuss the signs and symptoms of KCS, its association with various systemic conditions, as well as the tests and procedures that contribute to its diagnosis.

Topics: Adolescent; Adult; Blepharitis; Child; Cornea; Dysautonomia, Familial; Epithelium; Erythema Multiforme; Humans; Keratoconjunctivitis; Lactoferrin; Muramidase; Osmolar Concentration; Pemphigoid, Benign Mucous Membrane; Rose Bengal; Sarcoidosis; Sjogren's Syndrome; Tears

Topics: Humans; Immunoglobulins; Muramidase; Prealbumin; Proteins; Sjogren's Syndrome; Stevens-Johnson Syndrome; Tears

The objective of the present study was to evaluate the efficacy of Oral Balance saliva substitute in alleviating dry mouth symptoms in a sample of patients with secondary Sjögren's syndrome. Twenty-one consecutive secondary Sjögren's syndrome patients with dry mouth complaints and hyposalivation were included in this study. Patients used a lactoperoxidase-system-containing gel (Biotène Oral Balance) for 4 weeks. The effects on subjective oral symptoms were recorded by means of a 7-items questionnaire which contained questions regarding dry mouth sensation and its effect on chewing, swallowing, taste, speech, burning sensation and denture retention. The severity of symptoms was assessed using a visual analogical scale. Oral symptom scores and unstimulated whole salivary flow were recorded at baseline and after 4 weeks' use of the product. Two patients withdrew from the study, because of nausea and unpleasant taste caused by the product. Nineteen patients (all women, mean age 52.7 years) participated throughout the entire study. Wilcoxon signed-ranked tests indicated significant improvements in visual analogical scale scores posttreatment for 5 of the 7 items on the oral dryness questionnaire, although no increase in salivary flow was found. However, the improvement in certain variables did not take a positive course in all cases. Patients with lower salivary flow at baseline tended to have greater improvement in oral symptoms. The study suggests that the use of Oral Balance gel is effective in alleviating the dry mouth symptoms in secondary Sjögren's syndrome patients, but a randomized controlled trial is needed to assess the placebo effect.

Topics: Adult; Aged; Drug Combinations; Female; Glucose Oxidase; Humans; Lactoperoxidase; Middle Aged; Muramidase; Patient Satisfaction; Pilot Projects; Sjogren's Syndrome; Surveys and Questionnaires; Treatment Outcome; Xerostomia

The aim of this study is to clarify the effects of cevimeline on various components in human saliva, such as immunoglobulin A (IgA), lysozyme, alpha-amylase and squamous cell carcinoma (SCC) antigen. Twelve female patients with Sjögren syndrome (SS) and 14 healthy women were enrolled. After the first saliva collection, one capsule (30 mg) of cevimeline was administered to each subject. Saliva was collected again after 90 min. The salivary flow rate and concentration of each component were measured. In both groups the salivary flow rate and amylase concentration were significantly increased by cevimeline. The lysozyme and IgA concentrations did not change significantly in both groups. The SCC antigen concentration did not change significantly in the SS group, but it decreased significantly in the control group. The secretion rates of amylase and IgA showed significant increases in both groups. The secretion rate of lysozyme significantly increased only in the control group, while the secretion rate of SCC significantly increased only in the SS group. Cevimeline augments not only the salivary flow rate but also the secretion rate of some digestive and/or defense factors from infections. It may be beneficial for SS patients to continue taking cevimeline to prevent oral infections, and other serious sequelae.

Topics: alpha-Amylases; Antigens, Neoplasm; Female; Humans; Immunoglobulin A; Middle Aged; Muramidase; Muscarinic Agonists; Quinuclidines; Saliva; Salivation; Serpins; Sjogren's Syndrome; Thiophenes; Xerostomia

Tear secretion and lysozyme tear content were measured in 30 patients with Sjögren's syndrome after treatment with oral bromhexine, 32 mg/day. In 21 patients (70%) there was a marked increase in tear secretion and in lysozyme content. In patients with keratoconjunctivitis sicca (KCS) good results in clarifying the mucoid eye discharge were obtained. A remarkable amelioration of xerostomia was also noted. Six other patients, serving as controls, were given a placebo and bromhexine. The placebo had no influence on the rate of tear secretion, while bromhexine caused it to increase in 70% of the controls. This side effects of bromhexine treatment encountered in the present study were negligible and transient. We consider bromhexine to be the drug of choice in the treatment of Sjögren's syndrome.

Topics: Bromhexine; Clinical Trials as Topic; Humans; Muramidase; Sjogren's Syndrome; Tears; Xerophthalmia; Xerostomia

To evaluate the concentration of tear lysozyme in individuals with Sjogren´s syndrome, meibomian gland dysfunction, and non-dry-eye disease.. Ninety subjects were recruited for this study, including 30 with Sjogren´s syndrome, 30 with meibomian gland dysfunction, and 30 with non-dry-eye disease. All subjects were referred to participate in the study based on a "dry eye" investigation. They underwent a complete ocular surface ophthalmic examination encompassing ocular surface disease index, biomicroscopy, tear break-up time, Schirmer test type I, conjunctival vital staining with fluorescein and lissamine green, tear lysozyme concentration, and impression cytology.. Clinical tests yielded the following results: ocular surface disease index Sjogren´s syndrome: 64.5 ± 22.6 meibomian gland dysfunction: 43.5 ± 21.4, non-dry-eye disease: 6.7 ± 4.3 (p=0.02 between groups); Schirmer I test (mm/5 min): Sjogren´s syndrome: 4.95 ± 2.25, meibomian gland dysfunction: 13.28 ± 1.53, non-dry-eye disease 13.70 ± 1.39 (p<0.01 Sjogren´s syndrome vs. non-dry-eye disease and p<0.01 meibomian gland dysfunction vs. non-dry-eye disease); tear break-up time (seconds): Sjogren´s syndrome: 3.97 ± 1.47, meibomian gland dysfunction: 3.95 ± 0.86, non-dry-eye disease: 7.25 ± 1.90 (p<0.01 Sjogren´s syndrome vs. non-dry-eye disease and p<0.01 meibomian gland dysfunction vs. non-dry-eye disease); Lissamine green score: Sjogren´s syndrome-dry-eye: 6.18 ± 2.14, meibomian gland dysfunction-dry-eye: 5.27 ± 1.27, non-dry-eye disease: 1.52 ± 0.97 (p<0.01 Sjogren´s syndrome vs. non-dry-eye disease and p<0.01 meibomian gland dysfunction vs. non-dry-eye disease); impression cytology score: Sjogren´s syndrome: 1.88 ± 0.92, meibomian gland dysfunction: 1.67 ± 0.56, non-dry-eye: 0.45 ± 0.44 (p<0.01 Sjogren´s syndrome vs. non-dry-eye disease and p<0.01 meibomian gland dysfunction vs. non-dry-eye disease) and; tear lysozyme concentration (µg/mL): Sjogren´s syndrome: 751.25 ± 244.73, meibomian gland dysfunction: 1423.67 ± 182.75, non-dry-eye disease: 1409.90 ± 188.21 (p<0.01 Sjogren´s syndrome vs. non-dry-eye disease and p<0.01 Sjogren´s syndrome vs. meibomian gland dysfunction).. The concentration of lysozyme in the tears was lower in Sjögren's syndrome patients than in meibomian gland dysfunction and non-dry-eye disease groups. Hence, the lacrimal lysozyme could be considered as a simple, non-invasive, and economical biomarker to differentiate between Sjögren's syndrome dry eye disease and meibomian gland dysfunction dry eye disease.

Topics: Dry Eye Syndromes; Humans; Meibomian Gland Dysfunction; Meibomian Glands; Muramidase; Sjogren's Syndrome; Tears

However, there are some informations on the salivary glands involvement in systemic sclerosis, and there is a lack of any data about salivary glands function depending on systemic sclerosis subsets.. The unstimulated and stimulated salivary flow, the activity of peroxidase, the total amount of lactoferrin, lysozyme and sIgA were determined in two subgroups of systemic sclerosis and healthy controls.. In the unstimulated saliva of both patients groups, the salivary flow, the output of total protein and peroxidase activity were significantly lower; the total: sIgA and lactoferrin were significantly higher as compared with the control. In the stimulated saliva of the patients with limited form, the total lysozyme and peroxidase activity were significantly higher than in the control. In the stimulated saliva of the patients with diffused form, the salivary flow was significantly lower and the total sIgA and peroxidase activity were significantly higher than in the control.. Systemic sclerosis regardless of its subset affects salivary defense system of human unstimulated and stimulated saliva. Patients with the limited form experience the same impairment of the submandibular glands function as compared with patients with the diffused form. Only patients with the diffused form are deficient in respect of stimulated saliva secretion; the parotid glands of the patients with the limited form have a good secretory capacity in comparison with the healthy control.

Topics: Adaptive Immunity; Adult; Aged; Antibodies, Antinuclear; Case-Control Studies; DMF Index; Female; Humans; Immunity, Innate; Immunoglobulin A, Secretory; Lactoferrin; Middle Aged; Muramidase; Parotid Gland; Periodontal Index; Peroxidase; Saliva; Salivary Proteins and Peptides; Scleroderma, Diffuse; Scleroderma, Limited; Secretory Rate; Sjogren's Syndrome; Submandibular Gland

Lysozyme amyloidosis (ALys) is a form of hereditary systemic non-neuropathic amyloidosis, which is inherited in an autosomal dominant fashion. Lysozyme, which is the amyloidogenic precursor protein in ALys, is a ubiquitous bacteriolytic enzyme synthesized by hepatocytes, polymorphs and macrophages. The aim of this study is to describe the phenotype and outcome of patients with ALys including the role of solid organ transplantation.. Retrospective evaluation of patients with ALys.. UK National Amyloidosis Centre.. All 16 patients with ALys followed at the centre.. A family history of amyloidosis was present in every affected individual. Although the phenotype was broadly similar amongst those from the same kindred, there were marked phenotypic differences between kindreds who possessed the same amyloidogenic mutation. Symptomatic gastrointestinal (GI) amyloid was prevalent, and macroscopically visible amyloidotic lesions were present in nine of 10 patients who underwent GI endoscopy. All symptomatic ALys individuals had hepatic amyloid. Four patients received orthotopic liver transplants (OLT), three for spontaneous hepatic rupture and one case, who had extensive hepatic amyloid and a strong family history of hepatic rupture, pre-emptively. All of the liver grafts were functioning at censor 1.7, 5.8, 9.0 and 11.0 years after OLT. Five patients had progressive amyloidotic renal dysfunction culminating in end-stage renal failure, three of whom underwent renal transplantation (RTx). There was no evidence of renal allograft dysfunction at censor 6.6, 1.8 and 0.8 years after RTx.. Lysozyme amyloidosis is a disease of the GI tract, liver and kidneys, which has a slow natural history. There was a clear family history in all cases within this cohort, demonstrating a high clinical penetrance in the presence of an amyloidogenic lysozyme mutation. There is currently no amyloid-specific therapy for the condition which is managed symptomatically. OLT and RTx appear to be successful treatments for patients with liver rupture or end-stage renal disease, respectively, with excellent outcomes in terms of medium-term graft function and patient survival.

Topics: Adult; Aged; Amyloidosis, Familial; Child; Female; Gastrointestinal Diseases; Humans; Kidney Failure, Chronic; Kidney Transplantation; Liver Diseases; Liver Transplantation; Lymphatic Diseases; Male; Middle Aged; Muramidase; Mutation; Peptic Ulcer Hemorrhage; Phenotype; Purpura; Radionuclide Imaging; Retrospective Studies; Rupture, Spontaneous; Serum Amyloid P-Component; Sjogren's Syndrome; Survival Analysis; United Kingdom

To evaluate the concentration of tear lipocalin, lysozyme, and total protein in Sjögren's Syndrome (SS), non-Sjögren's keratoconjunctivitis sicca (KCS), and non-dry-eyed (NDE) individuals.. Seventy-six subjects were recruited for this study: 25 SS subjects; 25 KCS subjects, and 26 NDE individuals. Symptoms were measured with a visual analogue scale. Tear flow was measured by the Schirmer I test without anesthesia. Tears were collected using an eye wash technique. Total tear protein was quantified using the DC Protein Assay Kit. Tear lipocalin and lysozyme were quantified via Western blotting performed on a Phast System.. By definition, the SS and KCS groups both had significantly lower mean Schirmer scores (5.12 +/- 5.96 mm and 7.84 +/- 7.35 mm) compared with the NDE group (23.83 +/- 7.85 mm; p < 0.0001). There was no difference in mean Schirmer scores between SS and KCS groups (p = 0.19). The tear film of the SS group was characterized by significantly reduced (p < 0.0001) total protein and lipocalin concentrations compared with both KCS and NDE groups. No difference between the KCS and NDE groups was found in total protein (p = 0.92) or lipocalin (p = 0.19) concentration. In contrast, the concentration of tear film lysozyme was found to be statistically similar in all three groups examined. No statistically significant correlation was found in any group between mean Schirmer values compared with total protein, lipocalin or lysozyme concentration.. Our data demonstrate a biochemical distinction between the Sjögren's group compared with both KCS and control groups, in that both tear lipocalin and total tear protein were significantly reduced. Although correlations were not found between protein measurements and tear flow, a combination of tests including Schirmer I and quantitation of tear film biomarkers may allow for the identification of SS patients without the need for invasive testing.

Topics: Blotting, Western; Eye Proteins; Female; Humans; Keratoconjunctivitis Sicca; Lipocalins; Male; Middle Aged; Muramidase; Sjogren's Syndrome; Tears

To identify the most significant salivary biomarkers in Sjögren's syndrome (SS) using proteomic methods.. Parotid saliva from 20 non-SS subjects and 41 primary SS patients was analysed. Protein expression profiles for each sample were generated by surface-enhanced laser desorption/ionization time-of-flight-mass spectrometry (SELDI-TOF-MS). Mean peak intensities of SS patients and non-SS subjects were compared by univariate analyses. Samples pooled by diagnosis (SS and non-SS) and labelled with different Cy dyes were compared by two-dimensional difference gel electrophoresis (2D-DIGE). Two protein levels that were most significantly different by SELDI-TOF-MS and 2D-DIGE were validated by enzyme-linked immunosorbent assay in individual samples.. SELDI-TOF-MS of 10-200 kDa peaks revealed eight peaks with >2-fold changes in the SS group that differed from non-SS at P < 0.005. Peaks of 11.8, 12.0, 14.3, 80.6 and 83.7 kDa were increased, while 17.3, 25.4, and 35.4 kDa peaks were decreased in SS samples. 2D-DIGE identified significant increases of beta-2-microglobulin, lactoferrin, immunoglobulin (Ig) kappa light chain, polymeric Ig receptor, lysozyme C and cystatin C in all stages of SS. Two presumed proline-rich proteins, amylase and carbonic anhydrase VI, were reduced in the patient group. Three of these ten biomarkers have not been associated previously with SS.. The salivary proteomic profile of SS is a mixture of increased inflammatory proteins and decreased acinar proteins when compared with non-SS. Future studies will test the ability of these biomarker levels, alone and in combination, to diagnose the salivary component of SS.

Topics: Amylases; beta 2-Microglobulin; Biomarkers; Carbonic Anhydrases; Case-Control Studies; Cystatin C; Cystatins; Electrophoresis, Gel, Two-Dimensional; Humans; Lactoferrin; Muramidase; Parotid Gland; Protein Subunits; Proteomics; Receptors, Polymeric Immunoglobulin; Saliva; Sjogren's Syndrome; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Statistics, Nonparametric

We analysed and compared electrophoretic tear proteins patterns of healthy subjects and patients with different autoimmune diseases associated with secondary Sjogren's syndrome.. Tears were collected using the Schirmer's method. Proteins were separated by sodium-dodecyl sulfate polyacrylamide gel electrophoresis. The lanes were stained by Coomassie blue and/or silver.. Lactoferrin, albumin, lipocalin and lysozyme were found to be the main components being identified using molecular weight markers.. Electrophoretic analysis of tear proteins patterns is a fast, reproducible and simple method which provides information about the possibility of lacrimal gland involvement in auto-immune diseases.

Topics: Anti-Infective Agents; Autoimmune Diseases; Carrier Proteins; Cysteine Proteinase Inhibitors; Electrophoresis, Gel, Two-Dimensional; Eye Proteins; Humans; Lactoferrin; Lipocalin 1; Muramidase; Sjogren's Syndrome; Tears

We analysed and compared electrophoretic tear protein patterns of healthy subjects and patients with different autoimmune diseases associated with secondary Sjogren's syndrome.. Tears were collected using the Schirmer's method. Proteins were separated by sodium-dodecyl sulfate poliacrylamide gel electrophoresis. The lanes were stained by Coomassie blue and/or silver.. Lactoferrin, albumin, lipocalin and lysozyme were found to be the main components being identified using molecular weight markers.. Electrophoretic analysis of tear proteins patterns is a fast, reproducible and simple method which provides information about the possibility of lacrimal gland involvement in autoimmmune diseases.

Topics: Albumins; Anti-Infective Agents; Autoimmune Diseases; Carrier Proteins; Case-Control Studies; Electrophoresis, Polyacrylamide Gel; Eye Proteins; Humans; Lactoferrin; Lipocalin 1; Muramidase; Sensitivity and Specificity; Sjogren's Syndrome; Tears

The routine clinical diagnosis of sicca syndrome remains difficult; the results of the standard tests, such as the Schirmer test, tear film break-up time and the rose Bengal test, correlate neither with the course of the disease nor with one another.. We introduce two procedures that can be used to differentiate patients with sicca syndrome from healthy individuals on the basis of tear fluid protein patterns. Electrophoretic separation of the tear proteins or measurement by high-performance liquid chromatography (HPLC) was followed by digital image processing and multivariate discriminant analysis.. In addition to analysis of tear protein patterns, these methods permit diagnostic classification. Statistical evaluation reveals whether an unidentified sample is to be classified as sicca syndrome or "healthy". Both HPLC analysis and protein electrophoresis detect differences in protein patterns between the tear fluid of healthy individuals and patients with sicca syndrome and point to a diagnosis accordingly.. Both of the techniques presented - electrophoresis and HPLC - could potentially be used for diagnostic purposes in the detection of sicca syndrome. The HPLC method of tear protein analysis is more reliable, lends itself more readily to automation and achieved greater success rates in the experiments we describe; for these reasons it is the preferred approach.

Topics: Albumins; Chromatography, High Pressure Liquid; Diagnosis, Differential; Discriminant Analysis; Electrophoresis; Humans; Immunoglobulin A; Lactoferrin; Muramidase; Prealbumin; Proteins; Sjogren's Syndrome; Tears

Tear lysozyme and tear lactoferrin are enzymes synthesized by the lacrimal gland. Their concentration in human tears reflects tear gland function. Tear gland dysfunction can lead to ocular surface disease. We developed a colorimetric lysozyme assay. The objective of this study was to determine the diagnostic power and the clinical application of this assay that allows rapid and precise quantification of tear lysozyme.. Tear specimens of 120 eyes (30 Sjögren's patients and 30 controls) were collected using standardized filter paper discs. Tear lysozyme concentration was determined using p-nitrophenyl penta-N-acetyl-beta-chitopentaoside as substrate in the colorimetric assay. The results were compared to clinical findings and to two commonly used tests, the Micrococcus agar diffusion assay for tear lysozyme and the tear lactoferrin immunodiffusion assay.. The colorimetric assay showed a good dose-response relationship. The use of the assay as a method of diagnosing aqueous tear deficiency, using the clinical findings and the medical history as gold standard, demonstrated 85% sensitivity and 92% specificity. The results of the colorimetric assay when compared with the Micrococcus agar diffusion assay showed a linear relationship of r=0.77; when compared with the lactoferrin immunoassay r=0.73.. The colorimetric assay is simple to perform and does not require sophisticated laboratory equipment and personnel. Results can be precisely quantified within one hour after tear collection. The diagnostic power of the test is comparable to previously reported assays for lysozyme and lactoferrin and will be useful in the diagnosis of ocular surface disease.

Topics: Adolescent; Adult; Aged; Colorimetry; Female; Humans; Immunodiffusion; Lacrimal Apparatus; Male; Middle Aged; Muramidase; Sensitivity and Specificity; Sjogren's Syndrome; Tears

The purpose of this study was to examine the effect of salivary flow rate on the levels of antimicrobial salivary proteins in 24 patients with Sjögren's syndrome and 22 age- and race-matched healthy control subjects.. Parameters examined included stimulated salivary flow rate, total salivary protein, lactoferrin, lysozyme, amylase, and secretory immunoglobulin A.. The mean total salivary protein and the mean salivary amylase were significantly greater in patients than in controls. However, no significant difference was observed in the mean stimulated salivary flow rates or the levels of lactoferrin, lysozyme, or secretory immunoglobulin A of patients and controls. To examine the effect of salivary flow rate on the levels of salivary antimicrobial protein, the levels of these proteins in patients with salivary flow rate of < or = 0.3 mL/min per gland were compared to those in healthy controls with salivary flow rate > or = 0.4 mL/min per gland. Analyses showed the levels of lactoferrin to be significantly higher among patients than among controls.. The levels of salivary amylase and lactoferrin may be influenced by the levels of salivary output in patients with Sjögren's syndrome. The relationship between salivary flow rate and the levels of amylase and lactoferrin is not clear at the present time.

Topics: Adult; Aged; Amylases; Case-Control Studies; Female; Humans; Immunoblotting; Immunoglobulin A, Secretory; Lactoferrin; Male; Middle Aged; Muramidase; Saliva; Salivary Proteins and Peptides; Secretory Rate; Sjogren's Syndrome; Statistics, Nonparametric

To assess the course of tear gland function of patients with keratoconjunctivitis sicca (KCS) associated with primary (KCS-PSS) or secondary Sjögren's syndrome (KCS-SSS), and of patients with KCS not related to Sjögren's syndrome (KCS-NS).. In 106 patients with dry eye an ophthalmic diagnosis of KCS was made. Subsequent evaluations revealed a diagnosis of KCS-PSS in 31, KCS-SS in 19, and KCS-NS in 56 patients. Follow up assessments have been performed 10-12 years after initial diagnosis.. At baseline and at follow up tear gland function tests were worse in patients with KCS-PSS compared with the other forms of KCS. At follow up in the KCS-SSS patient group the tear gland function variables returned to marginal normal limits. In contrast with expectation, a marked improvement of the tear gland function variables in the KCS-NS patient group was noted.. In KCS-PSS patients tear gland function is characterised by a steady state situation. In KCS-SSS patients the normalisation of tear gland function variables most probably reflects a remission of the underlying disease. In view of the overall improvement in KCS-NS patients the term age related KCS should be avoided.

Topics: Disease Progression; Female; Follow-Up Studies; Humans; Keratoconjunctivitis Sicca; Lacrimal Apparatus; Lactoferrin; Male; Middle Aged; Muramidase; Sjogren's Syndrome; Statistics, Nonparametric; Tears

Topics: Adult; Aged; Child; Clinical Enzyme Tests; Cryopreservation; Enzyme Stability; Eye Proteins; Female; Humans; Male; Middle Aged; Muramidase; Ophthalmology; Retrospective Studies; Rose Bengal; Sjogren's Syndrome; Tears

We have compared clinical (Schirmer I test, BUT and rose bengal staining), laboratory (lysozyme and lactoferrin tear levels) and histological tests (impression cytology) in 165 eyes from 85 patients with primary Sjögren's syndrome and in 80 eyes from 40 control subjects. Impression cytology can provide the location of cellular alterations on the ocular surface and information on the severity of the disease. The upper bulbar and interpalpebral areas from patients with primary Sjögren's syndrome were shown to have cellular alterations early in the course of the disease, while the lower bulbar and lower palpebral areas were only affected in severe cases. Statistical analysis has shown that impression cytology and rose bengal staining are the most specific and sensitive methods for the diagnosis of primary Sjögren's syndrome.

Topics: Adult; Aged; Aged, 80 and over; Conjunctiva; Epithelium; Female; Humans; Lactoferrin; Male; Middle Aged; Muramidase; Reproducibility of Results; Rose Bengal; Sensitivity and Specificity; Sjogren's Syndrome; Staining and Labeling; Tears

In search of a simple non-invasive diagnostic test for primary Sjögren's syndrome (SS) the concentration of beta 2-microglobulin (beta 2-m), lysozyme (LZM) and lactoferrin (Lf) was measured in stimulated parotid saliva of 39 patients with primary SS, 42 patients suspected of the syndrome in whom the diagnosis could be excluded (NON-SS) and in 41 normal control individuals. Salivary fluid levels of beta 2-m, LZM and Lf exceeding the mean + 2 x standard deviation of healthy control values were found in respectively 58%, 23%, and 26% of the primary SS patients and in 7%, 11% and 0% of the NON-SS patients. The results of this study indicate that due to the low sensitivity the tests are not suitable as a screening procedure for patients suspected of having primary SS. However, measurement of beta 2-m in stimulated parotid saliva may be used as an adjunctive diagnostic test for primary SS.

Topics: Adult; Aged; Aged, 80 and over; beta 2-Microglobulin; Female; Humans; Lactoferrin; Male; Middle Aged; Muramidase; Osmolar Concentration; Reference Values; Saliva; Sjogren's Syndrome

Human immunodeficiency virus (HIV) associated salivary gland disease is defined as the presence of enlargement of one or more major salivary glands and/or diminished salivary function in an HIV infected individual. It has a number of similarities to, as well as differences from, Sjögren's syndrome (SS). We studied the sialochemistry of stimulated parotid saliva of 11 patients with HIV associated salivary gland disease and bilateral parotid gland enlargement, and compared these findings with those of 15 HIV negative controls, 13 HIV positive individuals with no salivary gland involvement and 18 individuals with SS. The patients with HIV associated salivary gland disease had a significant decrease in the level of salivary protein, with increases in salivary IgA, lysozyme and albumin compared to the HIV negative controls. There were no changes in concentration of electrolytes. The sialochemistry among the patients with HIV associated salivary gland disease was unrelated to the degree of immune suppression and did not change over a 6 month period. The observed changes were similar to those of SS but less pronounced. The similar clinical, histologic and sialochemical features of HIV associated salivary gland disease and SS suggest that these conditions share common pathogenetic mechanisms, which may be modified in the former by the HIV infection.

Topics: Acquired Immunodeficiency Syndrome; Adult; Humans; Immunoglobulin A; Male; Middle Aged; Muramidase; Saliva; Salivary Gland Diseases; Salivary Glands; Sjogren's Syndrome

Topics: Humans; Muramidase; Osmolar Concentration; Saliva; Sjogren's Syndrome

The concentrations of sodium, potassium, calcium, protein and lactoferrin and the enzymatic activity of salivary kallikrein, phosphohexoisomerase, alpha-amylase, lysozyme and IgA were measured in the parotid saliva of 12 patients suffering from Sjögren's syndrome. Compared with a control group (n = 31) remarkable differences were found in the composition of the parotid saliva in Sjögren patients. The possible reasons for these sialochemical alterations are discussed.

Topics: Adult; Amylases; Electrolytes; Glucose-6-Phosphate Isomerase; Humans; Immunoglobulin A, Secretory; Kallikreins; Lactoferrin; Middle Aged; Muramidase; Saliva; Salivary Proteins and Peptides; Salivation; Secretory Rate; Sjogren's Syndrome

In this study, lysozyme mRNA in labial salivary glands has been localized with in situ hybridization technique using 35S-labeled hen lysozyme cDNA (cDNALZM) as a hybridization probe in normals and in patients with Sjögren's syndrome, 35S-DNALZM:mRNA hybrids were detected only in acinar serous cells, although lysozyme was identified in ductal cells using immunohistochemical techniques. Our results suggest that the serous acinar cells are the only site of lysozyme synthesis in small salivary glands. The presence of lysozyme in ductal cells may be a result of reabsorption from the saliva or concentration from the blood or surrounding tissues.

Topics: Autoradiography; DNA Probes; Humans; Immunohistochemistry; Lip; Muramidase; Nucleic Acid Hybridization; RNA, Messenger; Salivary Glands; Salivary Glands, Minor; Sjogren's Syndrome

In our study, we investigated the clinical features of sicca syndrome in the presence and absence of rheumatoid arthritis. Twenty patients with sicca syndrome alone and 22 patients with sicca syndrome accompanied by rheumatoid arthritis were examined. The average onset age of the sicca syndrome alone is 12 years younger than the syndrome associated with rheumatoid arthritis. Moreover, rheumatoid arthritis tended to antecede the clinical onset of the sicca syndrome in the latter group. Relevant to the clinical investigative data, frequent lower values of CH 50 and positive reactions to the anti-nuclear antibody were noted in the sicca syndrome alone group. In this group, a lowering of cell-mediated immunity and a decrease in lysozyme density in lacrimal fluid were also noted. Relevant to the clinical manifestation, a high frequency of recurrence of parotitis, purpura and lymphadenopathy was also noted. Related to the joint findings, 45% of the patients with sicca syndrome alone disclosed clinical evidence for arthritis, however, no significant radiographic findings were observed. It is clear that there were distinct differences in clinical figures in both groups, while continuity of the clinical figures between them was also confirmed. When we take the known pathological and molecular genetic findings into consideration, it may be assumed that the differences in the clinical figures between these two entities could result from the difference of the causative mechanism of the conditions. Furthermore, we may safely say that the sicca syndrome alone may reflect the essential pathophysiologic figure of this particular syndrome.

Topics: Age Factors; Antibodies, Antinuclear; Arthritis, Rheumatoid; Humans; Muramidase; Sjogren's Syndrome; Tears

The microflora of the oral cavity was studied with a view to the evaluation of the microbiological status and the content of lysozyme in mixed saliva samples from 14 patients with Sjögren's syndrome and the control group of 19 persons. Disturbances in the biocenosis of the oral cavity of the patients, characterized by the increased occurrence of rod-shaped forms of lactobacilli, yeast-like fungi of the genus Candida and cariogenic streptococci (S. mutans) in the cultures obtained by the inoculation of oral smears, was detected. This "cariogenic situation" was confirmed by clinical data on the stomatological status. In patients with Sjögren's syndrome the intensity of caries, determined by the ratio of carious, filled and extracted teeth, was high and reached 27.4 +/- 1.0 in comparison with 15.3 +/- 0.7 in the control group (P less than 0.05). A decrease in the level of mixed saliva secretion and in the content of lysozyme in secreted saliva was noted in the patients in comparison with the control group (P less than 0.05). The results thus obtained indicate that in Sjögren's syndrome the use of the preparations of eubiotic microorganisms with a view to the correction of the microflora of the oral cavity, as well as the application of 0.1% lysozyme solution to the mucous membrane of the oral cavity, may be recommended among other therapeutic measures.

Topics: Adult; Aged; Bacteria; Candida; Chronic Disease; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Mouth; Muramidase; Saliva; Salivation; Secretory Rate; Sjogren's Syndrome

Topics: Animals; Arthritis, Rheumatoid; Bromhexine; Humans; Keratoconjunctivitis Sicca; Muramidase; Rabbits; Saliva; Sjogren's Syndrome; Tears

Topics: Biopsy; Conjunctiva; Diagnosis, Differential; Fluorescein; Fluoresceins; Humans; Keratoconjunctivitis; Keratoconjunctivitis Sicca; Lip; Muramidase; Salivary Glands; Sjogren's Syndrome; Staining and Labeling; Tears; Xerophthalmia

The presence of multinucleate giant cells in the sublabial salivary gland tissue in Sjögren's syndrome is an unusual phenomenon which can give rise to differential diagnostic problems. We found in 4 cases of 55 patients with Sjögren's syndrome multinucleate giant cells. In 2 of these 4 patients epimyoepithelial islands were also present. The combination of both multinucleate giant cells as epimyoepithelial islands can mimic the histological picture of a non- caseating granulomatous disease. To discriminate between an epimyoepithelial island and an epithelioid granuloma the immunoperoxidase technique with antibodies directed against muramidase appeared an useful tool. The epithelioid cells contain muramidase whereas the cells in the epimyoepithelial island do not contain this enzyme. Thus, multinucleate giant cells are a rare phenomenon in Sjögren's syndrome, therefore restricting its diagnostic significance. When they occur in Sjögren's syndrome staining for muramidase can be of help to avoid a false positive diagnosis of diseases in which non- caseating granulomatous inflammation occur, such as in sarcoidosis.

Topics: Adult; Female; Histocytochemistry; Humans; Immunoenzyme Techniques; Male; Middle Aged; Muramidase; Salivary Glands; Sjogren's Syndrome

Topics: Conjunctivitis; Eye Diseases; Humans; Keratitis; Muramidase; Sjogren's Syndrome; Tears

Topics: Contact Lenses, Hydrophilic; Female; Humans; Keratitis; Male; Muramidase; Ophthalmic Solutions; Sjogren's Syndrome; Tears

Topics: Adult; Biopsy; Drug Administration Schedule; Female; Humans; Keratoconjunctivitis; Middle Aged; Muramidase; Prednisone; Salivary Glands; Sjogren's Syndrome; Tears

A simple, rapid, reproducible method of quantifying tear lysozyme levels with a dual-channel spectrophotometer was used to compare normal subjects and those with dry-eye syndrome. The method was sensitive (80%) and specific (85%) and had a predictive value of a positive result of 83%. One patient with clinical manifestations of dry-eye syndrome and paradoxically elevated levels of tear lysozyme was found to have underlying sarcoidosis.

Topics: Humans; Lacrimal Apparatus Diseases; Muramidase; Sarcoidosis; Sjogren's Syndrome; Syndrome; Tears

Lysozyme (LZM), immunoglobulins and beta 2-microglobulin concentrations were measured in the saliva of 79 patients with primary (n = 29) or secondary (n = 50) Sjögren's syndrome and in a control population. beta 2-microglobulin and immunoglobulins A, G and M concentrations were higher, and LZM concentrations lower than in controls. A significant correlation was established between LZM and immunoglobulins, but no correlation was found between immunoglobulins and beta 2-microglobulin, nor between the latter and LZM. These results indicate that salivary LZM concentration may be of value in the diagnosis of Sjögren's syndrome.

Topics: Adult; Aged; beta 2-Microglobulin; Beta-Globulins; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Middle Aged; Muramidase; Saliva; Sjogren's Syndrome

We have found that human polymorphonuclear leucocytes (PMN) can be stimulated by large aggregates (heat-aggregated IgG, chemically polymerized IgG, heavily aggregated human immune complexes) and by surface-bound immune complexes (IC) to release enzymes (lysozyme, beta glucuronidase) and a factor(s) able to induce platelet aggregation and ATP release from the platelets. Surface-bound IC were most effective in stimulating the release of this factor(s). We used several substrates for their preparation: plastic-adsorbed antigen. Sepharose-coupled antigen and polymerized antigen. The platelet-aggregating factor(s) released by IC-stimulated PMN and zymosan-stimulated PMN were compared for their susceptibility to inhibition by indomethacin. Both induced a first phase of platelet aggregation that was resistant to indomethacin, but the second phase of aggregation and the release of platelet ATP were inhibited to a variable degree, more pronounced in the case of the factor(s) released after PMN-IC interaction. The lack of inhibition of the early phases of aggregation induced by our factor(s) when platelets were simultaneously exposed to indomethacin suggests that the classical, phospholipid PAF is released under these experimental conditions. Although, further experiments will be necessary to fully characterize the factor(s) involved, our observations suggest a complex interrelationship between human PMN and platelet activation, which may play an important role in the sequence of events that mediate the tissue deposition of IC and appearance of inflammatory changes.

Topics: Adenosine Triphosphate; Antigen-Antibody Complex; Blood Coagulation Factors; Cell Membrane; Glucuronidase; Humans; Immunoglobulin G; Indomethacin; Muramidase; Neutrophils; Platelet Aggregation; Sjogren's Syndrome

Fifty-three patients with sicca syndrome and 34 healthy controls had their tear lysozyme concentration examined. Lysozyme level was significantly decreased (P less than .0005) in all patients with low Schirmer test values as compared with healthy controls. Even in rheumatoid arthritis patients with normal Schirmer test results a low concentration of tear lysozyme was found. Tear lysozyme can be used to detect subclinical involvement of lacrimal glands in collagen diseases.

Topics: Adult; Aged; Arthritis, Rheumatoid; Female; Humans; Male; Middle Aged; Muramidase; Sjogren's Syndrome; Tears

Topics: Adult; Aged; Bromhexine; Female; Humans; Keratoconjunctivitis; Male; Middle Aged; Muramidase; Sjogren's Syndrome; Tears

Lysozyme and total protein concentrations in parotid saliva were measured in 17 patients with primary Sjögren's syndrome, in six patients with Sjögren's syndrome secondary to hyperlipoproteinemia and in 14 age- and sex-matched healthy control subjects. Increased lysozyme concentrations were found only in patients with primary Sjögren's syndrome and correlated well with the presence of parotid gland enlargement. The total protein concentration in the saliva of patients with Sjögren's syndrome was not different from that of the control subjects. Parotid saliva lysozyme determination may be useful as an early adjunctive diagnostic test of primary Sjögren's syndrome.

Topics: Humans; Hyperlipoproteinemias; Muramidase; Parotid Gland; Saliva; Salivary Proteins and Peptides; Sjogren's Syndrome

In 37 patients and 143 control patients we estimated tear fluid lysozyme content by the Micrococcus lysodeikticus agar diffusion assay. We found no correlation between the titer of lysozyme in tear fluid and the rate of tear flow. Decrease in lysozyme production was found to be a sensitive indicator of the involvement of the lacrimal system in Sjögren's syndrome.

Topics: Adult; Aged; Arthritis, Rheumatoid; Biological Assay; Humans; Micrococcus; Middle Aged; Muramidase; Sjogren's Syndrome; Tears

Topics: Adolescent; Adult; Aged; Humans; Keratoconjunctivitis; Middle Aged; Muramidase; Sjogren's Syndrome; Tears

Topics: Adolescent; Adult; Autoimmune Diseases; Female; Humans; Male; Mikulicz' Disease; Muramidase; Parotid Gland; Parotitis; Sjogren's Syndrome

Topics: Diagnosis, Differential; Humans; Lacrimal Apparatus Diseases; Muramidase; Practolol; Sjogren's Syndrome; Tears

Topics: Humans; Keratoconjunctivitis; Muramidase; Sjogren's Syndrome; Syndrome; Tears

Topics: Adolescent; Adult; Aged; Animals; Cats; Child; Child, Preschool; Eye Proteins; Guinea Pigs; Haplorhini; Humans; Infant; Middle Aged; Muramidase; Prealbumin; Sjogren's Syndrome; Stevens-Johnson Syndrome; Tears