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.
Oral candidiasis is closely associated with changes in oral fungal biodiversity and is caused primarily by Candida albicans. However, the widespread use of empiric and prophylactic antifungal drugs has caused a shift in fungal biodiversity towards other Candida or yeast species. Recently, next-generation sequencing (NGS) has provided an improvement over conventional culture techniques, allowing rapid comprehensive analysis of oral fungal biodiversity. In this study, we used NGS to examine the oral fungal biodiversity of 27 patients with pseudomembranous oral candidiasis (POC) and 66 healthy controls. The total number of fungal species in patients with POC and healthy controls was 67 and 86, respectively. The copy number of total PCR products and the proportion of non-C. albicans, especially C. dubliniensis, in patients with POC, were higher than those in healthy controls. The detection patterns in patients with POC were similar to those in controls after antifungal treatment. Interestingly, the number of fungal species and the copy number of total PCR products in healthy controls increased with aging. These results suggest that high fungal biodiversity and aging might be involved in the pathogenesis of oral candidiasis. We therefore conclude that NGS is a useful technique for investigating oral candida infections.
Oral candidiasis is closely associated with changes in the oral fungal flora and is caused primarily by Candida albicans. Conventional methods of fungal culture are time-consuming and not always conclusive. However, molecular genetic analysis of internal transcribed spacer (ITS) regions of fungal rRNA is rapid, reproducible and simple to perform. In this study we examined the fungal flora in patients with oral candidiasis and investigated changes in the flora after antifungal treatment using length heterogeneity-polymerization chain reaction (LH-PCR) analysis of ITS regions. Fifty-two patients with pseudomembranous oral candidiasis (POC) and 30 healthy controls were included in the study. Fungal DNA from oral rinse was examined for fungal species diversity by LH-PCR. Fungal populations were quantified by real-time PCR and previously-unidentified signals were confirmed by nucleotide sequencing. Relationships between the oral fungal flora and treatment-resistant factors were also examined. POC patients showed significantly more fungal species and a greater density of fungi than control individuals. Sixteen fungi were newly identified. The fungal populations from both groups were composed predominantly of C. albicans, though the ratio of C. dubliniensis was significantly higher in POC patients than in controls. The diversity and density of fungi were significantly reduced after treatment. Furthermore, fungal diversity and the proportion of C. dubliniensis were positively correlated with treatment duration. These results suggest that C. dubliniensis and high fungal flora diversity might be involved in the pathogenesis of oral candidiasis. We therefore conclude that LH-PCR is a useful technique for diagnosing and assessing the severity of oral candidal infection.
ObjectivesKüttner 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 MethodsFifty-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).ResultsThere 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%).ConclusionsThese results suggest an association between the pathogeneses of KT-S (−) and IgG4-DS, but not KT-S (+).
Abstract:Objectives: Cevimeline hydrochloride (CH) and pilocarpine hydrochloride (PH) are recognized as salivation-inducers with a high affinity for M3 muscarinic receptors. However, these drugs have a high frequency of side effects, including digestive symptoms and hyperhidrosis. We compared the effectiveness and side effects of these two drugs before and after a medication change.Materials and Methods: Seventy-six patients with Sjögren' s syndrome were divided into the following four groups: 1) CH group, CH was administered for 12 months; 2) PH group, PH was administered for 12 months; 3) CH-PH group, CH was administered for 6 months followed by PH for 6 months; 4) PH-CH group, PH was administered for 6 months followed by CH for 6 months. We measured the salivary flow rate and recorded the subjective symptoms in each group.Results: In each group, stimulated whole saliva (SWS) and unstimulated whole saliva (UWS) significantly increased after 3 months and 6 months, respectively, and subjective symptoms improved after 3 months. The incremental changes in both SWS and UWS did not differ significantly between the groups. The CH and PH groups both had digestive symptoms (32.3% and 32.1%, respectively) and hyperhidrosis (29.0% and 39.3%, respectively) . We found no significant difference in salivary flow rate or subjective symptoms after the medication change. However, the frequencies of side effects in the CH-PH and PH-CH groups decreased significantly for both digestive symptoms (9.7% and 10.7%, respectively) and hyperhidrosis (25.8% and 14.3%, respectively) .Conclusions: After changing the salivation-inducing drug, there was no significant difference in salivary function or subjective symptoms, while the frequency of side effects markedly decreased. These results suggest that changing the salivation-inducing drug effectively reduces side effects.
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