Saliva Secretion in Patients with Allergic Rhinitis

Abstract

Background: Allergic rhinitis is manifested by watery discharge; however its clinical effect on the watery volume in the oral cavity is unknown. In addition, the low incidence of dry mouth due to treatment with the new generation antihistamines is based on subjective patients’ reports only. This study aimed to examine the effect of loratadine and fexofenadine on the salivary gland function in patients diagnosed with allergic rhinitis compared to untreated allergic patients and healthy individuals. Methods: A comparative observational study assessed parameters related to the patients’ perception of dry mouth as well as clinically observed parameters in fexofenadine-treated patients (group A) and in loratadine-treated patients (group B). Allergic patients without pharmacological treatment (group C) and healthy individuals (group D) served as a double control in order to evaluate the effect of allergy itself on dry mouth. A total of 36 patients were enrolled. Results: Patients in groups A and C reported the highest intensity of xerostomia. Sialometry values were significantly lower in these 2 groups compared to the healthy controls (p = 0.02 and 0.03, respectively). Average sialometry was over 0.2 ml/min in all groups and subjective dry mouth sensation ranged in the lower quarter of the visual analogue scale. Conclusions: In this pilot study, patients diagnosed with allergy presented a significant difference in salivary flow rate compared to healthy controls. Unlike the effect of loratadine, fexofenadine-treated patients showed significantly lower salivary flow rates compared to healthy individuals. In all cases the intensity of dry mouth was low.

Histamine H1 Receptor Induces Cytosolic Calcium Increase and Aquaporin Translocation in Human Salivary Gland Cells

“…This hypothesis, in general, was applied to classical antihistamines (for instance, chlorpheniramine and promethazine) that have been shown to inhibit muscarinic receptors (Brown and Eckberg, 1997;Yasuda and Yasuda, 1999;Shelton and McCarthy, 2000;Liu et al, 2006). However, recently developed "second-generation" antihistamines, such as astemizole and fexofenadine, also induce xerostomia (Wilson et al, 1987;Sreebny and Schwartz, 1997;Elad et al, 2006), despite their extremely low affinity for muscarinic receptors (Laduron et al, 1982;Liu et al, 2006). These observations suggest that xerostomia is not related solely to muscarinic receptor inhibition.…”

“…One example is antihistamine medication: classically, the histamine H1 receptor inhibitors. Frequently prescribed for minor allergic reactions or the cold-like symptoms of allergic rhinitis, antihistamines are reported to cause xerostomia (Elad et al, 2006); however, the exact mechanism for an antihistamine-induced decrease in salivary secretion is still unknown. The biological action of histamines is mediated by their binding to histamine receptors, classified as H1, H2, H3, and H4 (Parsons and Ganellin, 2006).…”

Surface Degradation of Resin-based Materials by Pediatric Syrup Containing Amoxicillin under Erosive Challenge

“…Furthermore, some chronic diseases and liquid medicines can reduce the salivary flow rate affecting its protective potential [29][30][31].…”

Evaluation of salivary gland function in allergic rhinitis patients by [99mTc] pertechnetate salivary gland scintigraphy

“…However, there have also been reports of allergic conjunctivitis, characterized by red watery and itchy eyes [7]. Additionally, dryness of the mucous membrane in the nasal cavity has been described [8,15]. Thus, subsequent to the allergic watery discharge, a dry mouth sensation may be expected.…”

“…Thus, subsequent to the allergic watery discharge, a dry mouth sensation may be expected. The anatomical proximity between the nasal cavity and the oral cavity may also lead to the patient's perception of dry mouth [8,16]. Compared to healthy controls, lower salivary flow rate was found among patients with allergic rhinitis [8].…”