Pilocarpine treatment of salivary gland hypofunction and dry mouth (xerostomia)

Article Abstract:

Xerostomia or dry mouth can result from various illnesses and treatments. These include Sjogren's syndrome, in which the salivary glands do not function properly, and radiation therapy for certain cancers. No approved treatment for xerostomia currently exists. The drug pilocarpine is known to stimulate the salivary glands to produce saliva, so a group of 39 patients with salivary gland dysfunction were enrolled in a study to determine if pilocarpine might be of benefit. For five out of the six months of the study, the patients were given pilocarpine, and for the remaining month, they were given placebo, or inert pills. The patients were assessed both objectively, in terms of measured increases in saliva flow, and subjectively, in terms of decreased sensation of dry mouth. Objective increases in rate of saliva production were documented in 26 patients, and 27 patients reported feeling that their mouths were less dry. No tolerance to pilocarpine was noted during the six months, and no significant side effects were observed. Pilocarpine has the potential to raise blood pressure and pulse, and to cause electrocardiogram abnormalities, but none of these were noted during the course of the study. Some patients experienced increased sweating, increased frequency of urination, and increased tearing, but these side effects were not felt to be of great significance. Interestingly, when the results were analyzed, those patients with the greatest dysfunction of their salivary glands going into the study had the least objective improvement with pilocarpine, yet they reported the greatest subjective improvement. Pilocarpine will not work for a patient whose salivary glands are completely nonfunctional. Its side effects in less-than-healthy patients are unknown, as are its interactions with other drugs. Nevertheless, the results of this study suggest that patients with salivary gland dysfunction might benefit from taking pilocarpine, and that further research to elucidate the effects of the drug are warranted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Drug therapy, Xerostomia, Pilocarpine

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Salivary inhibition of HIV-1 infectivity: functional properties and distribution in men, women, and children

Article Abstract:

Previous research with healthy men has demonstrated that human saliva inhibits the infection of lymphocytes (white blood cells) with human immunodeficiency virus type 1 (HIV-1), the virus that causes AIDS (acquired immunodeficiency syndrome). These findings were elaborated by examining the saliva of healthy men, women, and children, and also men known to be infected with HIV-1. Samples of whole saliva were collected from the healthy volunteers, who were nine women (aged 24 to 42), nine men (aged 21 to 42) and seven children (aged 4 to 11); nine HIV-seropositive men were also studied. A simplified description of the methods used follows. Saliva samples were mixed with concentrated HIV-1 and warmed. Normal human lymphocytes were then added. The mixture was placed in a growth medium to encourage replication of the virus. Testing over the next 18 days showed that complete inhibition of viral replication occurred in the saliva from all the women and children. Of the nine HIV-seropositive men, seven showed complete inhibition and the other two had substantial inhibition of viral replication. Six of the nine healthy men had complete inhibition and three showed partial inhibitory activity. The results suggest that human saliva from a broad spectrum of the population contains a factor that inhibits the infection of human lymphocytes with HIV-1. This supports the observation that the risk of transmitting AIDS through saliva is low. The finding that all the children showed complete inhibition of HIV-1 replication is particularly important considering the concerns of parents and school officials that young children could transmit AIDS to each other through common activities such as spitting, drooling, kissing, and sharing toys that have been put in their mouths. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, HIV (Viruses), HIV, Disease transmission, AIDS (Disease) in children, Pediatric AIDS (Disease)

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Elevation of salivary antimicrobial proteins following HIV-infection

Article Abstract:

The acquired immunodeficiency syndrome (AIDS) is associated with a failure of the immune system that is specifically due to a loss of T-helper cells, a type of immune cell. Infections of the mucosal surfaces lining certain body cavities such as the mouth, esophagus, nose, lungs, and gastrointestinal tract with microorganisms that do not normally cause disease indicates a failure of the secretory defense mechanisms. For example, the saliva is a part of the oral defense system and contains four proteins, lactoferrin, lysozyme, secretory IgA, and histatin, which fight against bacteria and fungi. The levels of these proteins in the saliva, and their relation to the presence of yeast infection of the mouth, were assessed in 37 patients with human immunodeficiency virus (HIV-1) infection and 15 healthy subjects. Among the HIV-1-infected patients, 19 were without symptoms and receiving no drug therapy, and 18 patients had developed signs of AIDS. The levels of all four antimicrobial proteins were increased in HIV-1-infected patients as compared with healthy subjects. Lysozyme and histatin levels were highest in patients with yeast infections of the mouth. The cause of the increased levels of salivary defense proteins is not known. The results suggest that HIV-1 infection is associated with changes in the levels of salivary defense proteins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Physiological aspects, HIV infection, HIV infections

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