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Sonesson M, Hamberg K, Lundin Wallengren M-L, Matsson L, Ericson D. Salivary IgA in minor-gland saliva of children, adolescents, and young adults. Eur J Oral Sci 2011; 119: 15-20. © 2011 Eur J Oral Sci According to previous studies, minor glands produce about 35% of the total salivary immunoglobulin A (salivary IgA). The age-dependent increase in whole-saliva salivary IgA concentrations has been studied extensively, but we found no published reports comparing the minor-gland saliva concentrations of salivary IgA in children, adolescents, and adults. In this study we measured the concentration of salivary IgA in saliva from the labial and the buccal minor glands of children, adolescents, and adults. Three age groups donated saliva for analysis: 3-yr-old children, 14-yr-old adolescents, and 20- to 25-yr-old adults. Minor-gland saliva was collected on filter paper and unstimulated whole saliva was collected by draining into a tube, and the salivary IgA concentration was determined by ELISA. The salivary IgA concentration in labial saliva was significantly lower among 3-yr-old children (0.037 mg 100 ml, SD = 0.035) than among 14-yr-old adolescents (0.126 mg 100 ml, SD = 0.128) and adults (0.128 mg 100 ml, SD = 0.13). The 3-yr-old children also had significantly lower whole-saliva salivary IgA values compared with the other age groups (0.09 mg 100 ml, SD = 0.091; 0.179 mg 100 ml, SD = 0.149; and 0.170 mg 100 ml, SD = 0.099, respectively). This increase in salivary IgA concentrations with age might reflect a developing immune response in the growing child. [ABSTRACT FROM AUTHOR]

Background: To assess the risk of incident cardiovascular disease in patients with primary Sjögren's syndrome, overall and stratified by Ro/SSA and La/SSB autoantibody status.Methods: A cohort of patients with primary Sjögren's syndrome in Sweden (n = 960) and matched controls from the general population (n = 9035) were included, and data extracted from the National Patient Register to identify events of myocardial infarction, cerebral infarction and venous thromboembolism. Hazard ratios were estimated using cox proportional hazard regressions.Results: During a median follow-up of 9.5 years, the overall hazard ratio (HR) was 1.6 (95% CI 1.2-2.1) for myocardial infarction, 1.2 (95% CI 0.9-1.7) for cerebral infarction and 2.1 (95% CI 1.6-2.9) for venous thromboembolism. Patients positive for both Ro/SSA and La/SSB autoantibodies had a substantially higher risk of cerebral infarction (HR 1.7, 95% CI 1.0-2.9) and venous thromboembolism (HR 3.1, 95% CI 1.9-4.8) than the general population. These risks were not significantly increased in Ro/SSA- and La/SSB-negative patients. Among autoantibody-positive patients, the highest HR of cerebral infarction was seen after ≥10 years disease duration (HR 2.8, 95% CI 1.4-5.4), while the HR for venous thromboembolism was highest 0-5 years after disease diagnosis (HR 4.7, 95% CI 2.3-9.3) and remained high throughout disease duration.Conclusions: Primary Sjögren's syndrome is associated with a markedly increased risk of cardiovascular disease and the presence of Ro/SSA and La/SSB autoantibodies identify the subgroup of patients carrying the highest risk. These findings suggest that monitoring and prevention of cardiovascular disease in this patient group should be considered. [ABSTRACT FROM AUTHOR]

Glimvall P, Wickström C, Jansson H. Elevated levels of salivary lactoferrin, a marker for chronic periodontitis? J Periodont Res 2012; 47: 655-660. © 2012 John Wiley & Sons A/S Background and Objective: Whole saliva is a complex mixture of fluids essential for the well-being of the oral hard and soft tissues. Saliva contains numerous antimicrobial proteins that help protect the oral ecosystem from infectious agents. Chronic periodontitis is an infectious chronic inflammatory condition that affects the tooth-supporting structures and leads to their destruction. The aim of the present study was to investigate differences in concentrations of salivary lactoferrin in subjects with and without periodontal disease and correlate these values with clinical variables associated with periodontal disease. Material and Methods: Stimulated whole saliva was collected from 17 subjects with chronic periodontitis and 17 periodontally healthy control subjects. Data relating to bleeding on probing, probing pocket depth and horizontal bone loss were registered. Concentrations of lactoferrin, lysozyme and IgA in stimulated whole saliva were quantified using ELISA. Results: Subjects with chronic periodontits showed higher concentrations of lactoferrin in stimulated whole saliva compared with periodontally healthy control subjects ( p < 0.05). Salivary concentrations of lactoferrin were positively correlated with bleeding on probing ( p < 0.001) and the number of sites with probing pocket depth ≥ 6 mm ( p < 0.001). Conclusion: Lactoferrin is raised in stimulated whole saliva in subjects with chronic periodontitis and is correlated with probing pocket depth ≥ 6 mm. [ABSTRACT FROM AUTHOR]

Brage M, Holmlund A, Johansson A. Humoral immune response toAggregatibacter actinomycetemcomitans leukotoxin. J Periodont Res 2011; 46: 170-175. © 2010 John Wiley & Sons A/S Periodontal disease is an inflammatory condition caused by bacterial infections that result in loss of the tooth supporting tissue. The periodontal pathogens produce virulence factors with capacity to affect the host immune response. Aggregatibacter actinomycetemcomitans is a periodontal pathogen that produces a leukotoxin that specifically affects human leukocytes. The aims of the present study were to examine the presence and function of systemic antibodies to the leukotoxin. One hundred and ninety-seven middle-aged (57 ± 5 years) Swedes with well-documented periodontal status and medical factors related to cardiovascular diseases were studied. These data have been published previously. The serum samples were examined for the presence of leukotoxin antibodies by western blot and the capacity to neutralize leukotoxicity in an activity assay with leukotoxin and cultured leukemic cells. The results showed a high prevalence (57%) of antibodies against A. actinomycetemcomitans leukotoxin in the analyzed population. These antibodies were correlated with leukotoxin neutralizing capacity as well as with the ELISA titers of A. actinomycetemcomitans-specific IgA and IgG. In addition, high levels of leukotoxin antibodies were correlated with increasing age, but not with periodontal disease parameters or cardiovascular risk factors. Systemic antibodies against A. actionmycetemcomitans leukotoxin were common in this adult Swedish population. These antibodies might contribute to limit the systemic effects of the infection. [ABSTRACT FROM AUTHOR]

The aims of this part of the European Respiratory Health Survey were to estimate the prevalence of atopic sensitization to inhalant allergens among adults in three different areas of Sweden and to investigate the association between sensitization and certain risk factors. Randomly selected subjects aged 20-46 years from Göteborg, Uppsala, and Västerbotten were investigated with the skin prick test (SPT), analyses for specific IgE antibodies in serum (specific IgE) and total serum immunoglobulin E (total IgE), and a questionnaire. SPT was performed in 1572 subjects and analyses of specific IgE in 1470. One or more positive SPT were found in 35.6% and one or more positive specific IgE in 31.7%-approximately the same values in all three areas. Birch, grass, cat, and dog were the most frequent sensitizing agents and occurred at similar prevalences, i.e., around 15%, in all areas. The SPT to mite was positive in 14.1% in Göteborg, 7.4% in Uppsala, and 7.9% in Vasterbotten. A positive SPT to pellitory of the wall (Parietaria), not described previously in Sweden, was found in 3.4% in Göteborg. Living in Göteborg was independently associated with a higher risk of a positive SPT to mite and Parietaria. Heredity, male sex, and low age were independently associated with atopy. Birth in the Scandinavian countries was independently associated with sensitization to cat, whereas birth in other countries was associated with sensitization to mite. The overall prevalence of atopy was similar in the three Swedish areas, but the sensitizing allergens varied. There is an indication that sensitization is increasing in the population, as low age was associated with sensitization. Sensitization to cat, but not to mite, appears to be particularly important in persons born in the Scandinavian countries. [ABSTRACT FROM AUTHOR]

ABO-incompatible kidney transplantations have previously only been performed after several pre-operative sessions of plasmapheresis followed by splenectomy, and with the conventional triple-drug immunosuppressive protocol being reinforced with anti-lymphocyte globulin and B-cell-specific drugs. We have designed a protocol without splenectomy, based on antigen-specific immunoadsorption, rituximab and a conventional triple-drug immunosuppressive protocol. Methods: The protocol called for a 1-month pre-transplantation conditioning period, starting with one dosage of rituximab and followed by full-dose tacrolimus, mycophenolate mofetil and prednisolone. Antigen-specific immunoadsorption was performed on pre-transplantation days −6, −5, −2 and −1. After the last session, 0.5 g/kg of intravenous immunoglobulin (IVIG) was administered. Postoperatively, three more apheresis sessions were given every third day. Results: Twenty-one patients have received transplants with this protocol. The ABO-antibodies (Abs) were readily removed by the antigen-specific immunoadsorption and were kept at a low level post-transplantation by further adsorptions. There were no side effects, and all but one patient have normal renal transplant function. Conclusions: We conclude that after one infusion each of rituximab and IVIG, and antigen-specific immunoadsorption, blood-group incompatible renal transplantations can be performed with standard immunosuppression and without splenectomy, and with excellent short- and long-term results. [ABSTRACT FROM AUTHOR]