Changes in whole saliva in patients with coeliac disease

Many systemic diseases impair salivary flow rate and composition and theref ore incite oral pathological processes. This study analyses the composition of whole saliva in patients with diagnosed coeliac disease (CD) and in hea lthy controls, and monitors possible changes in saliva composition after a short oral gluten challenge. Paraffin-stimulated whole saliva was collected from 128 CD patients and 55 healthy controls. In a separate study, paraffi n-stimulated whole saliva samples were collected from 33 CD patients and 10 controls both before and 24 h after an oral mucosal and submucosal gluten challenge. No difference in saliva flow rare was observed, but total protei n (P less than or equal to 0.001), albumin (P less than or equal to 0.001), IgA (P less than or equal to 0.01) and IgG (P less than or equal to 0.001) concentrations, as well as salivary peroxidase (P less than or equal to 0. 001) and myeloperoxidase (P less than or equal to 0.001) activities, were s ignificantly higher in CD patients than in healthy controls. The relative a mounts of secreted proteins (mg/mg), e.g. amylase (P less than or equal to 0.001), total IgA (P less than or equal to 0.005) and IgM (P less than or e qual to 0.001) were significantly lower in CD patients than in healthy cont rols. In CD patients, gluten challenge resulted in a decrease in myeloperox idase (P less than or equal to 0.005) activity, IgA (P less than or equal t o 0.001) and IgM (P less than or equal to 0.005) concentrations and the rel ative amounts of secreted IgA (P less than or equal to 0.001). In healthy i ndividuals, however, gluten challenge caused a decrease in total and relati ve amylase activity (P less than or equal to 0.005; P less than or equal to 0.001) and total IgM (P less than or equal to 0.005) concentration. It is concluded that CD patients, following a strict gluten-free diet, secrete lo wer relative amounts of amylase, IgA and IgM into paraffin-stimulated whole saliva than do healthy controls. (C) 2000 Elsevier Science Ltd. All rights reserved.