title: The effect of pilocarpine on salivary constituents in patients with chronic graft-versus-host disease.
abstract: Chronic graft-versus-host disease (cGVHD) is a complex clinical entity with various target organs, including the salivary glands. Oral pilocarpine (Salagen(R)), 30 mg/day, can ameliorate cGVHD-induced xerostomia and improve the flow rate from the major salivary glands. The purpose here was to evaluate the effect of this drug at 30 mg/day on salivary biochemical and immunological composition in cGVHD patients. Significantly higher concentrations of salivary sodium (Na), magnesium (Mg), total protein, albumin, epidermal growth factor (EGF) and total IgG, accompanied by a concomitant increase in total IgA which did not reach significance, were observed in cGVHD patients in comparison with controls, in both resting and stimulated conditions (p < 0.05), while salivary potassium, calcium and phosphate were not altered. Two weeks of oral pilocarpine, at 30 mg/day, resulted in normalization of the altered salivary biochemical and immunological composition in the cGVHD patients. Oral pilocarpine was able to reduce and normalise the elevated Na, Mg, total protein, albumin, EGF, IgG and IgA concentrations in both resting and stimulated conditions. The ability of oral pilocarpine to normalise and reverse the salivary biochemical and immunological alterations induced by cGVHD parallels its known stimulatory effect on salivary flow rates. As the biochemical and immunological composition of saliva provides its protective antimicrobial characteristics, the ability of pilocarpine to abrogate cGVHD salivary gland abnormalities may be of clinical significance.
authors.affiliation: Bone Marrow Transplantation Department and Cancer Biology Research Laboratory, Hadassah University Hospital, Jerusalem, Israel. nagler@tx.technion.ac.il
authors.forename: R M
authors.initials: RM
authors.lastname: Nagler
authors.forename: A
authors.initials: A
authors.lastname: Nagler
mesh_terms: D000284:Administration, Oral; D000418:Albumins / Q000032:analysis / Q000187:drug effects; D002118:Calcium / Q000032:analysis; D002908:Chronic Disease; D004815:Epidermal Growth Factor / Q000032:analysis / Q000187:drug effects; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000032:analysis / Q000187:drug effects; D007074:Immunoglobulin G / Q000032:analysis / Q000187:drug effects; D008274:Magnesium / Q000032:analysis; D018721:Muscarinic Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D010710:Phosphates / Q000032:analysis; D010862:Pilocarpine / Q000008:administration & dosage / Q000627:therapeutic use*; D011188:Potassium / Q000032:analysis; D012463:Saliva / Q000737:chemistry / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism; D012471:Salivary Proteins and Peptides / Q000032:analysis / Q000187:drug effects; D012636:Secretory Rate / Q000187:drug effects; D012964:Sodium / Q000032:analysis; D013223:Statistics as Topic; D014987:Xerostomia / Q000188:drug therapy / Q000209:etiology
chemical_list: D000418:Albumins; D007071:Immunoglobulin A, Secretory; D007074:Immunoglobulin G; D018721:Muscarinic Agonists; D010710:Phosphates; D012471:Salivary Proteins and Peptides; D010862:Pilocarpine; D004815:Epidermal Growth Factor; D012964:Sodium; D008274:Magnesium; D011188:Potassium; D002118:Calcium