This project examines the function of the salivary glands and other oral ti ues in individuals with alterations of normal oral function due to disease or ther eutic procedures. Major efforts have been directed at the evaluation of patients omplaining of xerostomia (oral dryness). Entry into all studies is through the Dry Mouth linic. Utilizing outpatient and inpatient services, specific evaluative and diagno ic approaches have been developed to aid in establishing the extent and causes of salivar gland dysfunction in the """"""""dry mouth"""""""" patient. Major patient groups studied inclu individuals with Sj?gren's syndrome, an autoimmune exocrinopathy, and those with saliva hypofunction secondary to therapeutic irradiation to the head and neck region. Oral and ecretory effects of a number of other systemic diseases also are evaluated. Recent eatment protocols have utilized the parasympathomimetic drug pilocarpine for saliva stimulation in the post-radiation group and steroid and non-steroidal anti-inflammatory rugs for Sj?gren's syndrome patients. Clinical and laboratory studies focusing on t immunological basis of the salivary component of Sj?gren's syndrome have ad nced and represent the main focus of our work. An anti-salivary duct antibody prese in serum and saliva of Sj?gren's syndrome patients has been characterized. Markers of s ivary gland disease activity in serum of patients with Sj?gren's syndrome have been ide ified. The effects of cytokines and other immune mediators on a cultured human salivar cell line have been investigated. In addition, our detailed studies of associated ora complaints in the salivary hypofunction group (taste, oro-pharyngeal swallow, and mucosal tatus) have progressed.
