Abstract
The potential market for artificial salivas is huge, yet the actual usage is relatively low. One reason may be the lack of effectiveness of current brands. At best they only mimic the viscous nature of saliva but not the other physical properties, such as elasticity. This leads to a poor retention of the product in the mouth which then requires frequent application to provide any kind of relief. Since most dry mouth sufferers have some residual secretory activity, it makes sense to formulate artificial salivas to supplement any pre-existing saliva. Due to their very low surface tension, artificial salivas may displace the pre-existing saliva. This chapter explores the components of some leading brands, examines their physical properties – both neat and when mixed with saliva – and suggests some potential future directions for new product development.
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References
Berg CH, Lindh L, Arnebrant T. Intraoral lubrication of PRP-1, statherin and mucin as studied by AFM. Biofouling. 2004;20(1):65–70.
Bhat PP, Appathurai S, Harris MT, Pasquali M, McKinley GH, Basaran OA. Formation of beads on a string structures during break-up of viscoelastic filaments. Nat Phys. 2010;6(8):625–31.
Bradway SD, Bergey EJ, Scannapieco FA, Ramasubbu N, Zawacki S, Levine MJ. Formation of salivary-mucosal pellicle – the role of transglutaminase. Biochem J. 1992;284:557–64.
Cardenas M, Elofsson U, Lindh L. Salivary mucin MUC5B could be an important component of in vitro pellicles of human saliva: an in situ ellipsometry and atomic force microscopy study. Biomacromolecules. 2007;8(4):1149–56.
Castro I, Sepulveda D, Cortes J, Quest AFG, Barrera MJ, Bahamondes V, Aguilera S, Urzua U, Alliende C, Molina C, Gonzalez S, Hermoso MA, Leyton C, Gonzalez MJ. Oral dryness in Sjogren’s syndrome patients. Not just a question of water. Autoimmun Rev. 2013;12(5):567–74.
Clegg JP, Guest JF, Lehman A, Smith AF. The annual cost of dry eye syndrome in France, Germany, Italy, Spain, Sweden and the United Kingdom among patients managed by ophthalmologists. Ophthalmic Epidemiol. 2006;13(4):263–74.
Dongari-Bagtzoglou A, Kashleva H. Development of a highly reproducible three-dimensional organotypic model of the oral mucosa. Nat Protoc. 2006;1(4):2012–8.
Frigerio L, Vine ND, Pedrazzini E, Hein MB, Wang F, Ma JKC, Vitale A. Assembly, secretion, and vacuolar delivery of a hybrid immunoglobulin in plants. Plant Physiol. 2000;123(4):1483–93.
Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R. Interventions for the management of dry mouth: topical therapies Cochrane Database Syst Rev. 2011;(12):106.
Gibbins HL, Yakubov GE, Wilson S, Carpenter GH. Concentration of salivary protective proteins in the bound oral mucosal pellicle. Oral Dis. 2013. doi:10.1111/odi.12194.
Gil-Montoya JA, Guardia-Lopez I, Gonzalez-Moles MA. Evaluation of the clinical efficacy containing the antimicrobial of a mouthwash and oral gel proteins lactoperoxidase, lysozyme and lactoferrin in elderly patients with dry mouth a pilot study. Gerodontology. 2008;25(1):3–9.
Gomez-Moreno G, Aguilar-Salvatierra A, Guardia J, Uribe-Marioni A, Cabrera-Ayala M, Delgado-Ruiz RA, Calvo-Guirado JL. The efficacy of a topical sialogogue spray containing 1% malic acid in patients with antidepressant-induced dry mouth: a double-blind, randomized clinical trial. Depress Anxiety. 2013;30(2):137–42.
Hanning SM, Yu T, Jones DS, Andrews GP, Kieser JA, Medlicott NJ. Lecithin-based emulsions for potential use as saliva substitutes in patients with xerostomia – viscoelastic properties. Int J Pharm. 2013;456(2):560–8.
Harvey NM, Carpenter GH, Proctor GB, Klein J. Normal and frictional interactions of purified human statherin adsorbed on molecularly-smooth solid substrata. Biofouling. 2011;27(8):823–35.
Hatton MN, Loomis RE, Levine MJ, Tabak LA. Masticatory lubrication – the role of carbohydrate in the lubricating property of a salivary glycoprotein albumin complex. Biochem J. 1985;230(3):817–20.
Klein J. Polymers in living systems: from biological lubrication to tissue engineering and biomedical devices. Polym Adv Technol. 2012;23(4):729–35.
Ma JKC, Christou P, Chikwamba R, Haydon H, Paul M, Ferrer MP, Ramalingam S, Rech E, Rybicki E, Wigdorowitz A, Yang DC, Thangaraj H. Realising the value of plant molecular pharming to benefit the poor in developing countries and emerging economies. Plant Biotechnol J. 2013;11(9):1029–33.
Nederfors T, Isaksson R, Mornstad H, Dahlof C. Prevalence of perceived symptoms of dry mouth in an adult Swedish population – relation to age, sex and pharmacotherapy. Community Dent Oral Epidemiol. 1997;25(3):211–6.
Ogawa M, Oshima M, Imamura A, Sekine Y, Ishida K, Yamashita K, Nakajima K, Hirayama M, Tachikawa T, Tsuji T. Functional salivary gland regeneration by transplantation of a bioengineered organ germ. Nat Commun. 2013;4:2498.
Park MS, Chang JY, Kim YY, Kang JH, Kho HS. Physical and biological properties of yam as a saliva substitute. Arch Oral Biol. 2010;55(2):177–83.
Pathak D, Kumar P, Kuppusamy G, Gupta A, Kamble B, Wadhwani A. Physicochemical characterization and toxicological evaluation of plant-based anionic polymers and their nanoparticulated system for ocular delivery. Nanotoxicology. 2014;8(8):843–55.
Proctor GB, Hamdan S, Carpenter GH, Wilde P. A statherin and calcium enriched layer at the air interface of human parotid saliva. Biochem J. 2005;389:111–6.
Ramos-Casals M, Brito-Zeron P, Siso-Almirall A, Bosch X, Tzioufas AG. Topical and systemic medications for the treatment of primary Sjogren’s syndrome. Nat Rev Rheumatol. 2012;8(7):399–411.
Ranc H, Elkhyat A, Servais C, Mac-Mary S, Launay B, Humbert P. Friction coefficient and wettability of oral mucosal tissue: changes induced by a salivary layer. Colloids Surf Physicochem Eng Asp. 2006;276(1–3):155–61.
Stokes JR, Davies GA. Viscoelasticity of human whole saliva collected after acid and mechanical stimulation. Biorheology. 2007;44(3):141–60.
Sugiura Y, Soga Y, Yamabe K, Tsutani S, Tanimoto I, Maeda H, Kokeguchi S, Fujii N, Ishimaru F, Tanimoto M, Nishimura F, Takashiba S. Total bacterial counts on oral mucosa after using a commercial saliva substitute in patients undergoing hematopoietic cell transplantation. Support Care Cancer. 2010;18(3):395–8.
Toida M, Nanya Y, Takeda-Kawaguchi T, Baba S, Iida K, Kato K, Hatakeyama D, Makita H, Yamashita T, Shibata T. Oral complaints and stimulated salivary flow rate in 1188 adults. J Oral Pathol Med. 2010;39(5):407–19.
Tsibouklis J, Middleton AM, Patel N, Pratten J. Toward mucoadhesive hydrogel formulations for the management of xerostomia: the physicochemical, biological, and pharmacological considerations. J Biomed Mater Res A. 2013;101(11):3327–38.
Veeregowda DH, Kolbe A, van der Mei HC, Busscher HJ, Herrmann A, Sharma PK. Recombinant supercharged polypeptides restore and improve biolubrication. Adv Mater. 2013;25(25):3426–31.
Vissink A, Waterman HA, Sgravenmade EJ, Panders AK, Vermey A. Rheological properties of saliva substitutes containing mucin, carboxymethylcellulose or polyethylenoxide. J Oral Pathol Med. 1984;13(1):22–8.
Yakubov GE, McColl J, Bongaerts JHH, Ramsden JJ. Viscous boundary lubrication of hydrophobic surfaces by mucin. Langmuir. 2009;25(4):2313–21.
Acknowledgements
The data shown in this chapter was produced by Amandeep Bains as part of a summer project during her BDS programme. The author is very grateful for her helpful comments in preparing this chapter.
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Carpenter, G. (2015). Artificial Salivas: Why Are They Not More Useful?. In: Carpenter, G. (eds) Dry Mouth. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55154-3_11
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DOI: https://doi.org/10.1007/978-3-642-55154-3_11
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