EFFECT OF AGE AND AGE RELATED DISEASE ON HUMAN SALIVA

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Saliva is a major factor contributing to the maintenance of oral health. This project is the first large epidemiologic-based study to document the prevalence of salivary gland dysfunction with aging (SpecifiC Aim 1). In addition, the effects on salivary gland function of two age-related diseases, i.e., hypertension and its treatment (Aim 2) and non-insulin dependent diabetes (NIDDM) (Aim 3) will be determined. This study will examine the correlation of salivary antimicrobial proteins with oral candida status (Aim 4) and will determine if parotid gland fluid secretion is related to gland size as measured by ultrasonography (Aim 5). The subjects are part of a large prospective community based, cross cultural study of NIDDM and cardiovascular disease in San Antonio (i.e., The San Antonio Heart Study and The San Antonio Longitudinal Study on Aging, projects funded by NIH since 1978). They represent a broad age spectrum (35 ->75 years), two ethnic groups (Mexican American and non-Hispanic white), both genders and three distinct San Antonio neighborhoods (low income, middle-income and upper-income). Their medical and socio-economic background are well documented. The following will be done on saliva to assess gland function: (l) flow rates of unstimulated and/or stimulated whole saliva, parotid and submandibular/sublingual saliva; (2) electrolytes (Na+, K+, Ca2+, Cl-) and (3) proteins of the acinar cells (amylase, acidic and basic proline-rich proteins, statherin and mucins) and ductal cells (lysozyme and lactoferrin) proteins, as well as secretory lgA and the antifungal proteins, histatins. Candida status will be determined by the presence of candidal pseudohyphae in cytologic smears of oral mucosa and by candida counts in whole unstimulated saliva. The hypotheses to be tested in this study will provide clinically significant insights regarding the effects of age and age-related diseases on salivary gland function for both non-Hispanic whites and Mexican Americans and, for the first time, for individuals of lower socio economic status, known to have a high index of oral disease. Further, the ultrasound measurements will provide baseline data for use of this non-invasive, low-cost, non- ionizing radiation technique for clinical diagnosis, i.e., transfer of state-of-the-art technology into Oral Medicine. Information gained from this project will be useful for planning the oral health needs of non- Hispanic white and Mexican American elderly while concurrently advancing our clinical understanding of Aging and the Pathobiology of salivary gland function.