Sialochemistry and cortisol levels in patients with Sjogren's syndrome

Objectives: (i) To determine whether salivary cortisol and electrolyte levels differ between patients with Sjogren's syndrome (SjS) and healthy individuals. (ii) To assess correlations between whole-saliva cortisol and some clinical manifestations in patients with SjS. Methods: A total of 24 healthy women (mean age 49.3±9.8) served as controls (C) vis-à-vis 17 patients with SjS (mean age 55.5±15.7). Salivary cortisol concentration was determined, and sialochemistry analysis was performed. Results: Significantly lower saliva flow rates and higher salivary chloride (Cl ^-), potassium (K ⁺), and Ca ²⁺ levels were found in the SjS group. No significant differences or correlations were found in other parameters, including sodium (Na ⁺), magnesium (Mg ²⁺), phosphate ( ^-), urea (U), and salivary cortisol levels. Conclusion: Increased whole-salivary output of Cl ^- and K ⁺ in SjS may reflect release from apoptotic rests of acinar cells after secondary necrosis. Normal levels of salivary Na ⁺, Mg ²⁺, and ^- argue against concentration effect, deranged tubular function or cortisol (mineralocorticosteroid) effect as the cause for these findings. Increased salivary Ca ²⁺ levels probably reflect leakage of plasma Ca ²⁺ through the injured oral mucosa in SjS. In spite of disease-associated stress, salivary cortisol, a stress biomarker, was not increased, suggesting insufficient hypothalamus-pituitary-adrenal (HPA) axis response and/or local consumption of cortisol by lymphocyte infiltrates.