Investigation of Saliva Parameters and Tissue Factor in Healthy Individuals Who Had Survived COVID-19 Infection

Abstract

Objectives: Oral mucosa is a suitable area for the spread of COVID-19 infection and it causes dysfunction in the salivary glands. Tissue factor is an important regulator that plays a role in hemostasis and coagulation mechanisms, also found in saliva. The aim of the study is to examine the effects of COVID-19 infection on salivary gland function and oral health through saliva. Materials and Methods: The control group consists of 20 individuals who have not had a COVID-19 infection before, while the COVID group consists of 26 individuals who had a COVID-19 infection at least 6 months ago. Salivary flow rate, buffering capacity, pH, and tissue factor activity were evaluated in saliva samples. Results: Salivary flow rate, buffering capacity, and tissue factor activity decreased significantly in the COVID group compared to the controls, while pH was found to be statistically not significant between the groups. Conclusions: Various damages and related dysfunctions develop in the oral tissues following a COVID-19 infection. For this reason, individuals who have had COVID-19 might have more tendency to oral diseases.

Keywords

• Saliva
• Flow rate
• Buffering capacity
• Tissue factor
• COVID-19

COVID-19 Enfeksiyonunu Geçirmiş Sağlıklı Bireylerde Tükürük Parametreleri ve Doku Faktörünün Araştırılması

Abstract

Amaç: Ağız mukozası, COVID-19 enfeksiyonunun yayılması için uygun bir alandır ve tükürük bezlerinde fonksiyon bozukluklarına neden olur. Doku faktörü, tükürükte de bulunan, hemostaz ve pıhtılaşma mekanizmalarında rol oynayan önemli bir düzenleyicidir. Çalışmanın amacı, COVID-19 enfeksiyonunun tükürük bezi fonksiyonu ve ağız sağlığı üzerindeki etkilerini tükürük yoluyla incelemektir. Gereç ve Yöntemler: Kontrol grubu daha önce COVID-19 enfeksiyonu geçirmemiş 20 kişiden oluşurken, COVID grubu ise en az 6 ay önce COVID-19 enfeksiyonu geçiren 26 kişiden oluştu. Tükürük örneklerinde tükürük akış hızı, tamponlama kapasitesi, pH ve doku faktörü aktivitesi değerlendirildi. Bulgular: Kontrole göre COVID grubunda tükürük akış hızı, tamponlama kapasitesi ve doku faktörü aktivitesi anlamlı derecede azalırken, pH'ın gruplar arasında istatistiksel olarak anlamlı olmadığı görüldü. Sonuçlar: COVID-19 enfeksiyonu sonrasında ağız dokularında çeşitli hasarlar ve buna bağlı fonksiyon bozuklukları gelişmektedir. Bu nedenle COVID-19 geçiren bireylerin ağız hastalıklarına eğilimi daha fazla olabilir.

Keywords

• Tükürük
• Akış hızı
• Tamponlama kapasitesi
• Doku faktörü
• COVID-19

References

1. Ahmadi-Motamayel F, Goodarzi MT, Hendi SS, Abdolsamadi H, Rafieian N. Evaluation of salivary flow rate, pH, buffering capacity, calcium and total protein levels in caries free and caries active adolescence. J. Dent. Oral. Hyg.2013; 5(4): 35-9.
2. Aksit-Bicak D, Akyuz S, Kıratlı B, Usta M, Urganci N, Alev B, Yarat A, Sahin F. The investigation of helicobacter pylori in the dental biofilm and saliva samples of children with dyspeptic complaints. BMC Oral. Health. 2017; 17: 67.
3. Bergdahl M, Bergdahl J. Low unstimulated salivary flow and subjective oral dryness: association with medication, anxiety, depression, and stress. J. Dent. Res. 2000; 79(9):1652-8.
4. Brandini DA, Takamiya AS, Thakkar P, Schaller S, Rahat R, Naqvi AR. Covid‐19 and oral diseases: Crosstalk, synergy or association?. Rev. Med. Virol. 2021; 31(6): e2226.
5. Chen L, Zhao J, Peng J, Li X, Deng X, Geng Z, Shen Z, Guo F, Zhang Q, Jin W, Wang S. Detection of SARS‐CoV‐2 in saliva and characterization of oral symptoms in COVID‐19 patients. Cell. Prolif. 2020; 53(12): e12923.
6. Chibly AM, Aure MH, Patel VN, Hoffman MP. Salivary gland function, development, and regeneration. Physio. Rev. 2022; 102(3): 1495-552.
7. Di Nicolantonio JJ, Mc Carty M. Thrombotic complications of COVID-19 may reflect an upregulation of endothelial tissue factor expression that is contingent on activation of endosomal NADPH oxidase. Open Heart. 2020; 7(1): e001337.
8. Dziedzic A & Wojtyczka R. The impact of coronavirus infectious disease 19 (COVID‐19) on oral health. Oral Dis. 2021: 27; 703-6.

9. Gofur NRP. Impact of SARS-CoV-2 on periodontal tissue manifestation. JIOH. 2020; 12(2): 90-2.
10. Gutierrez-Camacho JR, Avila-Carrasco L, Martinez-Vazquez MC, Garza-Veloz I, Zorrilla-Alfaro SM, Gutierrez-Camacho V, Martinez-Fierro ML. Oral lesions associated with COVID-19 and the participation of the buccal cavity as a key player for establishment of immunity against SARS-CoV-2. IJERPH. 2022; 19(18): 11383.
11. Hatipoğlu Ö, Maraş E, Hatipoğlu FP, Saygin AG. Salivary flow rate, pH, and buffer capacity in the individuals with obesity and overweight; A meta-analysis. Niger. J. Clin. Pract. 2022; 25(7): 1126-42.
12. Hu Y, Repa A, Lisman T, Yerlikaya‐Schatten G, Hau C, Pabinger I, Ay C, Nieuwland R, Thaler J. Extracellular vesicles from amniotic fluid, milk, saliva, and urine expose complexes of tissue factor and activated factor VII. JTH. 2022; 20(10): 2306-12.
13. Maegawa K, Nishioka H. COVID-19-associated parotitis and sublingual gland sialadenitis. BMJ Case. Rep. 2022; 15(12): e251730
14. Matuck BF, Dolhnikoff M, Duarte-Neto AN, Maia G, Gomes SC, Sendyk DI, Zarpellon A, Paiva de Andrade N, Monteiro RA, Pinho JRR, Gomes-Gouvêa MS, Souza SC, Kanamura C, Mauad T, Saldiva PHN, Braz-Silva PH, Caldini EG, Ferraz da Silva LF. Salivary glands are a target for SARS‐CoV‐2: a source for saliva contamination. J. Pathol. 2021; 254(3): 239-43.
15. Mackman N, Antoniak S, Wolberg AS, Kasthuri R, Key NS. Coagulation abnormalities and thrombosis in patients infected with SARS-CoV-2 and other pandemic viruses. Arterioscler. Thromb. Vasc. Biol. 2020; 40(9): 2033-44.
16. Proctor GB & Shaalan AM. Disease-induced changes in salivary gland function and the composition of saliva. J. Dent. Res. 2021; 100(11): 1201-9.
17. Quick A. One-stage prothrombin-time test. Lancet. 1953; 261:1307-8.
18. Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis. Clin. Oral. Invest. 2020: 24; 1619-21.
19. Saxena SK, Kumar S, Baxi P, Srivastava N, Puri B, Ratho RK. Chasing COVID-19 through SARS-CoV-2 spike glycoprotein. Virusdisease. 2020; 31: 399-407.
20. Song P, Li W, Xie J, Hou Y, You, C. Cytokine storm induced by SARS-CoV-2. Clin. Chim. Acta. 2020; 509: 280-7.
21. Unruh D & Horbinski C. Beyond thrombosis: the impact of tissue factor signaling in cancer. J Hematol. Oncol. 2020; 13(1): 93.
22. Van der Vorm LN, Brouwers JE, Mondria C, de Laat B, de Groot PG, Remijn JA. Salivary tissue factor induces thrombin generation in a diurnal rhythm. RPTH. 2018;2(4): 757-61.
23. Wani PD & Anand R. The physiology of salivary secretion and ıts role in tooth decay. EJDENT. 2023; 4(1): 1-3.
24. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, Chen Q. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int. J. Oral. Sci. 2020; 12(1): 1-5.
25. Yatsenko T, Skrypnyk M, Troyanovska O, Tobita M, Osada T, Takahashi S,Hattori K,Heissig B. 2023). The role of the plasminogen/plasmin system in inflammation of the oral cavity. Cells. 2023; 12(3): 445.