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Salivary Proteins
DENT 5302
Topics in Dental Biochemistry
Dr. Joel Rudney
Supplemental reading
Rudney JD (2000). Saliva and Dental Plaque.
Adv Dent Res 14:29-39.
Lamkin MS, Oppenheim FG (1993). Structural
features of salivary function. Crit Rev Oral Biol
Med 4:251-259.
Clinical Importance
 Demographic change - the number of elderly will increase
 Implications:
Increases in diseases affecting salivary glands
Sjogren's syndrome, other autoimmune diseases,
Head and neck cancer (radiation therapy)
Increased use of medications with effects on saliva
Anticholinergic (antihistamines, antidepressants)
• Reduced flow - indirect/direct effects on proteins
Beta adrenergic agonists and antagonists
• Direct effects on protein synthesis/secretion
• (asthma, hypertension, cardiovascular disease)
Salivary protein therapies
 Current artificial salivas replace mainly fluids, ions
 Genetically-engineered human salivary proteins soon
Raised from seed
Which ones go in artificial saliva? How much to add?
 Already toothpastes/rinses containing saliva proteins
Biotène™ (peroxidase, lysozyme lactoferrin)
Histatin rinses/gels in trials
 Clinicians will need to be able to evaluate new products
Origins of salivary proteins
 Different secretory cells in different glands
Serous acinar - water, ions, proteins
Most in parotid, less in SM/SL
Mucus acinar - complex glycoproteins
Only SM/SL and minor glands
Different proteins emphasized in different glands
Duct cells also secrete proteins - differs among glands
 Immune system cells contribute proteins
B cell product (S-IgA) translocated into ducts
Neutrophils - indirect leakage into gingival crevice
 Leakage from gingival fluid contributes serum proteins (WS only)
 Oral epithelial cells release surface proteins (whole saliva only)
Functions - Protect tissues
 Protect oral surfaces by forming pellicle
Statherin, acidic proline-rich proteins, amylase, histatins,
cystatins, MUC7 mucin, lysozyme, albumin, carbonic anhydrase
 Lubrication - oral surfaces must slide freely
Statherin, MUC5B mucin (also reflux protection)
 Maintain saliva calcium in equilibrium with enamel
Saliva supersaturated with calcium and phosphate
Precipitation must be prevented
Statherin, aPRP, histatins, cystatins
Functions - Food processing
 Initial breakdown of starches - Amylase
 Binding/detoxification of dietary tannins
aPRP, basic PRP, histatins
 Protein processing - Kallikrein and other proteases
 Swallowing - MUC5B
Functions - Manage Microbes
 Antimicrobial functions (bacteria, fungi, viruses)
Direct - cell killing - Histatins, lysozyme, amylase, MUC7,
lactoferrin, defensins, peroxidase
Indirect - Inhibition of infectivity, microbial metabolism,
bacterial/viral proteases - Lactoferrin, cystatins, histatins, basic
PRP, SLIPI, peroxidase, S-IgA
"Aggregation" - bind to microbes, clear by swallowing - MUC7,
lysozyme, lactoferrin, glcosylated PRP, parotid agglutinin, extraparotid glycoprotein, S-IgA
Functions - Microbes Manage
 Microbial use of saliva proteins (coevolution)
Microbial adherence to pellicle proteins - Statherin, aPRP,
amylase, MUC5B, MUC7, lysozyme, lactoferrin, glcosylated
PRP, parotid agglutinin, extra-parotid glycoprotein, S-IgA,
peroxidase
Microbial metabolism of salivary proteins - MUC5B
Microbial use to metabolize host diet - Amylase
Complexity and Redundancy
 Most saliva proteins have more than one function
Different domains on the same protein for different functions
 Most saliva proteins cans be "amphifunctional”
Some actions help host, others seem to help microbes
Also can be mediated by different domains
 Many proteins share similar functions - redundancy
Multiple gene families
2-4 closely linked genes coding very similar proteins
• aPRP, bPRP, gPRP, cystatins, histatins , amylase, MUCs
• Multiple alleles for each gene
Unrelated proteins with the same function - backup systems?
Fragments and Complexes
 Many salivary proteins are cleaved by proteases
During secretion or in the mouth
aPRP, bPRP, gPRP, histatins, S-IgA
Fragments may function differently than intact proteins
 Proteins function differently together than they do alone
Lysozyme, lactoferrin, peroxidase
 Salivary proteins bind in large heterotypic complexes
MUC5B, amylase, aPRP, S-IgA, peroxidase, lysozyme,
lactoferrin, statherin
Complexes function differently than component proteins
Pictures of proteins in pellicle
aPRP
statherin
histatins
Schupbach et. al. 2001, Eur J Oral Sci 109:60
Pictures of proteins in pellicle
statherin
Schupbach et. al. 2001, Eur J Oral Sci 109:60
histatins
Statherin up close
 Multiple gene family
 Small tyrosine-rich phosphoproteins
 Negatively charged Ca2+ binding N-terminal
Two phosphoserines - additional negative charges
Maintains Ca2+ balance, strongly prevents precipitation
 Binds tooth surfaces and changes conformation
C-terminal rich in "bulky" tyrosines
Lubrication of tooth surfaces (pellicle)
Adherence of Actinomyces species (pellicle)
Acidic PRP up close
 Multiple gene family
 Proline-rich phosphoproteins
Negatively charged Ca2+ binding N-terminal
Two phosphoserines - additional negative charges
Ca2+ balance, strongly prevents precipitation
 Binds tooth surfaces and changes conformation
C-terminal rich in "bulky" prolines
Adherence of Streptococcus species (pellicle)
 Proteases cleave N-terminal from C-terminal
Free C-terminal binds tannins; blocks bacterial adhesion
Histatins up close
 Multigene family - largest is phosphoprotein, others not
 Small peptides after proteolysis
Positive charge - histidine-rich
 Microbial cell damage - antibacterial and anti-fungal
Also Ca2+ balance, tannin binding, protease inhibitor
 Clinical interest - very safe - easy to make
Early trials with histatin rinses and gels
Some benefit in experimental gingivitis model
• No oral hygiene for a month
No trials with caries, periodontitis, or candidiasis patients yet
Current Products
 Products with added lysozyme, lactoferrin, peroxidase
 All influence aggregation/adherence, plus unique effects
Px enzyme - bacterial H2O2 + saliva SCN- > OSCNOSCN- inhibits/kills bacteria
Removing H2O2 may protect soft tissues
Lz enzyme cleaves bacterial cell walls > lysis
Also positive charge effects similar to histatins
Lf sequesters iron from some microbes, but not all
Unsaturated Lf is independently bactericidal
 Clinical interest - can be purified from cow's milk
Biotène™ toothpaste, rinses, gum, dry mouth gels
Minor to minimal benefit in published clinical trials
Future Prospects
 Ideas about salivary protein function come from lab
 Experimental models are greatly simplified
Change only one factor at a time
 The mouth is an extremely complex environment
Difficult to isolate effects of single proteins
Redundancy may “dilute” the effects of supplements
 We need to understand how different proteins work together
Supplements may need to be in the form of protein complexes