Neuropeptides of the autonomic nervous system in Sjogren's syndrome

doi:10.1136/ard.56.12.737

Annals of the Rheumatic Diseases 1997;56:737-740; doi:10.1136/ard.56.12.737

Ann Rheum Dis 1997;56:737-740 ( December )

Extended reports

Neuropeptides of the autonomic nervous system in Sjögren's syndrome Nina Santavirta,^a Yrjö T Konttinen,^d Jyrki Törnwall,^b Margaretha Segerberg,^c Seppo Santavirta,^e Marco Matucci-Cerinic,^f Hjördis Björvell^a

^a Centre of Caring Science North, Department of Medicine, Karolinska Hospital, Stockholm, Sweden, ^b Institute of Biomedicine, Department of Anatomy, University of Helsinki, Helsinki, Finland, ^c Research Unit ORTON, Invalid Foundation, Helsinki, Finland, ^d Division of Rheumatic Diseases, Department of Medicine, Helsinki University Central Hospital, Finland, ^e Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland, ^f Institute of Internal Medicine, University of Cagliari, Italy

Correspondence to: Dr Y T Konttinen, Institute of Biomedicine, Department of Anatomy, University of Helsinki, PO Box 9 (Siltavuorenpenger 20 A), FIN-00014, Finland.

Accepted for publication 18 September 1997

OBJECTIVE $---$ To assess the activity level of the autonomic nervous system in Sjögren's syndrome (SS) and to correlate this withstress.
METHODS $---$ Patients with SS (n=12) and healthy controls (n=10) were analysed for the content of vasoactive intestinal peptide (VIP) andneuropeptide Y (NPY) in their stimulated saliva by radioimmunoassaysand for stress by the use of a modified Jenkins Activity Survey(JAS).
RESULTS $---$ The data are expressed as median (interquartile range). Salivary VIP output (pg/min) and NPY output (pg/min) were high inSS compared with healthy controls (30.0 (15.6, 36.6) versus 12.3(9.2, 24.0), p=0.045, 4.8 (0.6, 24.1) versus 0.7 (0.0, 2.4), p=0.038,respectively). Patients experienced only a little, but not significantly,more stress than the healthy controls (stress index $-$ 2.8 ( $-$ 7.7,6.9) versus $-$ 5.2 ( $-$ 12.9, 2.7), p>0.05). Stress in general wasassociated with high salivary VIP concentrations (r=0.41, p=0.05).
CONCLUSIONS $---$ These findings show that adequately processed saliva (containing aprotinin and EDTA as neuropeptidase inhibitors) containsmeasurable amounts of marker peptides of the autonomic nervoussystem. Secondly, VIP concentration but not output may be affectedby stress, which may act by decreasing watery salivary flow. Inpatients with SS, VIP and NPY outputs are increased. This mayindicate increased leakage into saliva or efforts to compensatefor the diminished salivary flow, orboth.

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