Earn up to 14.5
Laboratory, Endocrine, & Neurotransmitter Symposium
October 4 - 6, 2019
Approved for 4.25 Pharm CEs from the OBNM!
Gain additional clinical insight and treatment considerations to evaluate some of the most prevalent and challenging conditions that patients present with, including depression, anxiety, altered mental focus and stamina, sexual dysfunction, sleep disturbances, addictions and dependencies, weight management, and chronic disease. Register now to get the early bird price of $329 (reg. $379).
Topic: Taking Action - Hormone Testing and Prescribing
By: Heather Hydzik, ND
August 7, 2019
Join our clinical staff and special guests on the first Wednesday of every month at 9:30 AM and 12:00 PM PST. This free, live webinar series will cover a variety of neuroendocrine topics that will enhance your knowledge, with clinically applicable testing and treatment considerations. 1 CE credit available upon attendee request.
July 18 - 23, 2019
We will be in Denver for IFM (APM) on July 18-23. Don't miss our lunch presentation on hormones by Brandon Lundell, DC on July 18.
July 26-28, 2019
Make sure to visit our booth at IWHIM in Portland. Dr. Lylen Ferris will be discussing neurotransmitters and the HPA axis on Friday, July 26. Chat with our booth representatives to learn what's new.
Secretory IgA and Oral Health
By Laura Neville, ND | July 9, 2019
Secretory Immunoglobulin A, (sIgA), is a subclass of immunoglobulin A (IgA). It is a product of the adaptive immune system and serves as the body’s first line of defense against toxins, enzymes, viruses, and bacteria. Located within mucosal membranes, sIgA can be found in saliva, breast milk, sweat, genitourinary secretions, GI tract, respiratory tract, and small amounts in the blood. SIgA is produced by B-lymphocytes adjacent to the mucosal cells, then transported through the cell interiors, and released into the secretions from the cells.
SIgA has the unique ability to prevent microbes, toxins, and antigens from impacting mucosal surfaces by a series of mechanisms known as immune exclusion. Immune exclusion refers to sIgA’s ability to prevent invading microorganisms from adhering to epithelium. This is accomplished through one of several mechanisms; clumping of the microorganism via cross-linking, entrapping bacteria within a mucus layer, and/or clearance of the pathogen via peristalsis. SIgA can also selectively interrupt certain virulence factors and may also play a role in decreasing inflammation via control of interleukin and cytokine response.
Although contradictory, some research has demonstrated an inverse relationship to the amount of salivary sIgA and dental carries in children and young adults. Further research indicates higher dental caries incidences with tobacco smoking, which has also been associated with low concentrations of salivary sIgA. Other research indicates a high level of sIgA during active caries and active oral infections.
Bacterial adherence to mucosa is necessary for bacterial establishment and growth in the oral cavity. The basic function of secretory immunoglobulin A is inhibition of bacterial adherence rather than antigen destruction. Several bacterial species frequently isolated from the oral cavity of patients with periodontitis have been identified as producers of IgA protease. These enzymes cleave serum IgA and secretory IgA, thereby promoting bacterial adherence and perpetuating pathogenic development.
Down syndrome or Trisomy 21 is a genetic disorder caused by extra chromosome on chromosome 21. Several studies indicate children with Down syndrome have good resistance against caries, and some are even caries-free. Besides factors of tooth eruption delays, wide spaces among teeth, microdontia, pH, and high saliva contents (calcium, sodium, bicarbonate), the low incidence of caries in Down syndrome children may also be related to higher level of salivary sIgA when compared to children without Down syndrome. Secretory immunoglobulin A (sIgA) inhibits the activity of Steptococcus mutans, which contributes to caries formation.
Think of salivary sIgA testing as a tool for investigating immune function and potentially a look at oral health status. Decreased levels of salivary sIgA are commonly seen in individuals with low immune system functioning, and are a sign of chronic, ongoing psychological and/or physical stress (HPA axis dysfunction) to the body which has depleted sIgA reserves. A low level of salivary sIgA may be associated with a high risk of developing dental caries and periodontal disease.
Elevated salivary levels of sIgA may be reflective of acute psychological and/or physical stressors, and can be associated with an upregulated, active immune or inflammatory response. High levels are often found in patients with chronic infections (CMV, EBV, HIV and infections of the GI tract).
Test for salivary sIgA levels by ordering the Comprehensive Adrenal Function Profile, which includes DHEA, diurnal cortisol, and sIgA.
Bokor-bratić M. [Clinical significance of analysis of immunoglobulin A levels in saliva]. Med Pregl. 2000;53(3-4):164-8.
Chawda JG, Chaduvula N, Patel HR, Jain SS, Lala AK. Salivary SIgA and dental caries activity. Indian Pediatr. 2011;48(9):719-21.
Golpasand hagh L, Zakavi F, Ansarifar S, Ghasemzadeh O, Solgi G. Association of dental caries and salivary sIgA with tobacco smoking. Aust Dent J. 2013;58(2):219-23.
Lee SR, Kwon HK, Song KB, Choi YH. Dental caries and salivary immunoglobulin A in Down syndrome children. J Paediatr Child Health. 2004;40(9-10):530-3.
Mantis, N. J., Rol, N., & Corthésy, B. (2011). Secretory IgA's complex roles in immunity and mucosal homeostasis in the gut. Mucosal Immunology,4(6), 603-611. doi:10.1038/mi.2011.41
Pandey S, Goel M, Nagpal R, Kar A, Rapsang E, Matani P. Evaluation of Total Salivary Secretory Immunoglobulin A and Mi/fans-specific SIgA among Children having Dissimilar Caries Status. J Contemp Dent Pract. 2018;19(6):651-655.
Rosdiana R, Mochammad FR. The relation between salivary sIgA level and caries incidence in Down syndrome children. Dental Journal (Majalah Kedokteran Gigi). 2012, 45 (2): 79-83.