Come attend Veronica Letawsky’s master’s thesis presentation and defence

You are invited to attend Veronica Letawsky’s master’s thesis presentation and defence.

When: Tuesday, July 23, 2019, 10:00AM
Where: UBC Friedman Building, Room 354
Title: Determining the feasibility of assessing salivary biomarkers and swallowing perception in those with Sjogren’s syndrome and healthy controls
By: Veronica H. Letawsky, UBC School of Audiology and Speech Sciences
Committee: Dr. Stacey Skoretz (Supervisor), Dr. Camilla Dawson, Dr. Caroline Nguyen


Background: Sjogren’s syndrome (SS) is an autoimmune disease characterized by changes to saliva quantity and composition. Integral to aspects of swallowing, saliva contributes to bolus formation, lubrication, and digestion. Salivary changes in SS can affect the perceptions and execution of deglutition through increased residue, and impaired bolus transport and formation. To date, no study has investigated the link between salivary biomarkers and swallowing perceptions.

Objectives: Our primary objective was to explore the operational feasibility of investigating saliva quantity (volume) and quality (proteins/hormones) in those with SS and healthy controls. Our secondary objective was to explore the relation between salivary differences and swallowing perceptions across participants.

Methods and Procedures: Using a matched case-control, mixed methods design, we collected feasibility data including: recruitment rate, operational requirements, and saliva collection methodology assessment. We also conducted both quantitative and qualitative measures. We collected unstimulated and stimulated whole saliva and conducted sialometric (flow rate) and sialochemical analyses of various analytes (α-amylase, mucins [MUC5B, MUC7], C-reactive protein [CRP], total protein, cortisol). We measured oral dryness severity (Clinical Oral Dryness Scale, Osailan et al., 2012) and swallowing perception (SWAL-QOL, McHorney et al., 2002). We analysed data descriptively using means (±SD) and medians (IQR). We conducted comparisons using t-tests and Mann-Whitney U, as appropriate. We explored Pearson correlations comparing salivary data with oral dryness and swallowing perception.

Results: Over 13-weeks, we enrolled a convenience sample of 12 (N): cases (n1) = 6, controls (n2) = 6 with five females, one male per group. Ages ranged from 31 to 68 years (n1, primary SS) and 31 to 64 years (n2). All participants completed assessments and produced analyzable saliva. Those with SS presented with reduced flow rate (p = .003) but greater total protein (p = .003), cortisol (p < .001), and CRP (p < .01). Oral dryness correlated negatively with unstimulated flow rates (r = -.63, p = .03) and positively with unstimulated and stimulated total protein (r = .77, p = .003) and α-amylase (r = .83, p = .001) concentrations. Congruently, for swallowing perception, (SWAL-QOL scores, domains, and symptoms), negatively correlated with unstimulated and stimulated total protein (r = -.81, p = .001) and α-amylase (r = -.83, p = .001) concentrations.

Conclusion: Given our successful recruitment and execution, our design was feasible as proposed. We were the first to determine associations between salivary properties and swallowing perceptions in those with and without SS. We propose improvements to study design and suggestions for future investigations.