[Effects of chronic pancreatitis on salivary secretion]

In chronic pancreatitis, increased concentrations of Na+ and Cl- in sweat have been attributed to increased parasympathetic drive. It was postulated that similar changes might occur in saliva. To avoid masking increased parasympathetic drive, saliva was collected without stimulation. In patients with chronic pancreatitis, there were significant increases of concentrations of Na+ and Cl- in basal salivary concentrations. These differences disappeared when salivary secretion was stimulated with citric acid. Anatomic or neurologic modification of the salivary glands seemed unlikely as stimulated concentrations did not differ from those in the control subjects. Perfusion of cholecystokinin (CCK) did not modify concentrations of Na+ or Cl-. Parasympathetic blockade reduced salivary secretion in both patients and controls (p less than 0.001). As tubular absorption of Na+ and Cl- was constant and the volume of saliva was diminished, it followed that there was a reduction in Na+ and Cl- salivary output. As amylase secretion is under sympathetic control, atropine had little effect other than increasing the salivary amylase concentration. The secretory modifications observed with atropine were the same in both patients and control subjects, as the increased parasympathetic drive of the patients was blocked.