Salivary protein composition in epileptic patients on different medications

Several salivary proteins were assayed in saliva from epileptic patients who were using different anti-epileptic drugs, viz, phenytoin, valproate and carbamazepine, and were compared with levels in unmedicated healthy control subjects. Flow rate and pH of the patient groups were not different from the controls. In all patient groups the specific amylase activity was increased up to twofold. In the phenytoin group only, the salivary IgA concentration was strongly reduced. Levels of salivary cystatin C were similar among all patient groups studied, and were not different from those of the control group. In contrast, the absolute and relative concentrations of cystatin S were diminished, particularly in patients using either valproate or phenytoin. These data suggest that use of anti-epileptic drugs over long periods may result in decreased levels of several salivary proteins such as sIgA and cystatins, which are involved in the protection of the oral cavity against microbial infections.