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aliva is a complex fluid, secreted by salivary glands, plays an important role in health and maintenance of oral cavity through its vast array of functions including, lubrication, protection, buffering action, antimicrobial function, facilitates swallowing and taste, helps in digestion and tissue repair.1 Saliva has important diagnostic implications as it contains various biomarkers that can be helpful in detection and monitoring of various oral and systemic diseases.2 The lacrimal fluid, secreted by lacrimal glands, is essential for the maintenance of healthy eyes. It performs important functions such as protection of the eye by producing IgA and various antibacterial and fungicidal substances and molecules, the aqueous component keeps the ocular surface moist and helps in maintaining normal visual acuity. It is also important for the normal growth and maintenance of ocular tissue by producing various growth factors, for example, Epidermal growth factor, Fibroblast growth factor, Transforming growth factor-beta.3 Proper secretion of saliva and lacrimal fluid is dependent upon different proteins for example aquaporins, tight junction proteins and ion channel proteins. Defective structure and function of these proteins leads to mys-regularities in saliva and lacrimal fluid secretion, resulting in xerostomia and dry eye syndrome. Xerostomia in Common Clinical Conditions Salivary gland hypofunction leads to a clinical condition known as xerostomia. Xerostomia is defined as a subjective complaint of dry mouth due to insufficient secretion of saliva.4 The absence of saliva in the oral cavity can cause difficulty in swallowing, tasting and chewing, oesophagal dysfunction (chronic esophagitis), nutritional compromises, loss of oral buffering capacity, increased susceptibility to dental caries, inability to wear dental prostheses, increased susceptibility to mucosal injury, increased incidence of glossitis, candidiasis, halitosis, angular cheilitis, bacterial sialadenitis and Burning Mouth Syndrome.5 The local and systemic causes of xerostomia are given in table 1. Xerostomia and hyposalivation have been reported as common oral manifestations of diabetes mellitus (DM). Xerostomia in DM patients can be due to a number of reasons, such as damage to the salivary gland parenchyma, alteration in the microcirculation of gland, dehydration and disturbed glycemic control, but the exact cause is still unknown.6 The salivary glands of head and neck are highly sensitive to radiation, and radiotherapy can cause temporary or permanent damage to the glands. Xerostomia is the most common presentation of glandular dysfunction in the head and neck region .7 Sjogren's syndrome is an autoimmune disease of salivary and lacrimal glands, resulting in dry mouth and dry eyes.8 Xerostomia is common in the geriatric population. The main causes for xerostomia are attributed to different medications, long-term systemic diseases and head and neck radiotherapy.9 Ectodermal dysplasia is a 1. M.Phil Trainee, Department of Oral Biology, University of Health Sciences, Lahore. 2. Assistant Professor, Department of Oral Biology, University of Health Sciences, Lahore. Corresponding author: “Dr. Sarah Ghafoor” < sarahghafoor@uhs.edu.pk >

Proteins Regulating Salivary and Lacrimal Flow in Xerostomia and Dry Eye Syndrome