{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:58:21Z","timestamp":1790621901303,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      The nitrate\u2013nitrite\u2013nitric oxide (NO) pathway has a wide range of effects including blood pressure (BP) regulation. Nitrate, produced endogenously, and absorbed from dietary sources (e.g., beetroot), is concentrated in\/secreted by the salivary glands and reduced by lingual bacterial nitrate reductases to nitrite (the \u2018enterosalivary circulation\u2019). Following systemic absorption, nitrite is further reduced to vasodilating NO intravascularly. The role of salivary pH in nitrate reduction has mainly been studied in isolated oral installation studies, rather than systemic studies employing the enterosalivary circulation. Our aim was to determine the acute relationship between salivary pH, salivary nitrite production, plasma [nitrite] and the BP\u2010lowering effect of dietary nitrate, by altering salivary pH using sugar\u2010containing chewing gum (\n                      <jats:italic>vs<\/jats:italic>\n                      . sugar\u2010free chewing gum).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a 7\u2010h crossover study, with 14 healthy volunteers consuming beetroot juice (Beet\u2010It\u00ae, 70\u2010mL, ~400\u2010mg nitrate) and randomized to initially chew either sugar\u2010containing acidic chewing (bubble) gum or sugar\u2010free non\u2010acidic chewing gum, with the alternate gum on the second visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sugar\u2010containing gum decreased salivary pH by 1.4\u2009\u00b1\u20090.09\n                      <jats:italic>vs<\/jats:italic>\n                      . sugar\u2010free gum (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001). While there was no significant effect on salivary nitrate secretion or plasma [nitrate], salivary nitrite production was increased by 45% (30.0\u2009\u00b1\u200911.0\u2009\u03bcmol\u00b7h\n                      <jats:sup>\u22121<\/jats:sup>\n                      ; [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01]), with plasma [nitrite] increasing by 25% (222.2\u2009\u00b1\u200950.3\u2009nmol\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      ; [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.0001]). Systolic and diastolic BP were decreased by 2.7\u2009\u00b1\u20090.5 and 1.9\u2009\u00b1\u20090.5\u2009mmHg, respectively (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acutely lowering salivary pH (with sugar\u2010containing gum) augments salivary nitrite production, plasma [nitrite] and BP\u2010lowering with dietary nitrate. This mechanism has potential to enhance other nitrate\u2013nitrite\u2013NO pathway effects, for example, exercise performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70640","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:01:20Z","timestamp":1781823680000},"page":"3485-3494","source":"Crossref","is-referenced-by-count":0,"title":["Lowering salivary pH with sugar\u2010containing gum augments salivary nitrite production and blood pressure reduction with dietary nitrate (beetroot juice)"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-1877","authenticated-orcid":false,"given":"Andrew J.","family":"Webb","sequence":"first","affiliation":[{"name":"King's College London British Heart Foundation Centre, School of Cardiovascular and Metabolic Medicine and Sciences, Department of Clinical Pharmacology  London UK"},{"name":"Clinical Research Facility Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5082-8629","authenticated-orcid":false,"given":"Harriet","family":"Clift","sequence":"additional","affiliation":[{"name":"King's College London British Heart Foundation Centre, School of Cardiovascular and Metabolic Medicine and Sciences, Department of Clinical Pharmacology  London UK"},{"name":"Clinical Research Facility Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Callum","family":"Hill","sequence":"additional","affiliation":[{"name":"King's College London British Heart Foundation Centre, School of Cardiovascular and Metabolic Medicine and Sciences, Department of Clinical Pharmacology  London UK"},{"name":"Clinical Research Facility Guy's and St Thomas' NHS Foundation Trust  London 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