{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:54:41Z","timestamp":1791831281800,"version":"4.3.4"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81403297"],"award-info":[{"award-number":["81403297"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81973723"],"award-info":[{"award-number":["81973723"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2021A515011476"],"award-info":[{"award-number":["2021A515011476"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Project of Administration of Traditional Chinese Medicine of Guangdong Province of China","award":["20215005"],"award-info":[{"award-number":["20215005"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nObjectives<\/jats:title>\nMalnutrition, defined according to Nutritional risk screening (NRS 2002), is commonly observed in patients of Myasthenia gravis (MG), a neuromuscular disorder manifested by varied degrees of skeletal muscle weakness. Because biochemical composition of saliva changes in correspondence to alterations in nutritional status, we tested our hypothesis that a certain saliva component(s) might serve as a biomarker(s) for nutrition status of MG, particularly for those MG patients with high risk of malnutrition.<\/jats:p>\n<\/jats:sec>\n\nMaterials and methods<\/jats:title>\n60 MG patients and 60 subjects belonging to the healthy control group (HCG) were enrolled in this case-control study. The salivary \u03b1-amylase (sAA) activity, salivary flow rate (SFR), pH, total protein density (TPD), and the concentrations of chloride and calcium ions in MG group with or without malnutrition were measured before and after citric acid stimulation. Thereafter, the relationship between sAA activity and BMI was determined in MG and HCG.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nCompared with HCG, more patients with malnutrition, increased TPD and chloride and calcium concentrations but decreased pH value and SFR both before and after acid stimulation, as well as reduced sAA activity, pH and TPD responses to acid stimulation. MG with malnutrition showed decreased sAA activity and TPD responding to acid stimulation compared with those without malnutrition. Compared with normal BMI, sAA activity response to acid stimulation was reduced in low BMI. There was a significant strong positive correlation between the ratio of sAA activity and BMI in MG.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nSalivary biochemical characteristics are abnormally altered in MG with malnutrition. Altered sAA activity responding to acid stimulation was associated with malnutrition.<\/jats:p>\n<\/jats:sec>\n\nClinical relevance<\/jats:title>\nDecreased sAA activity responding to acid stimulation can reflect malnutrition state and may be one potential screening marker for MG patients with high risk of malnutrition.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0269621","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T18:09:32Z","timestamp":1655316572000},"page":"e0269621","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Decreased salivary \u03b1-amylase activity responding to citric acid stimulation in Myasthenia gravis with malnutrition"],"prefix":"10.1371","volume":"17","author":[{"given":"Ye","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-kai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-mei","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-hong","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long-hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ru-liu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4529-7146","authenticated-orcid":true,"given":"Chuan-quan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,15]]},"reference":[{"key":"pone.0269621.ref001","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/BOR.0000000000000647","article-title":"Diagnosis and treatment of myasthenia gravis","volume":"31","author":"R Mantegazza","year":"2019","journal-title":"Curr Opin Rheumatol"},{"key":"pone.0269621.ref002","volume-title":"Myasthenia gravis (MG)","author":"Nicolle Hoesmith","year":"2010"},{"key":"pone.0269621.ref003","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1093\/ageing\/afs006","article-title":"Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study","volume":"41","author":"M Serra-Prat","year":"2012","journal-title":"Age Ageing"},{"key":"pone.0269621.ref004","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.2214\/ajr.156.6.2028863","article-title":"Altered swallowing function in elderly patients without dysphagia: radiologic findings in 56 cases","volume":"156","author":"O Ekberg","year":"1991","journal-title":"AJR. 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