ヤマムラ　ユキエ   YAMAMURA YUKIE   山村　幸江    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Sialorrhea Successfully Treated by the Combined Use of Selective M1 and M3 Muscarinic Acetylcholine Receptor Antagonists.
掲載誌名	正式名：Journal of Nippon Medical School = Nippon Ika Daigaku zasshi 略　 称：J Nippon Med Sch ISSNコード：(1347-3409)1345-4676(Linking)
掲載区分	国内
巻・号・頁	86(2),pp.117-121
著者・共著者	Yamamura Yukie, Nonaka Manabu
担当区分	筆頭著者,責任著者
発行年月	2019
概要	Sialorrhea is often treated with anticholinergic agents, but they can have undesirable side effects such as drowsiness, sedation, and constipation. Effective medication that acts selectively on the salivary glands is needed. We report the case of a patient with sialorrhea who was successfully treated by the combined use of pirenzepine and solifenacin (M1 and M3 muscarinic receptor antagonists, respectively). The patient was a 51-year-old man with mean unstimulated and stimulated salivary flow rates per 10 min of 6.1 mL and 41.7 mL, respectively (both were measured three times). 99mTcO4- salivary gland scintigraphy revealed characteristic spontaneous saliva secretion without stimulation. He was treated with Scopolia extract, escitalopram, solifenacin succinate, and the combined administration of solifenacin succinate and pirenzepine. A statistically significant decrease was observed from the pre-medication unstimulated and stimulated salivary flow rates only following the combined administration of solifenacin and pirenzepine. The major muscarinic receptor subtype expressed in the salivary glands is M3; however, M1 is also present. A study using knockout mice demonstrated that the presence of either M1 or M3 receptors was sufficient for salivation. Thus, the combined use of selective M1 and M3 antagonists could provide a good treatment option for sialorrhea.
DOI	10.1272/jnms.JNMS.2019_86-207
PMID	31130562