Alteration by cadmium of rat submandibular gland secretory function and the role of the l-arginine/nitric oxide pathway

Environmental particulate matter-one of the culprits in the development of caries

With the development of society, ecological and environmental problems have gradually become the focus of attention of countries around the world, among which environmental particulate matter poses a major harm to health. This article elucidates the association between environmental particulate matter and dental caries and provides new insights into the underlying mechanisms. In addition, this study emphasizes the role of oxidative stress in the occurrence and development of dental caries, and a new research pathway based on the interaction between oxidative stress and dental caries based on the Nrf2 pathway has become the focus of future research on the pathogenesis of dental caries. The relevant content of this review can provide a certain theoretical basis for the follow-up multidisciplinary joint research of researchers, and provide a certain reference for public health personnel and policymakers to formulate prevention strategies and public health interventions, carry out more accurate individualized treatment for high-risk groups, implement key prevention and treatment, and promote the overall improvement of effective prevention and treatment of caries. Ultimately, more attention must be paid to addressing the relationship between environmental particulate pollution and dental caries, with a focus on pollution control and reducing preventable environmental risks in order to protect oral health more broadly.

Correlation Between Urinary Heavy Metals and Early Childhood Caries in a Typical Industrial and Mining Area

In order to assess the association between urinary heavy metals and early childhood caries (ECC), a survey of deciduous tooth decay and urinary heavy metal concentrations of 408 children was conducted in a typical industrial and mining area. The results indicated that urinary heavy metal concentrations were ranked as Zn > Fe > Cu > Pb > Ni > Cd > As > Cr > Mn > Hg. The zero-inflated negative binomial model identified Hg as a significant risk factor for ECC (P25 ~ P75, OR = 3.499; > P75, OR = 3.184). Bayesian kernel machine regression further revealed that Pb, Cd, and Hg were positively correlated with ECC. Additional analysis using the Wilcoxon rank sum test and restricted cubic splines confirmed a positive correlation between the urinary concentrations of Pb, Cd, As, and Hg and the number of ECC (p < 0.05). Moreover, Bayesian kernel function regression and weighted quantile sum regression indicated that combined exposure to heavy metals was positively associated with ECC, with Hg (0.420) being the most dominant contributor, followed by As, Pb, and Cd. In conclusion, this study demonstrated a significant positive correlation between urinary heavy metals and both the occurrence and severity of ECC, with Hg identified as the most influential factor. It was recommended to minimize children's exposure to heavy metals to protect their dental health.

Assessment of the toxic effects of levetiracetam on biochemical, functional, and redox parameters of salivary glands in male Wistar rats

Levetiracetam (LEV) is an anticonvulsant for epilepsy. The toxic effects of this medication in tissues have been associated with redox state imbalance, which can lead to salivary gland dysfunction. Therefore, the current work investigated the effects of LEV on the biochemical, functional, and redox parameters of the parotid and submandibular glands in rats. For this, male Wistar rats (Rattus norvegicus albinus) were randomly divided into 3 groups (n = 10/group): Control (0.9% saline solution), LEV100 (100 mg/kg), and LEV300 (300 mg/kg). After 21 consecutive days of intragastric gavage treatments, pilocarpine stimulated saliva secretion was collected for salivary biochemical analysis. The extracted salivary glands were utilized for histomorphometry and redox state analyses. Our results showed that LEV300 increased plasma hepatotoxicity markers and reduced salivary amylase activity and the acinar surface area of the parotid gland. Total oxidant capacity and oxidative damage to lipids and proteins were higher in the parotid gland, while total antioxidant capacity and uric acid levels were reduced in the submandibular gland of the LEV100 group compared to Control. On the other hand, total oxidant capacity, oxidative damage to lipids and proteins, total antioxidant capacity, and uric acid levels were lower in both salivary glands of the LEV300 group compared to Control. Superoxide dismutase and glutathione peroxidase activities were lower in the salivary glands of treated animals compared to Control. In conclusion our data suggest that treatment with LEV represents a potentially toxic agent, that contributes to drug-induced salivary gland dysfunction.

Impact of bone marrow mesenchymal stem cells on the submandibular gland structure of adult male albino rats exposed to cadmium chloride toxicity

OBJECTIVE

This study was carried out in submandibular salivary glands of rats to demonstrate the changes induced by cadmium intoxication and the possible prophylactic and therapeutic effects of bone marrow mesenchymal stem cells (BMSCs).

DESIGN

Sixty-five rats were divided into five groups. Rats in Group I were controls while those of Group II received daily dose of 10 mg/kg cadmium for 24 days. Rats in Group III received single prophylactic dose of 1 × 106 BMSCs one week before cadmium administration. Rats of Group IV were concomitantly administered cadmium and BMSCs, while those of Group V received cadmium for 24 days and were then treated with single dose of 1 × 106 BMSCs. Rats of Groups I, II, III, and IV were euthanized at the end of the experiment while those of Group V were euthanized one week later. Salivary gland specimens were processed and stained with H&E and inducible nitric oxide synthase; other specimens were used to demonstrate metallothionein gene expression using RT-PCR, malondialdehyde and catalase enzymes were detected by ELISA.

RESULTS

Groups III and IV had nearly comparable findings to Group I regarding histological pattern with normal gland features. Group III recorded a lower fold of change for metallothionein gene (1.14 ± 0.20), a lower malondialdehyde enzyme (21.67 ± 1.63 nmol/mg), and a higher catalase enzyme (66.33 ± 2.16 mmol/mg). Regarding all variables, significant differences were found between the different groups (P < 0.001).

CONCLUSION

BMSCs have prophylactic and therapeutic effects against cadmium-induced cytotoxicity in rat salivary glands.

Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients

BACKGROUND

Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay.

METHODS

Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32).

RESULTS

The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort-mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27-34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA.

CONCLUSION

This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients.

Switching to normal diet reverses kwashiorkor-induced salivary impairments via increased nitric oxide level and expression of aquaporin 5 in the submandibular glands of male Wistar rats

Kwashiorkor, a form of malnutrition, has been shown to cause impaired salivary secretion. However, there is dearth of information on the mechanism that underlies this complication. Also, whether returning to normal diet after kwashiorkor will reverse these complications or not is yet to be discerned. Thus, this study aimed at assessing the mechanisms that underlie kwashiorkor-induced salivary impairments and to evaluate the effects of switching back to normal-diet on kwashiorkor-induced salivary impairments. Weaning rats were randomly divided into 3 groups (control group, kwashiorkor group (KG), re-fed kwashiorkor group (RKG)) of 7 rats each. The control group had standard rat chow while the KG and RKG were fed 2% protein diet for 6 weeks to induce kwashiorkor. The RKG had their diet changed to standard rat-chow for another 6 weeks. Blood and stimulated saliva samples were collected for the analysis of total protein, electrolytes, amylase, immunoglobulin A (IgA) secretion rate, leptin, and ghrelin. Tissue total protein, nitric oxide level, expressions of Na⁺/K⁺-ATPase, muscarinic (M3) receptor, and aquaporin 5 in the submandibular glands were also determined. Data were presented as means ± SEM and compared using ANOVA with Tukey's post hoc test. RKG showed improved salivary function evidenced by reduced salivary lag-time and potassium and increased flow rate, sodium, amylase, IgA secretion rate, leptin, submandibular nitric oxide level, and aquaporin 5 expression compared with KG. This study for the first time demonstrated that kwashiorkor caused significant reduction in salivary secretion through reduction of nitric oxide level and aquaporin 5 expression in submandibular salivary glands. Normal-diet re-feeding after kwashiorkor returned salivary secretion to normal.

Cellular Responses to Metal Ions Released From Implants

In the process of calcified tissue formation, cells secrete a protein-rich matrix into which they add a metal ion that nucleates in the presence of phosphorus to form an inorganic salt (usually calcium hydroxyapatite). Cellular and tissue responses to metal ions—released from implants, for example—can therefore be considered from the perspective of how cells handle calcium ions. A critical factor in determining cellular toxicity will be free ion concentrations and the competitive interactions that occur in a physicochemical manner. Three of the parameters used to assess the biocompatibility of implant materials are (1) the ability to influence mitotic activity, (2) intercellular adhesion, and (3) promotion of cell death. A spectrum of responses to free intracellular calcium ions can be identified, ranging from presence of the ion being essential for cell division through to an excess of the free ion that results in cell death (apoptosis). In between these extremes, cells may become postmitotic and express phenotypic variations as they adapt to their environment and establish equilibrium to maintain intracellular calcium homeostasis. The response of cells to implants can be linked to ions released and interactions between these and other ions and/or molecules present in the tissues, similar to the manner in which cells handle calcium ions.

Association of environmental cadmium exposure with pediatric dental caries

BACKGROUND

Although animal experiments have shown that cadmium exposure results in severe dental caries, limited epidemiologic data are available on this issue.

OBJECTIVES

We aimed to examine the relationship between environmental cadmium exposure and dental caries in children 6-12 years of age.

METHODS

We analyzed cross-sectional data, including urine cadmium concentrations and counts of decayed or filled tooth surfaces, from the Third National Health and Nutrition Examination Survey. We used logistic and zero-inflated negative binomial (ZINB) regression to estimate the association between urine cadmium concentrations and caries experience, adjusting these analyses for potential confounders including environmental tobacco smoke (ETS).

RESULTS

Urine cadmium concentrations ranged from 0.01 to 3.38 ng/mL. Approximately 56% of children had experienced caries in their deciduous teeth, and almost 30% had been affected by caries in their permanent dentition. An interquartile range (IQR) increase in creatinine-corrected cadmium concentrations (0.21 microg/g creatinine) corresponded to a 16% increase in the odds of having experienced caries in deciduous teeth [prevalence odds ratio (OR)=1.16; 95% confidence interval (CI), 0.96-1.40]. This association was statistically significant in children with low ETS exposure (prevalence OR=1.30; 95% CI, 1.01-1.67). The results from the ZINB regression indicated that, among children with any caries history in their deciduous teeth, an IQR increase in cadmium was associated with 17% increase in the number of decayed or filled surfaces. We observed no association between cadmium and caries experience in permanent teeth.

CONCLUSIONS

Environmental cadmium exposure may be associated with increased risk of dental caries in deciduous teeth of children.

A multifaceted molecule, nitric oxide in oral and periodontal diseases

Nitric oxide (NO) is a molecule with multiple effects on different tissues. NO takes important roles in vasodilatation, bacterial challenge and cytokine stimulation, regulation of mineralized tissue function, neurotransmission, and platelet aggregation, etc. However, under pathological conditions, NO has damaging effects. NO is synthesized by NO synthases (NOS) and inducible isoform of NOS (iNOS) is closely related to the pathophysiological characteristics of inflammatory diseases such as periodontal diseases. The expression of iNOS has been investigated in salivary gland-related diseases, temporomandibular joint disorders and oral cancer as well. The beneficial and damaging effects of NO in diseases related with periodontal, dental and maxillofacial area are discussed in this review. The biological pathways involved with NO and NO inhibitors may be good drug targets to have a role in the future management of patients with diseases in orofacial region.

Total antioxidant capacity and levels of epidermal growth factor and nitric oxide in blood and saliva of insulin-dependent diabetic patients

BACKGROUND

The aim of this study was to examine how type 1 diabetic patients have altered levels of lipid peroxidation, antioxidant defense, NO and EGF in their plasma and saliva. We tested the differences in lipid peroxidation level, antioxidant power, and concentrations of epidermal growth factor (EGF) and nitric oxide (NO) in saliva and blood of type 1 diabetic subjects in comparison to healthy control subjects.

METHODS

Nineteen subjects with type 1 diabetes mellitus and 19 healthy age- and sex-matched control subjects were included in the study. Blood and saliva samples were obtained and analyzed for thiobarbituric reactive substances (TBARS) as a marker of lipid peroxidation, ferric reducing ability (total antioxidant power), EGF and NO levels.

RESULTS

TBARS levels did not show a significant difference between the two groups. Analysis of antioxidant power revealed that saliva and plasma of diabetic patients had more antioxidant power (p <0.01) than the healthy control population (107 +/- 10.35 vs. 11.14 +/- 4.66 and 192 +/- 12.3 vs. 142 +/- 15.2 mmol/L, respectively). Concentration of EGF was increased (p <0.01) in saliva whereas it was reduced (p <0.01) in plasma of diabetic patients in comparison to those of healthy subjects (2423 +/- 322 vs. 1513 +/- 341 and 125 +/- 14 vs. 346 +/- 60 pg/mL, respectively). NO level increased in both saliva and plasma of diabetic patients in comparison to those of healthy subjects (46.61 +/- 7 vs. 72.89 +/- 13 and 62.11 +/- 4.6 vs. 76.25 +/- 5 micromol/L, respectively). Blood HbA1c (%) of patients was significantly higher than that of controls (8.3 +/- 0.32 vs. 5.4 +/- 0.24, p <0.01).

CONCLUSIONS

Existence of increased total antioxidant power in the presence of normal lipid peroxidation in plasma and saliva of type 1 diabetic patients indicates the existence of oxidative stress. Increased salivary EGF and NO levels in association with elevated TAOP is interesting and should be further studied.

On the relation of nitric oxide to nifedipine-induced gingival hyperplasia and impaired submandibular glands function in rats in vivo

Calcium-channel blockers such as nifedipine could be associated with gingival overgrowth. The aim of this study was to examine the role of nitric oxide (NO) on nifedipine-induced gingival hyperplasia along with submandibular secretory function in rats. Animals in divided groups received nifedipine (250 mg/kg diet) alone and in combination with L-arginine (2.25% w/v) or N(omega)-nitro-L-arginine methyl ester (L-NAME) (0.7% w/v) in drinking water for 20 days. Controls received only tap water. Pure submandibular saliva was collected intraorally by micropolyethylene cannula and the mandibular gingiva was examined by means of dissecting microscope for signs of redness, thickness, inflammation and exuda. Twenty-day nifedipine treatment induced gingival hyperplasia accompanied with reduced salivary flow rate and concentrations of total protein, epidermal growth factor (EGF) and calcium in comparison with controls. Co-treatment of animals with nifedipine and L-arginine protected from gingival hyperplasia and retained flow rate, and concentrations of total protein, EGF and calcium in normal levels. Co-treatment of animals with nifedipine and L-NAME potentiated nifedipine-induced gingival hyperplasia and reductions in flow rate and concentrations of total protein, EGF, and calcium. It is concluded that nifedipine-induced gingival hyperplasia is associated with salivary dysfunction. Activation of cGMP-dependent positive signal-transduction mechanisms in salivary glands might be the mechanism for protective effects of NO against nifedipine-induced gingival hyperplasia.

Reduction of diabetes-induced oxidative stress by phosphodiesterase inhibitors in rats

Increased oxidative stress has been suggested to be involved in the pathogenesis and progression of diabetic tissue damage. The aim of this study was to investigate the effect of different phosphodiesterase inhibitors on lipid peroxidation and total antioxidant capacity (TAC) of plasma in streptozotocin-induced diabetic rats (Rattus norvegicus). Rats became diabetic by a single administration of streptozotocin (STZ, 45 mg/kg). The effects of 15-days treatment by milrinone, sildenafil, and theophylline as cyclic-AMP and -GMP phosphodiesterase inhibitors (PDEIs) on diabetes-induced oxidative stress were studied. The levels of glucose, malonedialdehyde (MDA) the by product of lipid peroxides, and TAC (FRAP test) were estimated in plasma of control and experimental groups of rats. A significant increase in the levels of plasma glucose, and MDA and a concomitant decrease in the levels of TAC were observed in diabetic rats. These alterations were reverted back to near normal level after the treatment with PDEIs. Treatment of diabetic rats by PDEIs reduced MDA levels and increased TAC in the order of milrinone>sildenafil>theophylline. In conclusion, the present investigation show that PDIS possesses antioxidant activities, which may be attributed to their enhancing effect on cellular cyclic nucleotides contributing to the protection against oxidative stress in streptozotocin-induced diabetes. Exact mechanism of protective actions of cAMP- and cGMP-phosphodiesterase remains to be elucidated by further studies. This finding may suggest a place for PDEIs in maintaining health in diabetes.

Increasing intracellular cAMP and cGMP inhibits cadmium-induced oxidative stress in rat submandibular saliva

The effect of cadmium on induction of oxidative stress in rat submandibular saliva and protective role of increasing intracellular cAMP and cGMP by use of specific phosphodiesterase inhibitors, theophylline and sildenafil were investigated. Pure submandibular saliva was collected intraorally by micro polyethylene cannula from anaesthetized rats using pilocarpine as secretagogue. Acute administration of cadmium (10 mg/kg) caused significant oxidative stress by increasing lipid peroxidation by-products (thiobarbituric reactive substances, TBARS) and decreasing total thiols and total antioxidant power of the saliva. Concurrent therapy of rats by theophylline (25 mg/kg) and sildenafil (5 mg/kg) prevented cadmium-induced oxidative stress in saliva. Theophylline and sildenafil inhibited cadmium-induced increase in lipid peroxidation and decrease in total thiols and antioxidant power. It is concluded that cadmium administration results in oxidative stress in rat submandibular saliva, which can be protected by concurrent administration of specific cyclic nucleotide phosphodiesterase inhibitors.

Protection by nitric oxide of morphine-induced inhibition of rat submandibular gland function

The effects of morphine, l -arginine (nitric oxide precursor) and l -NAME (nitric oxide synthesis inhibitor ) and their concurrent therapy on rat submandibular secretory function were studied. Pure submandibular saliva was collected intraorally by micro polyethylene cannula from anaesthetized rats using pilocarpine as secretagogue. Single intraperitoneal injection of morphine (6 mg kg(-1)) to rats induced significant (P< 0.01) inhibition of salivary flow rate (28%), total protein (12%) and calcium concentrations (27%). Sodium output was increased (23%, P< 0.01). Single intraperitoneal administration of l -arginine (100 mg kg(-1)) and l -NAME (10 mg kg(-1)) affected salivary gland function. Saliva flow rate was reduced by l -NAME (23%, P< 0.01). The total protein concentration of saliva was increased by l -arginine (21%, P< 0.05) and decreased by l -NAME (19%, P< 0.01). Calcium concentration of saliva was increased by l -arginine (25%, P< 0.01) and reduced by l -NAME (21%, P< 0.01). In combination treatment, l -arginine prevented (P< 0.01) morphine-induced reduction of flow rate while l -NAME potentiated it (P< 0.01). The secretion of total protein and calcium were influenced in a similar trend by concurrent therapy. l -NAME potentiated morphine-induced decrease of total protein and calcium concentrations (P< 0.01) while l -arginine restored (P< 0.01) them to levels close to control and morphine groups respectively. It is concluded that morphine inhibits salivary gland function and nitric oxide (NO) plays a positive role in this system. Also it is confirmed that morphine inhibitory effects on submandibular function are somewhat restored by l -arginine and expanded by l -NAME. The modulatory effect of the l -arginine/NO system on salivary gland function is suggested.

Inhibition of rat parotid and submandibular gland functions by ofloxacin, a fluoroquinolone antibiotic

While fluoroquinolones are widely used in the treatment of various infectious disease, not enough attention has been paid to their adverse effects on salivary glands functions. In the present study, the effects of ofloxacin, a fluoroquinolone antibiotic, on rat parotid and submandibular gland functions, were examined in an acute experiment. Ofloxacin (OFLX) was administered intraperitoneally at various doses (20, 40, and 80 mg/kg). Pure parotid and submandibular saliva were collected intraorally by microployethylene tubes under anaesthesia using a dissecting microscope. Flow rate, amylase activity, total protein, and calcium concentrations were reduced by all doses of OFLX (20, 40, 80 mg/kg, P < 0.01) in parotid saliva. In parotid saliva, sodium and potassium were increased by doses of 20 and 40 mg/kg (P < 0.01) and 20, 40, 80 mg/kg (P < 0.01) respectively. In submandibular saliva, flow rate, total protein and calcium concentrations were significantly reduced by all doses (20, 40, 80 mg/kg, P < 0.01). Sodium and potassium concentrations were also increased by a dose of 80 mg/kg, (P < 0.05) in submandibular saliva. It is concluded that ofloxacin inhibits rat salivary gland functions, which might be observed as a side-effect in humans. Properties of fluoroquinolones to alter intracellular cAMP and calcium levels and their ability to suppress DNA, RNA and protein synthesis of acinar cells might be possible reasons for the observed changes.