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Mosannen Mozaffari P, Delavarian Z, Fekrazad R, Fani Pakdel A, Rashed Mohassel M, Taghi Shakeri M, Ghazi A. Evaluation of the Effect of Photobiomodulation on Radiation-Induced Xerostomia in Head and Neck Cancer Patients: A Randomized Clinical Trial. J Lasers Med Sci 2024; 15:e4. [PMID: 38655042 PMCID: PMC11033859 DOI: 10.34172/jlms.2024.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/16/2023] [Indexed: 04/26/2024]
Abstract
Introduction: Radiotherapy-induced xerostomia is an important side effect of head and neck cancer (HNC) treatment. Photobiomodulation (PBM) is one of the new emerging methods for preventing or reducing this problem. The aim of this study is to evaluate the effect of PBM on radiation-induced xerostomia in HNC patients. Methods: Thirty-seven patients with HNC who were referred for radiotherapy to Mashhad cancer center. In the case group, an infrared diode laser was used in contact mode on 16 points (covering minor and major salivary glands). The device emitted a wavelength of 810 nm and operated at the power of 200 mW and continuous wave mode. Each area was irradiated for 4 seconds in contact mode with gentle pressure, and the laser energy was 0.8 J with an energy density of 2.85 J/cm2 at the surface of the probe (spot size, 0.28 cm2 ). The total dose was 45.6 J/cm2. The power density was 714.2 w/cm2. In the control group, the sham laser device was used. Subjective xerostomia was evaluated through the LENT SOMA scale (LSS). Stimulated and unstimulated saliva was also assessed. Data were analyzed with SPSS ver22 statistical software. Results: The study included 26 men and 11 women with a mean age of 55.6±15.3 years. In the sixth week, the case group produced more stimulated saliva than the control group (P=0.006). They also had less subjective xerostomia than the control group in weeks four to six. Conclusion: In the present study, PBM had a preventive effect on stimulated saliva and subjective xerostomia and can be recommended as an adjunctive treatment. Further studies with a higher sample size and the use of a low-level laser in more sessions are needed for definitive comment.
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Affiliation(s)
- Pegah Mosannen Mozaffari
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research, Network (USERN), Tehran, Iran
| | - Azar Fani Pakdel
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Taghi Shakeri
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala Ghazi
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Zayed HM, Kheir El Din NH, Abu-Seida AM, Abo Zeid AA, Ezzatt OM. Gingival-derived mesenchymal stem cell therapy regenerated the radiated salivary glands: functional and histological evidence in murine model. Stem Cell Res Ther 2024; 15:46. [PMID: 38365799 PMCID: PMC10874004 DOI: 10.1186/s13287-024-03659-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Radiotherapy in head and neck cancer management causes degeneration of the salivary glands (SG). This study was designed to determine the potential of gingival mesenchymal stem cells (GMSCs) as a cell-based therapy to regenerate irradiated parotid SG tissues and restore their function using a murine model. METHODS Cultured isolated cells from gingival tissues of 4 healthy guinea pigs at passage 3 were characterized as GMSCSs using flow cytometry for surface markers and multilineage differentiation capacity. Twenty-one Guinea pigs were equally divided into three groups: Group I/Test, received single local irradiation of 15 Gy to the head and neck field followed by intravenous injection of labeled GMSCs, Group II/Positive control, which received the same irradiation dose followed by injection of phosphate buffer solution (PBS), and Group III/Negative control, received (PBS) injection only. Body weight and salivary flow rate (SFR) were measured at baseline, 11 days, 8-, 13- and 16-weeks post-irradiation. At 16 weeks, parotid glands were harvested for assessment of gland weight and histological and immunohistochemical analysis. RESULTS The injected GMSCs homed to degenerated glands, with subsequent restoration of the normal gland histological acinar and tubular structure associated with a significant increase in cell proliferation and reduction in apoptotic activity. Subsequently, a significant increase in body weight and SFR, as well as an increase in gland weight at 16 weeks in comparison with the irradiated non-treated group were observed. CONCLUSION The study provided a new potential therapeutic strategy for the treatment of xerostomia by re-engineering radiated SG using GMSCs.
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Affiliation(s)
- Hagar M Zayed
- Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, 20 Organization of African Union St., Cairo, 1156, Egypt
- Central Lab of Stem Cells and Biomaterial Applied Research (CLSBAR), Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Nevine H Kheir El Din
- Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, 20 Organization of African Union St., Cairo, 1156, Egypt
| | - Ashraf M Abu-Seida
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Cairo University, Cairo, 13736, Egypt
| | - Asmaa A Abo Zeid
- Department of Histology, and Cell Biology, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | - Ola M Ezzatt
- Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, 20 Organization of African Union St., Cairo, 1156, Egypt.
- Central Lab of Stem Cells and Biomaterial Applied Research (CLSBAR), Faculty of Dentistry, Ain-Shams University, Cairo, Egypt.
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Ribeiro LN, de Vasconcelos Carvalho M, de Oliveira Limirio JPJ, do Egito Vasconcelos BC, Moraes SLD, Pellizzer EP. Impact of low-level laser therapy on the quality of life of patients with xerostomia undergoing head and neck radiotherapy: a systematic review. Support Care Cancer 2024; 32:118. [PMID: 38244087 DOI: 10.1007/s00520-024-08325-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE To carry out a systematic review to assess whether low-level laser therapy can improve the quality of life of patients with xerostomia undergoing head and neck radiotherapy. METHODS A systematic search was performed through Embase, Medline/PubMed, Cochrane, Scopus, Web of Science, nonpeer-reviewed clinicaltrials.gov and LILACS. The strategy included clinical studies were selected that prospectively followed or evaluated the quality of life by directly comparing the use of low-level laser therapy for xerostomia induced by head and neck radiotherapy with alternative therapies without the use of a laser. The risk of bias in the studies was assessed by RoB 2.0 and Robins I. RESULTS After all application of the predetermined criteria, four studies were included, dated between the years 2014 and 2023. Three studies described as randomized clinical trials were included, one of which was a randomized pilot study and only one was a prospective clinical trial. A total of 126 patients were evaluated, all four studies used the infrared wavelength, with two studies using the combination with the red wavelength. It was observed that low-level laser therapy can change the sensation of dry mouth, improving patients' quality of life. In addition, changes related to increased stimulated and unstimulated salivary flow were also identified. CONCLUSION The use of low-level laser therapy has promising results on xerostomia, consequently improving the quality of life of patients undergoing radiotherapy in the head and neck region.
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Affiliation(s)
- Lucas Nascimento Ribeiro
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Integrated Anatomic Pathology Center, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil
| | - Marianne de Vasconcelos Carvalho
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Integrated Anatomic Pathology Center, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil.
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pernambuco (UPE), Cícero Monteiro Street, s/n - São Cristóvão, Arcoverde, PE, 56503-146, Brazil.
| | - João Pedro Justino de Oliveira Limirio
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, São Paulo State University (UNESP), José Bonifácio Street 1193, Araçatuba, São Paulo, 1605000, Brazil
| | - Belmiro Cavalcanti do Egito Vasconcelos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil
| | - Sandra Lúcia Dantas Moraes
- Department of Prosthodontics, School of Dentistry, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, São Paulo State University (UNESP), José Bonifácio Street 1193, Araçatuba, São Paulo, 1605000, Brazil
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Faruque MRJ, Taidouch K, Bikker FJ, Ligtenberg AJM. Exploring the Correlation between Salivary Spinnbarkeit and Caries Scores. Caries Res 2024; 58:115-120. [PMID: 38246142 PMCID: PMC10997273 DOI: 10.1159/000536402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION In this study, the relationship between the spinnbarkeit, i.e., the stretchability of saliva, and dental caries was investigated. METHODS Dentistry students were divided into a group with more than 2 decayed, missed, and filled teeth (DMFT ≥2, n = 30) and caries-free group (DMFT = 0, n = 36). RESULTS Unstimulated saliva flow rate, pH, and spinnbarkeit were determined. Salivary spinnbarkeit was significantly lower in the caries-prone group compared to the caries-free group (5.4 ± 3.9 mm vs. 13.5 ± 7.6 mm, respectively, p < 0.001). CONCLUSION This suggests that saliva with high spinnbarkeit protects better against dental caries.
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Affiliation(s)
- Mouri R J Faruque
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Kawtar Taidouch
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Floris J Bikker
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Antoon J M Ligtenberg
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Taha RM, Abdel-Latif GA, Said RH. The Prospective Effect of Green Tea versus Pomegranate Peels Extracts on Submandibular Salivary Glands of Albino Rats after Methotrexate Administration (Histological and Immunohistochemical Study). Int J Dent 2024; 2024:3290187. [PMID: 38213552 PMCID: PMC10781530 DOI: 10.1155/2024/3290187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
Background There is curiosity in the use of substances that can stop cell damage. Antioxidants are substances that can prevent free radicals from damaging cells, and they can be used to treat and avoid a wide variety of illnesses. Objectives The current investigation set out to evaluate the histological changes brought on by a single high dose of methotrexate in the submandibular glands of rats treated with green tea and pomegranate peel extract, both are well-known as antioxidants. Materials and Methods Forty-eight healthy Albino rats were used in the current study. Animals were divided into six groups. Group 1: Vehicle group which is control group, Group 2: methotrexate treated group, Group 3: green tea control group, Group 4: pomegranate peel extract control group, Group 5: green tea + methotrexate group, and Group 6: pomegranate peel extract + methotrexate group. Rats of all groups were left 1 week after the end of the treatment. Cervical dislocation was used to kill all of the rats. Samples were gained from the rats' submandibular salivary glands of different groups for histological and immunohistochemical evaluation. Results Green tea + methotrexate group showed improvement in the histological picture of the submandibular salivary gland compared to methotrexate group and the pomegranate peel extract + methotrexate group. Conclusion The antioxidant activity of green tea is more potent than that of pomegranate peels extract in blocking methotrexate that induced cytotoxicity in the submandibular salivary glands of rats. As a result, it can be administered to people undergoing cancer treatment as a safeguard for their salivary glands.
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Affiliation(s)
- Rasha M. Taha
- Oral Biology Department, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | - Ghada A. Abdel-Latif
- Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry and Hospital, Taibah University, Medina, Saudi Arabia
| | - Rania H. Said
- Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
- Oral Pathology Department, College of Dental Medicine, Umm Alqura University, Makkah, Saudi Arabia
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Riantiningtyas RR, Valenti A, Dougkas A, Bredie WLP, Kwiecien C, Bruyas A, Giboreau A, Carrouel F. Oral somatosensory alterations and salivary dysfunction in head and neck cancer patients. Support Care Cancer 2023; 31:627. [PMID: 37828382 PMCID: PMC10570204 DOI: 10.1007/s00520-023-08086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE Patients with head and neck cancer (HNC) are at high risk of malnutrition due to eating difficulties partly mediated by sensory alterations and salivary dysfunction. Clinical studies have mostly focused on taste and smell alterations, while changes in oral somatosensory perception are largely understudied. The study aimed to investigate oral somatosensory (tactile, texture, chemesthetic, and thermal) responses and salivary functions of HNC patients in comparison to healthy controls. METHODS A cross-sectional study was conducted using psychophysical tests in HNC patients (n = 30) and in age- and gender-matched control subjects (n = 30). The tests included measurements of point-pressure tactile sensitivity, whole-mouth chemesthetic stimulation, food texture discrimination, and temperature discrimination. Salivary functions, including hydration, saliva consistency, pH, volume, and buffering capacity, were also evaluated. RESULTS HNC patients demonstrated significantly lower chemesthetic sensitivity (for medium and high concentrations, p < 0.05), thermal sensitivity (p = 0.038), and salivary functions (p = 0.001). There were indications of lower tactile sensitivity in the patient group (p = 0.101). Patients were also less sensitive to differences in food roughness (p = 0.003) and firmness (p = 0.025). CONCLUSION This study provided evidence that sensory alterations in HNC patients extend beyond their taste and smell. The measurements demonstrated lower somatosensory responses, in part associated with their reduced salivary function. Oral somatosensory alterations and salivary dysfunction may consequently impart the eating experience of HNC patients. Thus, further investigations on food adjustments for this patient group seem warranted.
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Affiliation(s)
- Reisya Rizki Riantiningtyas
- Institute Paul Bocuse Research Centre, 69130, Ecully, France.
- Health Systemic Process (P2S), Research Unit UR4129, University Claude Bernard Lyon 1, University of Lyon, 69008, Lyon, France.
- Section for Food Design and Consumer Behaviour, Department of Food Science, Faculty of Science, University of Copenhagen, 1958, Frederiksberg C, Denmark.
| | | | - Anestis Dougkas
- Institute Paul Bocuse Research Centre, 69130, Ecully, France
- Laboratoire Centre Européen Nutrition Et Santé (CENS), CarMeN, Unité INSERM 1060, Université Claude Bernard Lyon 1, 69310, Pierre-Bénite, France
| | - Wender L P Bredie
- Section for Food Design and Consumer Behaviour, Department of Food Science, Faculty of Science, University of Copenhagen, 1958, Frederiksberg C, Denmark
| | | | - Amandine Bruyas
- Institute of Cancerology, Hospices Civils de Lyon, Hôpital Croix Rousse, 69004, Lyon, France
| | - Agnès Giboreau
- Institute Paul Bocuse Research Centre, 69130, Ecully, France
- Health Systemic Process (P2S), Research Unit UR4129, University Claude Bernard Lyon 1, University of Lyon, 69008, Lyon, France
| | - Florence Carrouel
- Health Systemic Process (P2S), Research Unit UR4129, University Claude Bernard Lyon 1, University of Lyon, 69008, Lyon, France
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Soares SC, Roux LJD, Castro AR, Silva CC, Rodrigues R, Macho VMP, Silva F, Costa C. Oral Manifestations: A Warning-Sign in Children with Hematological Disease Acute Lymphocytic Leukemia. Hematol Rep 2023; 15:491-502. [PMID: 37754666 PMCID: PMC10530953 DOI: 10.3390/hematolrep15030051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/22/2023] [Accepted: 08/18/2023] [Indexed: 09/28/2023] Open
Abstract
Acute lymphocytic leukemia (ALL) is the most frequent form of all childhood leukemias, mostly affecting children between 2 and 4 years old. Oral symptoms, such as mouth ulcers, mucositis, xerostomia, Herpes or Candidiasis, gingival enlargement and bleeding, petechiae, erythema, mucosal pallor and atrophic glossitis, are very common symptoms of ALL and can be early signs of the disease. Secondary and tertiary complications, a direct effect of chemo and radiotherapy, are associated with more severe bleeding, higher susceptibility to infections, ulcerations, inflammation of the mucous membranes, osteoradionecrosis, xerostomia, taste alterations, trismus, carious lesions and dental abnormalities. Immunotherapy, though less toxic, causes oral dysesthesia and pain. Overall, the effects in the oral cavity are transient but there are long-term consequences like caries, periodontal disease and tooth loss that impair endodontic and orthodontic treatments. Also, dental abnormalities resulting from disturbed odontogenesis are known to affect a child's quality of life. The medical dentist should identify these complications and perform appropriate oral care in tandem with other health professionals. Thus, poor oral hygiene can lead to systemic ALL complications. The aim of this review is to describe the oral complications in children with ALL who are undergoing chemo, radio or immunotherapy.
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Affiliation(s)
- Sandra Clara Soares
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal; (F.S.)
| | - Louis J. D. Roux
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
| | - Ana Rita Castro
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal; (F.S.)
| | - Cristina Cardoso Silva
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal; (F.S.)
| | - Rita Rodrigues
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal; (F.S.)
| | - Viviana M. P. Macho
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal; (F.S.)
| | - Fátima Silva
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal; (F.S.)
- Escola Superior da Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal
| | - Céu Costa
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal; (F.S.)
- Escola Superior da Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal
- Grupo de Patologia Experimental e Terapêutica, Centro de Investigação, Instituto Português de Oncologia do Porto, 4200-072 Porto, Portugal
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Abdel Fattah HS, Omar EM. The protective role of curcumin nanoparticles on the submandibular salivary gland toxicity induced by methotrexate in male rats. Arch Oral Biol 2023; 152:105717. [PMID: 37182319 DOI: 10.1016/j.archoralbio.2023.105717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/05/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To evaluate the protective role of nanocurcumin on the toxicity induced by methotrexate in the submandibular glands of rats. DESIGN Twenty- four healthy male Wistar albino rats were randomly distributed into 3 groups, 8 rats each. Group I-control: rats received a single intraperitoneal injection of saline; Group II-methotrexate (MTX): rats received methotrexate 20 mg/ kg day 1 of the experiment; Group III-methotrexate and nanocurcumin (MTX+NCU): rats received methotrexate 20 mg/ kg on day 1 of the experimental period in addition to nanocurcumin 100 mg/kg/day for 7 days. After euthanasia, the submandibular salivary glands of all rats were collected and prepared for histological, histomorphometric, and immunohistochemical examination (Caspase 3, Bcl2), in addition to transmission electron microscopy. RESULTS Histological and ultrastructural assessment revealed less salivary gland damage in the nanocurcumin group in comparison to the methotrexate group, and the percentage of acinar vacuolization showed significantly lower values in the nanocurcumin group. Group III (MTX+NCU) showed lower immunoexpression of caspase 3 than group II (MTX), while Bcl2 immunoreactivity was higher in the MTX group than in the MTX+NCU group. CONCLUSIONS Our results suggest that simultaneous administration of nanocurcumin reduces apoptosis in salivary glands subjected to methotrexate.
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Affiliation(s)
- Hagar Sherif Abdel Fattah
- Department of Oral Biology, Faculty of Dentistry, Alexandria University, Champollion Street, Alexandria 21526, Egypt.
| | - Enas Magdi Omar
- Department of Oral Pathology, Faculty of Dentistry, Alexandria University, Champollion Street, Alexandria 21526, Egypt
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Yokoyama M, Katsumata-Kato O, Fujita-Yoshigaki J. Acinar Cell Proliferation Promoted by BMP2 in Injured Mouse Parotid Gland: BMP2 Promotes Cell Proliferation in Parotid Gland. Int J Dent 2023; 2023:1765317. [PMID: 37033127 PMCID: PMC10081898 DOI: 10.1155/2023/1765317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 04/03/2023] Open
Abstract
Objective. To identify factors that affect salivary gland recovery, we investigated the expression and function of bone morphogenetic protein 2 (BMP2) in mice. Materials and Methods. Using a micro clip, mice parotid glands were removed 7 days after the ligation of the unilateral parotid excretory duct. Thereafter, they were weighed and stained with hematoxylin and eosin, and BMP2 expression was examined via real-time reverse transcription-polymerase chain reaction. Primary cultures of parotid glands were prepared, and BMP2 protein was added to the culture medium for 48 hr to examine its effect on cell proliferation. E-cadherin and vimentin expression was examined using western blotting. Finally, immunohistochemical staining using an anti-Ki67 antibody was performed. Results. Duct-ligated parotid glands weighed less than those that were collected after sham surgery and showed acinar cell atrophy. They also showed higher BMP2 expression than control glands. Primary-cultured parotid acinar cells supplemented with BMP2 showed higher proliferative potential than control cells. Furthermore, they showed E-cadherin, but not vimentin, expression, and their percentage of Ki67-positive cells were higher than that corresponding to the controls. Conclusions. Injury to salivary glands by excretory duct ligation increased BMP2 expression, which may be involved in maintaining salivary gland function by inducing acinar cell proliferation.
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Affiliation(s)
- Megumi Yokoyama
- Department of Physiology, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Osamu Katsumata-Kato
- Department of Physiology, Nihon University School of Dentistry at Matsudo, Chiba, Japan
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Śledzińska A, Śledzińska P, Bebyn M, Komisarek O. Title: Chemotherapy-Induced Oral Complications and Prophylaxis Strategies. Cancer Invest 2023:1-24. [PMID: 36892292 DOI: 10.1080/07357907.2023.2188558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Cancer is currently a significant therapeutic challenge and is frequently connected with numerous adverse effects. Despite many improvements in chemotherapy, oral complications are common, leading to poor quality of life and chemotherapeutic dose reduction, which impair survival. This review summarizes the most common dental complications in patients receiving chemotherapy. We mainly focus on oral mucositis as it is a major cause of dose-limiting toxicity. Furthermore, oral candidiasis, viral infections, and xerostomia will be discussed. Conclusions: preventing complications is significantly more important than treating them. All patients beginning systemic anticancer treatment should undergo a thorough oral examination and get appropriate prophylaxis.
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Affiliation(s)
- Aleksandra Śledzińska
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznań, Poland
| | - Paulina Śledzińska
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Marek Bebyn
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Oskar Komisarek
- Department of Maxillofacial Orthopedics and Orthodontics, Fredry 10, 61-701 Poznań University of Medical Sciences, Poznan, Poland
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Ferraz LN, Vieira I, Ambrosano GMB, Lopes MA, Lima DANL. Effect of bleaching gels with different thickeners under normal and hyposalivation conditions: in situ study. J Appl Oral Sci 2022; 30:e20220285. [PMID: 36477556 PMCID: PMC9724495 DOI: 10.1590/1678-7757-2022-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Bleaching gel thickeners induce important changes in tooth enamel and these changes are reversed by saliva. OBJECTIVE This in situ study aimed to evaluate the effect of bleaching gels with different thickeners on tooth enamel under normal and hyposalivation conditions. METHODOLOGY Of 28 participants, 14 had normal salivary flow and 14 had low salivary flow. For each salivary flow, four types of treatment were performed with different thickeners: no bleaching (negative control), bleaching with a commercial 10% carbamide peroxide (CP) gel with carbopol (positive control) and bleaching with experimental 10% CP gels with natrosol and aristoflex. Participants used a palatal appliance containing bovine enamel/dentin specimens for 15 days. From day 2 to day 15, specimens were bleached extraorally. The bleaching gel was applied according to the groups for four hours. When the bleaching gel was removed, the palatal appliance was inserted again in the participants' mouth until the next day for another bleaching application. This procedure was repeated for 14 days and on day 15, surface microhardness (SMH), color (ΔE*ab and ΔE00), surface roughness (Ra), scanning electron microscopy (SEM), and energy-dispersive X-ray spectrometry (EDS) analyses were performed and data were subjected to statistical analysis. RESULTS Neither salivary flow nor thickeners influenced ΔE*ab and ΔE00 results. Carbopol had the lowest SMH, the highest Ra, and the lowest Ca% among all groups. For normal flow, natrosol and aristoflex had higher SMH. For low flow, aristoflex had higher SMH and natrosol and aristoflex had lower Ra. Aristoflex had higher Ca% and Ca/P and differed from carbopol for normal flow. CONCLUSION For normal flow, 10% CP gels with natrosol and aristoflex caused fewer surface changes, and for low flow, only the 10% CP gel with aristoflex.
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Affiliation(s)
- Laura Nobre Ferraz
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Odontologia RestauradoraPiracicabaSPBrasilUniversidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora, Piracicaba, SP, Brasil.,Corresponding address: Laura Nobre Ferraz, Universidade Estadual de Campinas - Faculdade de Odontologia de Piracicaba - Departamento de Odontologia Restauradora - Av. Limeira, 901 - Zip Code 13414-903 - Piracicaba - SP - Brazil. Phone: +55 19 997835350,
| | - Isabele Vieira
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Odontologia RestauradoraPiracicabaSPBrasilUniversidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora, Piracicaba, SP, Brasil.
| | - Gláucia Maria Bovi Ambrosano
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Odontologia SocialPiracicabaSPBrasilUniversidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Social, Piracicaba, SP, Brasil.
| | - Márcio Ajudarte Lopes
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Diagnóstico OralPiracicabaSPBrasilUniversidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral, Piracicaba, SP, Brasil.
| | - Débora Alves Nunes Leite Lima
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Odontologia RestauradoraPiracicabaSPBrasilUniversidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora, Piracicaba, SP, Brasil.
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12
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Faruque M, Wanschers M, Ligtenberg AJ, Laine ML, Bikker FJ. A review on the role of salivary MUC5B in oral health. J Oral Biosci 2022. [DOI: 10.1016/j.job.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
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13
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Siripamitdul P, Sivavong P, Osathanon T, Pianmee C, Sangsawatpong W, Bunsong C, Nantanapiboon D. The Effects of Radiotherapy on Microhardness and Mineral Composition of Tooth Structures. Eur J Dent 2022. [PMID: 35944576 DOI: 10.1055/s-0042-1746414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the microhardness and mineral composition alterations in enamel and dentine after radiotherapy. MATERIALS AND METHODS Forty human maxillary premolar teeth (20 pairs) were assigned to nonirradiated and irradiated groups, the latter irradiated by fractional radiation to achieve a total dose of 70 Gy. Microhardness measurement was performed on a Knoop microhardness tester. Chemical components were analyzed using energy dispersive spectroscopy and Fourier transform Raman spectroscopy. The morphology was observed using a scanning electron microscope. The microhardness data were analyzed using a paired t-tested and one-way repeated analysis of variance (ANOVA), and the mineral composition data using related-samples Wilcoxon signed rank test and related-samples Friedman's two-way ANOVA by ranks. RESULTS The irradiated teeth had a significantly lower microhardness in both enamel and dentine compared with the nonirradiated teeth. The irradiated dentine at 50 μm from the external tooth surface at the cemento-enamel junction showed the lowest microhardness compared with other locations. There was no statistically significant difference in calcium:phosphate ratio and chemical components. There was a reduction in protein:mineral ratio in dentine and at the cemento-enamel junction after irradiation. The irradiated teeth exhibited crack lines at the dentine-enamel junction and in dentine. CONCLUSION Fractional radiation reduced microhardness in both enamel and dentine. The cervical dentine exhibited the highest microhardness reduction compared with other enamel and dentine locations.
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Affiliation(s)
- Patcharawat Siripamitdul
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pimduean Sivavong
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Thanaphum Osathanon
- Dental Stem Cell Biology Research Unit and Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | | | | | - Dusit Nantanapiboon
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Dental Material Research and Development Center, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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14
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Harada K, Ferdous T, Fujiwara R, Watanabe K, Mizukami Y, Mishima K. An elemental diet protects mouse salivary glands from 5‑fluorouracil‑induced atrophy. Oncol Lett 2022; 23:178. [PMID: 35464303 PMCID: PMC9025579 DOI: 10.3892/ol.2022.13298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/14/2022] [Indexed: 11/18/2022] Open
Abstract
An elemental diet (ED) reduces adverse effects of chemotherapy, including oral mucositis, in patients with cancer. However, the detailed mechanism(s) of the healing effects of an ED remains unclear. In the present study, the protective effects of the ED, Elental®, were examined against 5-fluorouracil (5-FU)-induced oral mucositis and salivary gland atrophy in mice. Mucositis was induced in female ICR mice by injection of 5-FU. The mice were orally administered Elental® (ED group) or saline (control group). After treatment, the mice body weight, salivary gland weight and the histological changes in the salivary gland granular duct area were monitored. The mice body weight remained stable in the ED group, but was significantly decreased in the control group. Moreover, the salivary gland weight was higher in the ED group compared with the control group. In addition, the salivary gland granular duct area cells were larger in the ED group compared with the control group. Whole transcriptome analysis and network analysis were conducted to understand the mechanisms of action of Elental® against oral mucositis. Whole transcriptome analysis and Ingenuity Pathways Analysis data suggested that Elental® contributed to the recovery of mitochondrial function in 5-FU-damaged salivary glands. Immunohistochemical analysis of salivary gland tissue demonstrated that the expression of cytochrome c oxidase subunit 4 and epidermal growth factor were higher in the ED group compared with the control group. Next, the rate of apoptosis in the salivary glands was examined using terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) assays. The number of TUNEL-positive cells in the salivary glands was lower in the ED group compared with the control group. These findings suggested that Elental® may protect mouse salivary glands from 5-FU-induced atrophic changes, which suggests that ED treatment may improve xerostomia and alleviate oral mucositis in patients with cancer receiving 5-FU-based chemotherapy.
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Affiliation(s)
- Koji Harada
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755‑8505, Japan
| | - Tarannum Ferdous
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755‑8505, Japan
| | - Rieko Fujiwara
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755‑8505, Japan
| | - Kenji Watanabe
- Center for Gene Research, Yamaguchi University, Ube, Yamaguchi 755‑8505, Japan
| | - Yoichi Mizukami
- Center for Gene Research, Yamaguchi University, Ube, Yamaguchi 755‑8505, Japan
| | - Katsuaki Mishima
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755‑8505, Japan
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15
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Al-Zubidi N, Page JC, Gombos DS, Srivastava A, Appelbaum E, Gidley PW, Chambers MS, Nader ME. Immune-Related Oral, Otologic, and Ocular Adverse Events. Adv Exp Med Biol 2022; 1342:399-416. [PMID: 34972977 DOI: 10.1007/978-3-030-79308-1_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Emerging immunotherapeutic agents, including immune checkpoint inhibitors targeting cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), programmed cell death protein 1 (PD-1), and programmed cell death protein ligand 1 (PD-L1), have revolutionized cancer treatment. The first immune checkpoint inhibitor (ICI) ipilimumab, an anti-CTLA-4, was approved in 2011. Since then, the US Food and Drug Administration (FDA) has approved more than half a dozen immune checkpoint inhibitors to treat various malignancies. These agents are part of a broader class of chemotherapy agents termed immunotherapy, which selectively target different steps in the immune response cascade to upregulate the body's normal response to cancer. While the effects of traditional chemotherapy are well known, the toxicity profile of emerging immune therapies is not fully elucidated. They have been associated with atypical side effects labeled collectively as immune-related adverse events (irAEs).
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Affiliation(s)
- Nagham Al-Zubidi
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Cody Page
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Dan S Gombos
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Akanksha Srivastava
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eric Appelbaum
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paul W Gidley
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark S Chambers
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marc-Elie Nader
- Department of Head and Neck Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Fujiwara R, Harada K, Ferdous T, Mishima K. Amino Acids May Have Protective Effects on Salivary Glands of 5-FU-administered Mice. In Vivo 2022; 36:198-205. [PMID: 34972715 DOI: 10.21873/invivo.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIM This study aimed to identify the most useful components of Elental® in the treatment of 5-fluorouracil (FU)-induced mucositis and salivary gland atrophy in mice. MATERIALS AND METHODS Mice (except the control group) were intraperitoneally injected with 5-FU. The mice received saline (control group and 5-FU group), dextrin (Dextrin group), amino acids (17AA group), or Elental® (Elental® group). RESULTS The volume and weight of salivary glands was higher in 17AA and Elental® groups compared to 5-FU group. The number of mucous glands was higher, whereas the number of damaged granular ductal epithelial cells was lower in the salivary glands of all groups except the 5-FU group. Salivation was also decreased in the 5-FU group compared to the other groups. CONCLUSION Amino acids could be the most effective components of Elental® for protecting mouse salivary glands from 5-FU-induced atrophic changes, and might be useful in the treatment of oral mucositis in cancer patients.
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Affiliation(s)
- Rieko Fujiwara
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Koji Harada
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Tarannum Ferdous
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Katsuaki Mishima
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
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17
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Yu IC, Liu CY, Fang JT. Effects of hemodialysis treatment on saliva flow rate and saliva composition during in-center maintenance dialysis: a cross-sectional study. Ren Fail 2021; 43:71-78. [PMID: 33327832 PMCID: PMC7751405 DOI: 10.1080/0886022x.2020.1857769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim To analyze changes in saliva flow rate and clinical measures from unstimulated whole saliva (UWS) among patients undergoing hemodialysis for end-stage kidney disease (ESKD). Background Chronic hemodialysis causes changes in blood chemistry as well as dry mouth, due to removal of excess fluids. UWS is used to examine saliva flow rate as an indicator of mouth dryness. Whether UWS can be used to measure changes in clinical variables following hemodialysis has not been explored. Design A cross-sectional quantitative study. Methods Patients with ESKD were recruited by purposive sampling (n = 100) between 1 January and 30 June 2015 from a hospital in northern Taiwan. UWS was collected 1-hour pre-dialysis (T1), mid-dialysis (T2), and 1-hour post-dialysis (T3). Saliva flow rate and clinical variables were analyzed. Results Saliva flow rate increased significantly from T1 to T3 (Wald χ2 = 10.40, p < .01). Changes in saliva from T1 to T3 included decreases in blood urea nitrogen and creatinine (Wald χ2 = 97.12, p < .001 and Wald χ2 = 36.98, p < .001, respectively). The pH and osmolality also decreased (p < .001 and p < .01, respectively). Changes in electrolytes included decreases in potassium and calcium (Wald χ2 = 6.71, p < .05 and Wald χ2 = 17.64, p < .01, respectively) and increases in chloride (Wald χ2 = 17.64, p < .001). Conclusion Our findings demonstrated saliva flow rate and several saliva components were altered during hemodialysis. The total volume of saliva secretion increased following dialysis, which can reduce xerostomia. Therefore, medical personnel could provide interventions of relieving dry mouth symptoms and increasing saliva flow rate before hemodialysis treatment.
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Affiliation(s)
- I-Chen Yu
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan.,Department of Nephrology, Chang Gung Memorial Hospital in Linkou, Tao-Yuan, Taiwan
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ji-Tseng Fang
- Department of Nephrology, Chang Gung Memorial Hospital in Linkou, Tao-Yuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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18
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Ferraz LN, Vieira I, Ambrosano GMB, Lopes MA, Lima DANL. Effect of tooth bleaching and application of different dentifrices on enamel properties under normal and hyposalivation conditions: an in situ study. Clin Oral Investig 2021. [PMID: 34115201 DOI: 10.1007/s00784-021-03899-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this in situ study was to evaluate different dentifrices on enamel after bleaching under normal and hyposalivatory conditions. MATERIALS AND METHODS Twenty-four participants were assigned of which 12 had normal and 12 had low salivary flow. The study was conducted in 6 in situ experimental phases of 24 h duration: placebo, NaF, SnF2, F/Sn/Chitosan, F/Arginine, and F/Bioactive Glass. The specimens were previously bleached in vitro. Microhardness (SMH), roughness (Ra), and color analyses (CIELAB and ΔE00) were performed at baseline (T1), after bleaching (T2) and after in situ phase (T3). Scanning electron microscopy (SEM) and the elemental levels (wt%) of Ca, P, and Na and the proportion between Ca and P were determined using an energy-dispersive X-ray spectrometer (EDS) in T3. The SMH and Ra were analyzed by mixed models for repeated measures and Tukey Kramer. The color and Na% were analyzed by split-plot ANOVA and Tukey test. The EDS were analyzed by Mann's Whitney nonparametric, Friedman, and Nemenyi tests (p<0.05). RESULTS The dentifrices placebo and NaF in the low flow presented lower SMH and higher Ra in T3 and lower Ca% compared to the same dentifrices in normal flow. For normal flow, SnF2 resulted in greater SMH. For low flow, SnF2, F/Sn/Chitosan, and F/Bioactive Glass resulted in higher SMH in T3 and did not differ from T1. F/Bioactive Glass showed lower Ra among the dentifrices evaluated for both salivary flows, whereas SnF2 showed the highest. F/Bioactive Glass showed a statistically significant difference from placebo for Ca%, P%, Na%. For ΔE*ab and ΔE00 (T1×T3), no differences were found for the dentifrices and salivary flows. CONCLUSION The low salivary flow had less capacity for remineralization of bleached enamel compared to normal flow. Overall, the dentifrice with bioactive glass had the best performance in bleached enamel under low and normal salivary flow condition. CLINICAL RELEVANCE It is recommended to use a bioactive glass-based dentifrice after bleaching to promote tooth enamel recovery for patients with or without impaired salivary flow.
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Dyal BW, Powell-Roach KL, Robison J, Campbell B, Yoon SL, Wilkie DJ. Sublingual Versus Swallowed Morphine: A Comparison. Cancer Nurs 2021; 44:E13-22. [PMID: 31895174 DOI: 10.1097/NCC.0000000000000784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The optimal route for immediate-release morphine administration is controversial. The known physical characteristics of morphine that allow absorption are counter to the unproven belief that sublingual morphine is absorbed more quickly. OBJECTIVE The aim of this study was to compare swallowed and sublingual morphine for effects on plasma morphine concentrations (PMCs), pain relief, and taste. METHODS Ten participants with cancer (mean age, 50 ± 12 years) received a 10-mg morphine tablet in a randomized crossover design with repeated premeasure and postmeasure for 60 minutes. Measures included PMC and visual analog scale (100 mm) scores for pain relief and taste. RESULTS Interindividual variability in maximum PMC was 25-fold (2.2-55 ng/mL). At 60 minutes, sublingual and swallowed routes were not significantly different for mean area under the curve for PMC (swallowed, 329 ± 314 ng/mL; sublingual, 314 ± 299 ng/mL) or for mean pain relief scores (swallowed, 81 ± 32; sublingual, 78 ± 31). Taste scores at 5 (P < .05), 10 (P < .04), 15 (P < .02), and 20 (P < .04) minutes after swallowed doses were significantly less unpleasant than after sublingual doses. CONCLUSION In this crossover design, between-group PMCs were similar for sublingual and swallowed morphine and resulted in a similar level of pain relief. Given the 25-fold across-participant differences in PMC after the same dose, additional research is warranted to identify the sources of this tremendous variability in PMC. IMPLICATIONS FOR PRACTICE Because of unpleasant taste, which could influence adherence and subsequent analgesia, clinicians should encourage patients to swallow their morphine doses and restrict use of sublingual morphine to individuals who are unable to swallow.
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Abstract
Of all the oral sensations that are experienced, "metallic" is one that is rarely reported in healthy participants. So why, then, do chemotherapy patients so frequently report that "metallic" sensations overpower and interfere with their enjoyment of food and drink? This side-effect of chemotherapy-often referred to (e.g., by patients) as "metal mouth"-can adversely affect their appetite, resulting in weight loss, which potentially endangers (or at the very least slows) their recovery. The etiology of "metal mouth" is poorly understood, and current management strategies are largely unevidenced. As a result, patients continue to suffer as a result of this poorly understood phenomenon. Here, we provide our perspective on the issue, outlining the evidence for a range of possible etiologies, and highlighting key research questions. We explore the evidence for "metallic" as a putative taste, and whether "metal mouth" might therefore be a form of phantageusia, perhaps similar to already-described "release-of-inhibition" phenomena. We comment on the possibility that "metal mouth" may simply be a direct effect of chemotherapy drugs. We present the novel theory that "metal mouth" may be linked to chemotherapy-induced sensitization of TRPV1. Finally, we discuss the evidence for retronasal olfaction of lipid oxidation products in the etiology of "metal mouth." This article seeks principally to guide much-needed future research which will hopefully one day provide a basis for the development of novel supportive therapies for future generations of patients undergoing chemotherapy.
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Affiliation(s)
- Alastair J M Reith
- Oxford Medical School, Medical Sciences Division, John Radcliffe Hospital, UK
| | - Charles Spence
- Crossmodal Research Laboratory, Department of Experimental Psychology, Oxford University, UK
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Mansy M, Soliman M, Mubarak R, Shamel M. The role of exogenous epidermal growth factor on Ki-67 proliferation marker expression in the submandibular salivary gland of albino rats receiving doxorubicin. F1000Res 2020; 9:1393. [PMID: 33456767 PMCID: PMC7797936 DOI: 10.12688/f1000research.27186.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/20/2022] Open
Abstract
Background: This study was conducted to evaluate the role of exogenous epidermal growth factor (EGF) injection on the Ki-67 immuno-expression in submandibular salivary gland tissue of rats receiving doxorubicin (DXR). Methods: A total of 21 two-month-old male albino rats, of 200 g body weight, were divided into three groups: control group; DXR group, the rats received 20 mg/kg body weight DXR as a single intra peritoneal injection; DXR+EGF group, the rats received the same dose of DXR and on the next day they were injected intraperitoneally with 10 µg/kg body weight of EGF daily for one week. Histological sections and immunohistochemical expression of Ki67 sections were examined using a ZEISS Primo Star light microscopy and images taken using Tucsen IS 1000 10.0MP Camera. Results: Ki-67 expression was significantly increased in submandibular salivary glands of rats after DXR injection. However, Ki-67 expression in the glandular tissue was restored to normal levels after EGF injection. Conclusions: EGF preserved glandular architecture after DXR injection and maintained Ki-67 immune-expression within the glandular tissue near to the normal level.
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Affiliation(s)
- Mohamed Mansy
- Department of Oral Biology, Jazan University, Jazan, Saudi Arabia
| | - Malak Soliman
- Department of Oral Biology, Cairo University, Cairo, Egypt
| | - Rabab Mubarak
- Department of Oral Biology, Cairo University,Vice Dean of faculty of Dentistry, Deraya University, Cairo, Egypt
| | - Mohamed Shamel
- Department of Oral Biology, The British University in Egypt, Shorouk city, Egypt
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22
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Chen WC, Tsai MS, Tsai YT, Lai CH, Lee CP, Chen MF. Long-Term Taste Impairment after Intensity-Modulated Radiotherapy to Treat Head-and-Neck Cancer: Correlations with Glossectomy and the Mean Radiation Dose to the Oral Cavity. Chem Senses 2020; 44:319-326. [PMID: 30957861 DOI: 10.1093/chemse/bjz018] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We explored the effects of various parameters on taste impairments (TIs) in head-and-neck (H&N) cancer patients receiving intensity-modulated radiotherapy (IMRT). From January 2014 to September 2017, 88 H&N cancer patients subjected to curative or postoperative IMRT were enrolled in this prospective study. All patients underwent at least 1 year of follow-up after IMRT. Quality-of-life assessments in terms of patient-reported gustatory function were measured using the taste-related questions of the European Organization for Research and Treatment of Cancer H&N35 questionnaires. At a median follow-up time of 27 months, 27 of 88 patients (30.7%) reported long-term TIs. In multivariate analyses, glossectomy most significantly predicted TIs (P = 0.04). The percentage of TIs (61.5%) was significantly (P = 0.03) higher in patients who underwent partial or total glossectomy than in patients who did not undergo surgery (28.0%) and those who underwent radical surgery without glossectomy (20.0%). When we excluded surgical patients from analyses, the mean radiation dose to the oral cavity was of borderline significance in terms of TI prediction (P = 0.05). Only 10.5% of patients suffered from TIs when the mean radiation dose was <5000 cGy compared with 38.7% when the mean dose was ≥5000 cGy. In conclusion, glossectomy is the major cause of long-term TIs in H&N cancer patients receiving IMRT. In patients who do not undergo glossectomy, reduction of the mean radiation dose to the oral cavity may reduce TIs after IMRT.
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Affiliation(s)
- Wen-Cheng Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Tao-yuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chuan-Pin Lee
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Miao-Fen Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Tao-yuan, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Jensen SB, Vissink A, Limesand KH, Reyland ME. Salivary Gland Hypofunction and Xerostomia in Head and Neck Radiation Patients. J Natl Cancer Inst Monogr 2020; 2019:5551361. [PMID: 31425600 DOI: 10.1093/jncimonographs/lgz016] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 05/21/2019] [Accepted: 05/26/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The most manifest long-term consequences of radiation therapy in the head and neck cancer patient are salivary gland hypofunction and a sensation of oral dryness (xerostomia). METHODS This critical review addresses the consequences of radiation injury to salivary gland tissue, the clinical management of salivary gland hypofunction and xerostomia, and current and potential strategies to prevent or reduce radiation injury to salivary gland tissue or restore the function of radiation-injured salivary gland tissue. RESULTS Salivary gland hypofunction and xerostomia have severe implications for oral functioning, maintenance of oral and general health, and quality of life. Significant progress has been made to spare salivary gland function chiefly due to advances in radiation techniques. Other strategies have also been developed, e.g., radioprotectors, identification and preservation/expansion of salivary stem cells by stimulation with cholinergic muscarinic agonists, and application of new lubricating or stimulatory agents, surgical transfer of submandibular glands, and acupuncture. CONCLUSION Many advances to manage salivary gland hypofunction and xerostomia induced by radiation therapy still only offer partial protection since they are often of short duration, lack the protective effects of saliva, or potentially have significant adverse effects. Intensity-modulated radiation therapy (IMRT), and its next step, proton therapy, have the greatest potential as a management strategy for permanently preserving salivary gland function in head and neck cancer patients.Presently, gene transfer to supplement fluid formation and stem cell transfer to increase the regenerative potential in radiation-damaged salivary glands are promising approaches for regaining function and/or regeneration of radiation-damaged salivary gland tissue.
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Affiliation(s)
- Siri Beier Jensen
- Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center, Groningen, The Netherlands
| | | | - Mary E Reyland
- Department of Craniofacial Biology, School of Dental Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
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Saito E, Watari I, Mizumachi-Kubono M, Hsu-Hayashi S, Ono T. Occlusional Modifications Reversibly Alter Aquaporin 5 Expression and Localization in Rat Salivary Glands. Front Physiol 2020; 11:528. [PMID: 32587522 PMCID: PMC7298139 DOI: 10.3389/fphys.2020.00528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/29/2020] [Indexed: 11/22/2022] Open
Abstract
Background Aquaporin 5 (AQP5) is a water channel–forming protein that plays a key role in saliva secretion. A decrease in masticatory function associated with the molar extraction adversely affects the submandibular salivary gland (SMG) in rats, inducing hypertrophic changes in the acinar cells and the expression of AQP5 in acinar cells or intercalated duct of the SMG. However, changes in AQP5 expression and localization in the SMG in association with occlusal modification have not been fully characterized. Methods We examined the influence of the decline and recovery of masticatory function on expression and localization of AQP5 in the rat SMG by inserting and removing an incisor bite plate (IBP). Thirty 5-week-old male Wistar rats were randomly divided into IBP (n = 12), recovery (REC) (n = 6), and control (CON) (n = 12) groups. Each rat in both the IBP and REC groups was fitted with the IBP on its maxillary incisors. Rats without the IBPs served as controls. All rats were fed powder diet and water ad libitum. Rats in the IBP and CON groups were sacrificed after 14 (n = 6) and 28 (n = 6) days after the IBP attachment. In the REC group, the IBP was detached on the 14th day and sacrificed on 28th day after the IBP attachment. AQP5 mRNA expression was quantified by reverse transcription–polymerase chain reaction. Changes in the localization of AQP5 were tracked by immunohistochemical staining. Results Attachment of IBP resulted in a decrease in the expression of AQP5 in the IBP group. Changes in the localization of AQP5 were observed between 14 and 28 days in the IBP group. In contrast, changes in the expression and localization of AQP5 were not observed in the REC group. Conclusion Findings suggested that a loss of molar occlusion, due to the IBP attachment, altered AQP5 expression and localization in the rat SMG. However, removal of the bite plate allowed the recovery of both AQP5 expression and its normal localization in the SMGs.
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Affiliation(s)
- Eri Saito
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ippei Watari
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mariko Mizumachi-Kubono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sumire Hsu-Hayashi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Hassan SS, Attia MA, Attia AM, Nofal RA, Fathi A. Distribution of Cytokeratin 17 in the Parenchymal Elements of Rat's Submandibular Glands Subjected to Fractionated Radiotherapy. Eur J Dent 2020; 14:440-447. [PMID: 32590870 PMCID: PMC7440947 DOI: 10.1055/s-0040-1713705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives
The aim of this research was to study the intensity of cytokeratin 17 (CK17) in the parenchymal elements of rat’s submandibular salivary glands subjected to fractionated radiotherapy regimen that used for treatment of head and neck malignancy.
Materials and Methods
Twenty male albino rats were divided into two equal groups (normal and irradiated). The irradiated group received a radiation dose of 5 Grays daily for 5 days using therapeutic X-ray beam. Six months later, submandibular gland was dissected out and prepared for both histological and immunohistochemical studies.
Results
Submandibular gland of irradiated group showed two different types of histological alterations. The first alteration showed severe gland atrophy replaced by either fibrous or fatty tissues. In some sections, the gland exhibited proliferating activity in the form of profuse amounts of mitotic figures. Immunohistochemical examination of control glands displayed a mild cytoplasmic expression of CK17 of duct cells as well as serous acini. The staining pattern was either diffused or concentrated at the basal part of the cell with negative expression at its apical part.
Statistical Analysis
Expression of CK17 in submandibular gland of irradiated group displayed a highly significant differences (P < 0.001) in both intercalated and striated ducts. Many serous acini displayed a highly significant differences (P < 0.001) whereas, mucous acini were negatively stained.
Conclusions
The intensity and diffusion of CK17 expression in our results foretell the pathological effect of radiotherapy on the intermediate filaments of salivary gland parenchyma that interfered with production and/or secretion of saliva leading to xerostomia.
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Affiliation(s)
- Sherif S Hassan
- Department of Oral Biology and Dental Anatomy, Faculty of Dentistry, Al-Azhar University (Assiut), Egypt and, Umm Al-Qura University, Saudi Arabia
| | - Mahmoud A Attia
- Department of Oral Pathology, Faculty of Dentistry, Al-Azhar University, (Assiut), Egypt and Faculty of Applied Medical Science, Al-Baha University, Saudi Arabia
| | - Alaa M Attia
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Al-Azhar University (Assiut), Egypt and Umm Al-Qura University, Saudi Arabia
| | - Reda A Nofal
- Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Al-Azhar University (Assiut), Egypt
| | - Adel Fathi
- Department of Pedodontics and Oral Health, Faculty of Dentistry, Al-Azhar University (Cairo), Egypt and Umm Al-Qura University, Saudi Arabia
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Chen H, Zhou Y, Zhou X, Liao B, Xu HHK, Chu CH, Cheng L, Ren B. Dimethylaminododecyl methacrylate inhibits Candida albicans and oropharyngeal candidiasis in a pH-dependent manner. Appl Microbiol Biotechnol 2020; 104:3585-95. [PMID: 32125481 DOI: 10.1007/s00253-020-10496-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 01/28/2020] [Accepted: 02/20/2020] [Indexed: 02/05/2023]
Abstract
The prevalence of stomatitis, especially that caused by Candida albicans, has highlighted the need for new antifungal agents. We previously found that a type of quaternary ammonium salts, dimethylaminododecyl methacrylate (DMADDM), incorporated in dental materials inhibited the growth and hyphal development of C. albicans. However, how the quaternary ammonium salts inhibited the fungal pathogens and whether the oral condition, such as salivary pH variation under different diseases, can affect the antimicrobial capacity of quaternary ammonium salts is unknown. This study evaluated the antifungal effects of DMADDM at different pH in vitro and in vivo. A pH-dependent antifungal effect of DMADDM was observed in planktonic and biofilm growth. DMADDM enhanced antifungal activity at alkaline pH. Two pH-regulated genes (PHR1/PHR2) of C. albicans were correlated with the pH-dependent antifungal effects of DMADDM. The PHR1/PHR2 genes and pH values regulated the zeta potential of C. albicans, which then influenced the binding between C. albicans cells and DMADDM. The pH-dependent antifungal activity of DMADDM was then substantiated in a murine oropharyngeal candidiasis model. We directly demonstrated that the antifungal abilities of quaternary ammonium salts relied on the cell zeta potential which affected the binding between fungal cells and quaternary ammonium salts. These findings suggest a new antifungal mechanism of quaternary ammonium under different pH and that DMADDM can be a potential antifungal agent applied in dental materials and stomatitis therapy.Key Points • DMADDM has stronger antifungal activity in alkaline than in acidic pH conditions. • The pH values and pH-regulated genes can affect the zeta potential of fungal cells. • Zeta potential of fungal cells directly affect the binding between DMADDM and cells. Graphical abstract Schematic diagram of the antifungal activities of DMADDM at different pH values.
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Srivastava A, Al-Zubidi N, Appelbaum E, Gombos DS, Nader ME, Gidley PW, Chambers MS. Immune-Related Oral, Otologic, and Ocular Adverse Events. Adv Exp Med Biol 2020; 1244:295-307. [PMID: 32301024 DOI: 10.1007/978-3-030-41008-7_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Emerging immunotherapy agents, such as immune checkpoint inhibitors, have shown remarkable promise in the treatment of various malignancies. These drugs selectively target different steps in the immune response cascade to upregulate the body's normal response to cancer. Due to the novelty of these therapeutic agents, their toxicity profile is less well understood.Meta-analysis results reveal that the overall prevalence of oral mucositis, stomatitis, and xerostomia is lower with checkpoint inhibitors compared to conventional chemotherapy, and head and neck radiation therapy. However, the widespread use of immunotherapy reveals new oral mucosal barrier adverse events, including bullous pemphigoid, mucous membrane pemphigoid, and lichenoid mucositis. Audiovestibular dysfunction can occur from autoimmune-mediated pathways of immunotherapy (adoptive cell) with limited treatment options. Such auditory complications can lead to speech recognition deficits and sensorineural hearing loss. Ocular toxicities are among the most common adverse events resulting from the use of these agents. The majority of ocular immune-related adverse events (irAEs) are mild, low-grade, non-sight threatening, such as blurred vision, conjunctivitis, and ocular surface disease. Serious and sight-threatening events, including corneal perforation, optic neuropathy, and retinal vascular occlusion, can occur but are infrequent. In this chapter, we review the current evidence on the clinical manifestations of oral, audiovestibular, and ocular immune-related adverse events (i.e., irAEs).
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Kaae JK, Stenfeldt L, Hyrup B, Brink C, Eriksen JG. A randomized phase III trial for alleviating radiation-induced xerostomia with chewing gum. Radiother Oncol 2020; 142:72-78. [DOI: 10.1016/j.radonc.2019.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/31/2019] [Accepted: 09/16/2019] [Indexed: 01/07/2023]
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Sousa AS, Silva JF, Pavesi VCS, Carvalho NA, Ribeiro-Júnior O, Varellis MLZ, Prates RA, Bussadori SK, Gonçalves MLL, Horliana ACRT, Deana AM. Photobiomodulation and salivary glands: a systematic review. Lasers Med Sci 2019; 35:777-788. [DOI: 10.1007/s10103-019-02914-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
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Kaae JK, Spejlborg ML, Spork U, Bjørndal K, Eriksen JG. Reducing Late Dysphagia for Head and Neck Cancer Survivors with Oral Gel: A Feasibility Study. Dysphagia 2019; 35:231-241. [PMID: 31073746 PMCID: PMC7136308 DOI: 10.1007/s00455-019-10018-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/29/2019] [Indexed: 11/24/2022]
Abstract
Dysphagia is a significant late morbidity following treatment with radiotherapy (RT) for head and neck squamous cell carcinomas (HNSCC). The purpose of this feasibility study was to test a gel-based saliva substitute to reduce the subjective assessment of dysphagia while eating food items varying in size and texture. Eligible study subjects treated with curative intended RT and suffering from dysphagia and xerostomia were recruited from the outpatient clinic during a two-month period. Nineteen subjects consented to participation and completed the EORTC QLQ-H&N35 questionnaire and three test meals. A Numeric Rating Scale (NRS) was used for subjective assessment of dysphagia during all test meals. All data on patient, tumor, and treatment characteristics were obtained from the Danish Head and Neck Cancer (DAHANCA) database. NRS data suggested reduction of dysphagia after application of the oral gel. The swallowing dysfunctions, discomfort while swallowing (p = 0.008), stuck food items (p = 0.02), and multiple attempts of clearing the throat (p = 0.05), improved significantly for soft and regular items. Both small- and large-sized food items were tested. EORTC QLQ-H&N35 showed improvement regarding eating problems (p = 0.03) and social eating (p = 0.02). No episodes of food aspiration were recorded during the test meals. Late dysphagia reduces QOL and is an important morbidity following RT. In this feasibility study, the oral gel was able to reduce dysphagia while eating soft and selected regular food items. Eating-related EORTC QLQ-H&N35 items also improved, indicating a beneficial reduction in dysphagia after application of the oral gel.
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Affiliation(s)
- Julie Killerup Kaae
- Department of Clinical Research, University of Southern Denmark, J.B. Winslows Vej 19.3, 5000, Odense C, Denmark. .,Department of Oncology, Odense University Hospital, Kløvervænget 19, Entrance 85, 5000, Odense C, Denmark.
| | - Marie Louise Spejlborg
- Department of Oncology, Odense University Hospital, Kløvervænget 19, Entrance 85, 5000, Odense C, Denmark
| | - Ulrik Spork
- Salient Pharma IvS, Taarbaeck Strandvej 108A, 2930, Klampenborg, Denmark
| | - Kristine Bjørndal
- Department of Otolaryngology - Head and Neck Surgery, Odense University Hospital, J.B. Winslows Vej 4, 5000, Odense C, Denmark
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
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Shin K, Koo KH, Jeong J, Park SJ, Choi DJ, Ko YG, Kwon H. Three-Dimensional Culture of Salivary Gland Stem Cell in Orthotropic Decellularized Extracellular Matrix Hydrogels. Tissue Eng Part A 2019; 25:1396-1403. [PMID: 30632466 DOI: 10.1089/ten.tea.2018.0308] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Radiotherapy in patients with cancer can kill cancer cells but also damage normal cells or tissues. During the treatment of patients with head and neck cancer or thyroid cancer, hyposalivation is a representative chronic side effect of radio-damaged salivary glands (SGs). The major symptom of hyposalivation is mouth dryness, resulting in several subsequent long-term complications. No effective therapeutic approaches have been developed to manage this symptom. In this study, we developed the first rat SG tissue-derived decellularized extracellular matrix hydrogel (DSGM-hydrogel) as a functional orthotropic bioscaffold for future efficient SG stem cell therapy. DSGM-hydrogels were characterized by rheological or biochemical analyses, and rat SG stem/progenitor cells (rSGSCs) were then subjected to three-dimensional culture in the DSGM-hydrogels. Interestingly, DSGM-hydrogel-embedded rSGSCs survived and expressed SG functional differentiation marker of amylase IA and increased enzyme activity of α-amylase in protein level, whereas they showed reduced levels of adult ductal stem/progenitor markers, including c-Kit, c-Met, and CD44. Furthermore, the expression levels of basic epithelial tight junction markers were recovered to levels similar to those naked SG tissues after culture in DSGM-hydrogels in transcription level. Therefore, our findings suggested that the DSGM-hydrogels could provide an appropriate microenvironment for stem/progenitor cell survival and a source of SG cytodifferentiation. This approach could be an applicable method to SG stem cell research as a potential source for an organoid and for clinical regenerative reagents to manage radio-damaged SGs in vivo. Impact Statement In this study, we established the first rat salivary gland (SG) tissue-derived decellularized extracellular matrix hydrogel (DSGM-hydrogel) and assessed the role of this hydrogel as a functional orthotropic bioscaffold. Our findings provide important insights into the applications of the DSGM-hydrogel as a biocompatible matrix for regenerative therapy of radio-damaged SGs.
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Affiliation(s)
- Kyungshin Shin
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea.,Department of Biotechnology, Korea University, Seoul, Republic of Korea
| | - Kyung Hee Koo
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea
| | - Jaemin Jeong
- Department of Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Sang Jun Park
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea
| | - Dong Jin Choi
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea
| | - Young-Gyu Ko
- Department of Life Sciences, Korea University, Seoul, Republic of Korea
| | - Heechung Kwon
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea
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Likhterov I, Ru M, Ganz C, Urken ML, Chai R, Okay D, Liu J, Stewart R, Culliney B, Palacios D, Lazarus CL. Objective and subjective hyposalivation after treatment for head and neck cancer: Long-term outcomes. Laryngoscope 2018; 128:2732-2739. [PMID: 30325025 DOI: 10.1002/lary.27224] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study examined saliva weight over time and its association with diet and patient-rated swallowing, dry mouth, sticky saliva, and dysgeusia quality of life in head and neck cancer (HNCA) patients treated with surgery plus adjuvant chemoradiotherapy (CRT), or primary CRT. STUDY DESIGN Prospective cohort study in an outpatient HNCA center setting. METHODS Patients were seen pretreatment, and 1, 3, 6, 12, 24, and 36 + months post-treatment. All had newly diagnosed oral, oropharynx, nasopharynx, larynx/hypopharynx cancer from 2010 to 2016 and were to undergo surgery + CRT or primary CRT. Stimulated saliva weight was assessed with the Saxon test. Diet, eating, dry mouth, and dysgeusia quality of life were assessed and correlated with saliva weight, treatment modality, and tumor site. RESULTS Saliva weight decreased the most within the first 3 months across treatment groups, except for the surgery + CRT group, which continued to decline. Similar trends were seen by tumor site. Performance Status Scale (PSS) Normalcy of Diet and all quality-of-life scores declined following treatment. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck-35 (EORTC QLQ-H&N35); Eating Assessment Tool (EAT-10); M. D. Anderson Dysphagia Inventory (MDADI) Composite, Global, and subdomain scores; and PSS Diet were significantly correlated with saliva weight. CONCLUSIONS Saliva weight worsened post-treatment across groups and tumor site, with improvement by 36 + months. Saliva weight correlated with diet, eating quality of life and perception of dysgeusia across time points. Despite dose-sparing intensity-modulated radiation therapy, newer technologies are needed to preserve saliva production and maintain higher quality of life. LEVEL OF EVIDENCE 2b Laryngoscope, 128:2732-2739, 2018.
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Affiliation(s)
- Ilya Likhterov
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Meng Ru
- Department of Population Health Science and Policy
| | - Cindy Ganz
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Mark L Urken
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Raymond Chai
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Devin Okay
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Jerry Liu
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York
| | - Robert Stewart
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York
| | - Bruce Culliney
- Department of Radiation Oncology.,Department of Medical Oncology, Mount Sinai Health System, New York, New York, U.S.A
| | - Daisy Palacios
- Department of Radiation Oncology.,Department of Medical Oncology, Mount Sinai Health System, New York, New York, U.S.A
| | - Cathy L Lazarus
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
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Çetiner D, Çetiner S, Uraz A, Alpaslan GH, Alpaslan C, Toygar Memikoğlu TU, Karadeniz C. Oral and dental alterations and growth disruption following chemotherapy in long-term survivors of childhood malignancies. Support Care Cancer 2019; 27:1891-9. [DOI: 10.1007/s00520-018-4454-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 08/30/2018] [Indexed: 11/30/2022]
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Abstract
Saliva is a complex fluid produced by 3 pairs of major salivary glands and by hundreds of minor salivary glands. It comprises a large variety of constituents and physicochemical properties, which are important for the maintenance of oral health. Saliva not only protects the teeth and the oropharyngeal mucosa, it also facilitates articulation of speech, and is imperative for mastication and swallowing. Furthermore, saliva plays an important role in maintaining a balanced microbiota. Thus, the multiple functions provided by saliva are essential for proper protection and functioning of the body as a whole and for the general health. A large number of diseases and medications can affect salivary secretion through different mechanisms, leading to salivary gland dysfunction and associated oral problems, including xerostomia, dental caries and fungal infections. The first part of this review article provides an updated insight into our understanding of salivary gland structure, the neural regulation of salivary gland secretion, the mechanisms underlying the formation of saliva, the various functions of saliva and factors that influence salivary secretion under normal physiological conditions. The second part focuses on how various diseases and medical treatment including commonly prescribed medications and cancer therapies can affect salivary gland structure and function. We also provide a brief insight into how to diagnose salivary gland dysfunction.
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Affiliation(s)
- A M L Pedersen
- Oral Medicine, Oral Pathology & Clinical Oral Physiology, University of Copenhagen, Copenhagen, Denmark
| | - C E Sørensen
- Oral Biochemistry, Cariology & Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G B Proctor
- Mucosal & Salivary Biology Division, King's College London Dental Institute, London, UK
| | - G H Carpenter
- Mucosal & Salivary Biology Division, King's College London Dental Institute, London, UK
| | - J Ekström
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Liu B. Treatment of systemic diseases and oral focal infection. Infection International 2018; 6:118-23. [DOI: 10.2478/ii-2018-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractOral lesions are highly correlated with the occurrence and development of many diseases. In addition, the treatment of systemic diseases may aggravate oral focal infections, affect the life quality of patients, interfere with the treatment of systemic diseases, and even cause systemic infection in serious cases. Treatment strategies for systemic diseases may induce or aggravate oral local lesion infections. In specific, administration of oral antiepileptic drugs and immunosuppressive drugs may induce gingivitis, radiotherapy or chemotherapy for malignant tumors may cause oral mucositis, long-term use of bisphosphonates for inhibition of tumor bone metastasis or prevention of osteoporosis may cause osteonecrosis of the jaw, and allogeneic hematopoietic stem cell transplantation may cause oral rejection reactions.
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Palma LF, Gonnelli FAS, Marcucci M, Giordani AJ, Dias RS, Segreto RA, Segreto HRC. A novel method to evaluate salivary flow rates of head and neck cancer patients after radiotherapy: a pilot study. Braz J Otorhinolaryngol 2018; 84:227-231. [PMID: 28400176 PMCID: PMC9449237 DOI: 10.1016/j.bjorl.2017.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/09/2017] [Accepted: 03/04/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction The procedure used to evaluate salivary flow rate is called sialometry. It can be performed through several techniques, but none appears to be really efficient for post-radiotherapy patients. Objective To adequate sialometry tests for head and neck cancer patients submitted to radiotherapy. Methods 22 xerostomic patients post-radiotherapy (total radiation dose ranging from 60 to 70 Gy) were included in this study. Ten patients were evaluated using sialometries originally proposed by the Radiation Therapy Oncology Group and twelve were assessed by our modified methods. Unstimulated and stimulated sialometries were performed and the results were classified according a grading scale and compared between both groups. Results There was no statistically significant difference between the salivary evaluations of both groups (p = 0.4487 and p = 0.5615). Also, most of these rates were classified as very low and low. Conclusion This novel method seems to be suitable for patients submitted to radiotherapy.
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Jaguar GC, Prado JD, Campanhã D, Alves FA. Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s41241-017-0037-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Barbe AG, Schmidt-Park Y, Hamacher S, Derman SHM, Noack MJ. Efficacy of GUM® Hydral versus Biotène® Oralbalance mouthwashes plus gels on symptoms of medication-induced xerostomia: a randomized, double-blind, crossover study. Clin Oral Investig 2017; 22:169-180. [PMID: 28353023 DOI: 10.1007/s00784-017-2096-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/02/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this study is to determine the efficacy of GUM® Hydral versus Biotène® Oralbalance (both a mouthwash plus gel) on the subjective burden and clinical symptoms of patients with medication-induced xerostomia. MATERIALS AND METHODS Subjects (N = 40) with medication-induced xerostomia (minimum 4/10 mm visual analog scale [VAS]) were randomized to treatment with GUM Hydral or Biotène Oralbalance mouthwash, both with gel, for 28 days. Subjects then entered a 21-day wash-out period, before crossing over to the other treatment for 28 days. Outcomes measured included the VAS, German Oral Health Impact Profile (OHIPG)-14, Xerostomia Questionnaire (XQ), after-use questionnaire, and clinical parameters. RESULTS Both GUM Hydral and Biotène Oralbalance significantly (p < 0.05) reduced VAS, OHIPG-14 total score and single items, and XQ Part 1 (oral dryness, oral pain, taste loss) and Part 2 items. GUM Hydral also significantly reduced the XQ Part 1 dysphagia score, while Biotène Oralbalance significantly reduced the halitosis organoleptic score and plaque index. Significant increases in saliva secretion did not reach clinical relevance. No significant between-group differences were observed, apart from OHIPG-14 items "trouble pronouncing words" and "uncertainty" in favor of GUM Hydral. No adverse effects were reported. CONCLUSIONS Both products effectively improve oral health and xerostomia-related quality of life. However, they cannot completely substitute the continuous in-mouth secretion of saliva, and symptomatic relief is temporary. Product selection will be based on personal preference. CLINICAL RELEVANCE Both products diminish xerostomic burden and should be part of the management strategy. Affected patients should be informed of these treatments, since no adverse effects were reported.
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Affiliation(s)
- Anna Greta Barbe
- Centre of Dental Medicine, Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Köln, Germany.
| | - Yasmin Schmidt-Park
- Centre of Dental Medicine, Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Köln, Germany
| | - Stefanie Hamacher
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, 50924, Köln, Germany
| | - Sonja Henny Maria Derman
- Centre of Dental Medicine, Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Köln, Germany
| | - Michael Johannes Noack
- Centre of Dental Medicine, Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Köln, Germany
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Palma LF, Gonnelli FAS, Marcucci M, Dias RS, Giordani AJ, Segreto RA, Segreto HRC. Impact of low-level laser therapy on hyposalivation, salivary pH, and quality of life in head and neck cancer patients post-radiotherapy. Lasers Med Sci 2017; 32:827-832. [DOI: 10.1007/s10103-017-2180-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
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Velten DB, Zandonade E, Monteiro de Barros Miotto MH. Prevalence of oral manifestations in children and adolescents with cancer submitted to chemotherapy. BMC Oral Health 2017; 17:49. [PMID: 28109192 PMCID: PMC5251332 DOI: 10.1186/s12903-016-0331-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/04/2016] [Indexed: 01/16/2023] Open
Abstract
Background Oral complications may be observed during chemotherapy and are important side effects that may directly affect the anticancer treatment, even causing septicaemia in some cases. This research was done in order to evaluate changes in oral lesions during follow-up of children and adolescents in chemotherapy at Hospital Estadual Infantil Nossa Senhora da Glória (HEINSG). Methods The study design was longitudinal, 45 patients were evaluated and monitored for 1 month after the initiation of chemotherapy. Twenty-eight patients were male and 17 female, ranging from 3 months to 18 years old. Results The results show an increase in the number of mucositis cases and a decrease in xerostomia cases after the initiation of treatment, and other oral lesions were also found in low numbers. Conclusions It is possible to avoid oral complications by maintaining a good oral health, and reducing infectious outbreaks. It is also feasible to obtain an early diagnosis of, and treat these oral complications, preventing them from following a more severe clinical course that may negatively affect the individual’s treatment. This outcome requires the presence of a dental surgeon on the multidisciplinary cancer treatment team.
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Affiliation(s)
- Deise Berger Velten
- Federal University of Espírito Santo, Av. Mal. Campos, 1468 - Maruípe, Vitória, ES, 29043-900, Brazil.
| | - Eliana Zandonade
- Federal University of Espírito Santo, Av. Mal. Campos, 1468 - Maruípe, Vitória, ES, 29043-900, Brazil
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Labah D, Wahba O. Flaxseed oil: an emerging nutraceutical decimates cisplatin-induced submandibular salivary glands damage in rats. ACTA ACUST UNITED AC 2017. [DOI: 10.4103/tdj.tdj_7_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cotomacio C, Campos L, Simões A, Jaguar G, Crosato EM, Abreu-Alves F. Influence of bethanechol on salivary parameters in irradiated patients. Med Oral Patol Oral Cir Bucal 2017; 22:e76-e83. [PMID: 27918737 PMCID: PMC5217501 DOI: 10.4317/medoral.21395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 11/25/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Some studies have shown evidence that the prophylactic use of bethanechol chloride (BC) may be useful in preventing the incidence and/or severity of xerostomia (XT). However, the indication of BC in irradiated patients with XT needs to be better characterized. The study aimed to evaluate the influence of BC on XT, salivary flow rate, and salivary composition in patients previously submitted to head and neck radiotherapy. MATERIAL AND METHODS Forty five irradiated patients complaining of XT used 50 mg/day of BC for 3 months, and the salivary parameters were evaluated in 4 Phases (Before BC therapy, after one month of BC, 2 months of BC, and 3 months of BC). Biochemical analysis included buffering capacity; pH; total protein concentration (TP); amylase concentration (AM); catalase (CAT) and peroxidase (PX) activities. In addition, unstimulated and stimulated salivary flow rates were determined and XT was classified. RESULTS According to the XT grading system used, patients showed improvement in XT between Phase 1, and Phases 2, 3 and 4. In addition, some changes were observed in TP concentration (decreased); AM concentration (increased); and PX and CAT activities (decreased and increased, respectively) after Phase 2, for stimulated saliva collection (p<0.05). CONCLUSIONS Our results suggested that when BC was used to treat salivary gland dysfunction induced by head and neck radiotherapy, improvement in XT symptoms, and some changes in saliva composition were shown.
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Affiliation(s)
- C Cotomacio
- Stomatology Department - AC Camargo Hospital, R. Prof. Antônio Prudente, 211, CEP: 01509-900 São Paulo, Brazil,
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Berger Velten D, Zandonade E, Monteiro de Barros Miotto MH. Prevalence of oral manifestations in children and adolescents with cancer submitted to chemotherapy. BMC Oral Health 2016; 16:107. [PMID: 27716167 PMCID: PMC5047274 DOI: 10.1186/s12903-016-0300-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/04/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Oral complications may be observed during chemotherapy and are important side effects that may directly affect the anticancer treatment, even causing septicaemia in some cases. This research was done in order to evaluate changes in oral lesions during follow-up of children and adolescents in chemotherapy at Hospital Estadual Infantil Nossa Senhora da Glória (HEINSG). METHODS The study design was longitudinal, 45 patients were evaluated and monitored for 1 month after the initiation of chemotherapy. Twenty-eight patients were male and 17 female, ranging from 3 months to 18 years old. RESULTS The results show an increase in the number of mucositis cases and a decrease in xerostomia cases after the initiation of treatment, and other oral lesions were also found in low numbers. CONCLUSIONS It is possible to avoid oral complications by maintaining a good oral health, and reducing infectious outbreaks. It is also feasible to obtain an early diagnosis of, and treat these oral complications, preventing them from following a more severe clinical course that may negatively affect the individual's treatment. This outcome requires the presence of a dental surgeon on the multidisciplinary cancer treatment team.
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Affiliation(s)
- Deise Berger Velten
- Federal University of Espírito Santo, Av. Mal. Campos, 1468-Maruípe, Victoria, 29043-900, Brazil.
| | - Eliana Zandonade
- Federal University of Espírito Santo, Av. Mal. Campos, 1468-Maruípe, Victoria, 29043-900, Brazil
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Gonnelli FAS, Palma LF, Giordani AJ, Deboni ALS, Dias RS, Segreto RA, Segreto HRC. Low-Level Laser for Mitigation of Low Salivary Flow Rate in Head and Neck Cancer Patients Undergoing Radiochemotherapy: A Prospective Longitudinal Study. Photomed Laser Surg 2016; 34:326-30. [DOI: 10.1089/pho.2016.4104] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fernanda Aurora Stabile Gonnelli
- Division of Radiotherapy, Department of Imaging Diagnosis, Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo – UNIFESP/EPM/HSP, São Paulo/SP, Brazil
| | - Luiz Felipe Palma
- Division of Radiotherapy, Department of Imaging Diagnosis, Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo – UNIFESP/EPM/HSP, São Paulo/SP, Brazil
| | - Adelmo José Giordani
- Division of Radiotherapy, Department of Imaging Diagnosis, Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo – UNIFESP/EPM/HSP, São Paulo/SP, Brazil
| | - Aline Lima Silva Deboni
- Division of Radiotherapy, Department of Imaging Diagnosis, Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo – UNIFESP/EPM/HSP, São Paulo/SP, Brazil
| | - Rodrigo Souza Dias
- Division of Radiotherapy, Department of Imaging Diagnosis, Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo – UNIFESP/EPM/HSP, São Paulo/SP, Brazil
| | - Roberto Araújo Segreto
- Division of Radiotherapy, Department of Imaging Diagnosis, Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo – UNIFESP/EPM/HSP, São Paulo/SP, Brazil
| | - Helena Regina Comodo Segreto
- Division of Radiotherapy, Department of Imaging Diagnosis, Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo – UNIFESP/EPM/HSP, São Paulo/SP, Brazil
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Patel-yadav A, Singh A. Acupuncture-like transcutaneous nerve stimulation therapy success after 5 years post-radiation-induced xerostomia: a case report. J Radiother Pract 2016; 15:215-217. [DOI: 10.1017/s1460396915000576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundSuccess with acupuncture-like transcutaneous nerve stimulation (ALTENS) in the treatment of radiation-induced xerostomia has not been reported after an extended time.MethodsWe report a case of successful ALTENS therapy 5 years after radiation treatment.ResultsThe patient discontinued treatments in a second course due to complete resolution of symptoms.ConclusionThis case report demonstrates a potential for offering ALTENS to those long suffering from radiation-induced xerostomia.
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Gonnelli FAS, Palma LF, Giordani AJ, Deboni ALS, Dias RS, Segreto RA, Segreto HRC. Low-level laser therapy for the prevention of low salivary flow rate after radiotherapy and chemotherapy in patients with head and neck cancer. Radiol Bras 2016; 49:86-91. [PMID: 27141130 PMCID: PMC4851476 DOI: 10.1590/0100-3984.2014.0144] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective To determine whether low-level laser therapy can prevent salivary
hypofunction after radiotherapy and chemotherapy in head and neck cancer
patients. Materials and Methods We evaluated 23 head and neck cancer patients, of whom 13 received laser
therapy and 10 received clinical care only. An InGaAlP laser was used
intra-orally (at 660 nm and 40 mW) at a mean dose of 10.0 J/cm2
and extra-orally (at 780 nm and 15 mW) at a mean dose of 3.7
J/cm2, three times per week, on alternate days. Stimulated
and unstimulated sialometry tests were performed before the first
radiotherapy and chemotherapy sessions (N0) and at 30 days after the end of
treatment (N30). Results At N30, the mean salivary flow rates were significantly higher among the
laser therapy patients than among the patients who received clinical care
only, in the stimulated and unstimulated sialometry tests
(p = 0.0131 and p = 0.0143,
respectively). Conclusion Low-level laser therapy, administered concomitantly with radiotherapy and
chemotherapy, appears to mitigate treatment-induced salivary hypofunction in
patients with head and neck cancer.
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Affiliation(s)
| | - Luiz Felipe Palma
- Masters Student in Clinical Radiology, Department of Diagnostic Imaging, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Adelmo José Giordani
- PhD, Physicist in Charge of the Medical Physics Sector, Department of Clinical and Experimental Oncology, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | | | - Rodrigo Souza Dias
- PhD, Interim Head of the Radiotherapy Sector, Department of Clinical and Experimental Oncology, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Roberto Araújo Segreto
- Tenured Associate Professor in the Department of Clinical and Experimental Oncology, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Helena Regina Comodo Segreto
- PhD, Associate Professor in the Department of Clinical and Experimental Oncology, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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Vered Y, Chetrit A, Sgan-Cohen HD, Amitai T, Mann J, Even-Nir H, Sadetzki S. Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood - The Tinea Capitis Cohort. Front Public Health 2016; 4:18. [PMID: 26942172 PMCID: PMC4763082 DOI: 10.3389/fpubh.2016.00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/01/2016] [Indexed: 12/12/2022] Open
Abstract
While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low-moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (p = 0.002). Controlling for gender, age, education, income, smoking, dental visit in the last year, and brushing teeth behavior, irradiation was associated with a 72% increased risk for higher DMFT level (95% CI: 1.19-2.50). A quantification of the risk by dose absorbed in the salivary gland and in the thyroid gland showed adjusted ORs of 2.21 per 1 Gy (95% CI: 1.40-3.50) and 1.05 per 1 cGy (95% CI: 1.01-1.09), respectively. Childhood exposure to ionizing radiation (0.2-0.4 Gy) might be associated with late outcomes of dental health. In line with the guidelines of the American Dental Association, these results call for caution when using dental radiographs.
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Affiliation(s)
- Yuval Vered
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Angela Chetrit
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Harold D Sgan-Cohen
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Tova Amitai
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Jonathan Mann
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Hadas Even-Nir
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Theodoro LH, Longo M, Ervolino E, Duque C, Ferro-Alves ML, Assem NZ, Louzada LM, Garcia VG. Effect of low-level laser therapy as an adjuvant in the treatment of periodontitis induced in rats subjected to 5-fluorouracil chemotherapy. J Periodontal Res 2016; 51:669-80. [DOI: 10.1111/jre.12347] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 01/04/2023]
Affiliation(s)
- L. H. Theodoro
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - M. Longo
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - E. Ervolino
- Department of Basic Science; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - C. Duque
- Department of Paediatric and Social Dentistry; São Paulo State University (“Univ Estadual Paulista” - UNESP; Araçatuba SP Brazil
| | - M. L. Ferro-Alves
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - N. Z. Assem
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - L. M. Louzada
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - V. G. Garcia
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
- University Centre of the Educational Foundation of Barretos (UNIFEB); Barretos SP Brazil
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Kawashima R, Fujimaki M, Ikenoue Y, Danjo K, Koizumi W, Ichikawa T. Influence of an elemental diet on 5-fluorouracil-induced morphological changes in the mouse salivary gland and colon. Support Care Cancer 2016; 24:1609-16. [DOI: 10.1007/s00520-015-2947-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 09/14/2015] [Indexed: 12/15/2022]
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