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Ayala G. Neuroepithelial Interactions in Cancer. ANNUAL REVIEW OF PATHOLOGY 2023; 18:493-514. [PMID: 36323005 DOI: 10.1146/annurev-pathmechdis-031521-023248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Nerves not only regulate the homeostasis and energetic metabolism of normal epithelial cells but also are critical for cancer, as cancer recapitulates the biology of neural regulation of epithelial tissues. Cancer cells rarely develop in denervated organs, and denervation affects tumorigenesis, in vivo and in humans. Axonogenesis occurs to supply the new malignant epithelial growth with nerves. Neurogenesis happens later, first in ganglia around organs or the spinal column and subsequently through recruitment of neuroblasts from the central nervous system. The hallmark of this stage is regulation of homeostasis and energetic metabolism. Perineural invasion is the most efficient interaction between cancer cells and nerves. The hallmark of this stage is increased proliferation and decreased apoptosis. Finally, carcinoma cells transdifferentiate into a neuronal profile in search of neural independence. The latter is the last stage in neuroepithelial interactions. Treatments for cancer must address the biology of neural regulation of cancer.
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Affiliation(s)
- Gustavo Ayala
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, McGovern School of Medicine, Houston, Texas, USA;
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2
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Li J, Sudiwala S, Berthoin L, Mohabbat S, Gaylord EA, Sinada H, Cruz Pacheco N, Chang JC, Jeon O, Lombaert IM, May AJ, Alsberg E, Bahney CS, Knox SM. Long-term functional regeneration of radiation-damaged salivary glands through delivery of a neurogenic hydrogel. SCIENCE ADVANCES 2022; 8:eadc8753. [PMID: 36542703 PMCID: PMC9770982 DOI: 10.1126/sciadv.adc8753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/05/2022] [Indexed: 05/11/2023]
Abstract
Salivary gland acinar cells are severely depleted after radiotherapy for head and neck cancer, leading to loss of saliva and extensive oro-digestive complications. With no regenerative therapies available, organ dysfunction is irreversible. Here, using the adult murine system, we demonstrate that radiation-damaged salivary glands can be functionally regenerated via sustained delivery of the neurogenic muscarinic receptor agonist cevimeline. We show that endogenous gland repair coincides with increased nerve activity and acinar cell division that is limited to the first week after radiation, with extensive acinar cell degeneration, dysfunction, and cholinergic denervation occurring thereafter. However, we found that mimicking cholinergic muscarinic input via sustained local delivery of a cevimeline-alginate hydrogel was sufficient to regenerate innervated acini and retain physiological saliva secretion at nonirradiated levels over the long term (>3 months). Thus, we reveal a previously unknown regenerative approach for restoring epithelial organ structure and function that has extensive implications for human patients.
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Affiliation(s)
- Jianlong Li
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Sonia Sudiwala
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Lionel Berthoin
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Seayar Mohabbat
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Eliza A. Gaylord
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Hanan Sinada
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Noel Cruz Pacheco
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Jiun Chiun Chang
- Orthopedic Trauma Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Oju Jeon
- Department of Biomedical Engineering, University of Illinois, Chicago, Chicago, IL, USA
| | - Isabelle M.A. Lombaert
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Biologic and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Alison J. May
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Eben Alsberg
- Department of Biomedical Engineering, University of Illinois, Chicago, Chicago, IL, USA
- Departments of Orthopedics, Pharmacology and Regenerative Medicine, and Mechanical and Industrial Engineering, University of Illinois, Chicago, Chicago, IL, USA
| | - Chelsea S. Bahney
- Orthopedic Trauma Institute, University of California, San Francisco, San Francisco, CA, USA
- Center for Regenerative Sports Medicine, Steadman Philippon Research Institute, Vail, CO, USA
| | - Sarah M. Knox
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA
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Neural Regulations in Tooth Development and Tooth-Periodontium Complex Homeostasis: A Literature Review. Int J Mol Sci 2022; 23:ijms232214150. [PMID: 36430624 PMCID: PMC9698398 DOI: 10.3390/ijms232214150] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
The tooth-periodontium complex and its nerves have active reciprocal regulation during development and homeostasis. These effects are predominantly mediated by a range of molecules secreted from either the nervous system or the tooth-periodontium complex. Different strategies mimicking tooth development or physiological reparation have been applied to tooth regeneration studies, where the application of these nerve- or tooth-derived molecules has been proven effective. However, to date, basic studies in this field leave many vacancies to be filled. This literature review summarizes the recent advances in the basic studies on neural responses and regulation during tooth-periodontium development and homeostasis and points out some research gaps to instruct future studies. Deepening our understanding of the underlying mechanisms of tooth development and diseases will provide more clues for tooth regeneration.
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Rocchi C, Emmerson E. Mouth-Watering Results: Clinical Need, Current Approaches, and Future Directions for Salivary Gland Regeneration. Trends Mol Med 2020; 26:649-669. [PMID: 32371171 DOI: 10.1016/j.molmed.2020.03.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 03/03/2020] [Accepted: 03/27/2020] [Indexed: 12/31/2022]
Abstract
Permanent damage to the salivary glands and resulting hyposalivation and xerostomia have a substantial impact on patient health, quality of life, and healthcare costs. Currently, patients rely on lifelong treatments that alleviate the symptoms, but no long-term restorative solutions exist. Recent advances in adult stem cell enrichment and transplantation, bioengineering, and gene transfer have proved successful in rescuing salivary gland function in a number of animal models that reflect human diseases and that result in hyposalivation and xerostomia. By overcoming the limitations of stem cell transplants and better understanding the mechanisms of cellular plasticity in the adult salivary gland, such studies provide encouraging evidence that a regenerative strategy for patients will be available in the near future.
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Affiliation(s)
- Cecilia Rocchi
- The MRC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh BioQuarter, 5 Little France Drive, Edinburgh, EH16 4UU, UK
| | - Elaine Emmerson
- The MRC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh BioQuarter, 5 Little France Drive, Edinburgh, EH16 4UU, UK.
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Sudiwala S, Knox SM. The emerging role of cranial nerves in shaping craniofacial development. Genesis 2019; 57:e23282. [PMID: 30628162 DOI: 10.1002/dvg.23282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 12/17/2022]
Abstract
Organs and structures of the vertebrate head perform a plethora of tasks including visualization, digestion, vocalization/communication, auditory functions, and respiration in response to neuronal input. This input is primarily derived from afferent and efferent fibers of the cranial nerves (sensory and motor respectively) and efferent fibers of the cervical sympathetic trunk. Despite their essential contribution to the function and integration of processes necessary for survival, how organ innervation is established remains poorly understood. Furthermore, while it has been appreciated for some time that innervation of organs by cranial nerves is regulated in part by secreted factors and cell surface ligands expressed by those organs, whether nerves also regulate the development of facial organs is only beginning to be elucidated. This review will provide an overview of cranial nerve development in relation to the organs they innervate, and outline their known contributions to craniofacial development, thereby providing insight into how nerves may shape the organs they innervate during development. Throughout, the interaction between different cell and tissue types will be highlighted.
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Affiliation(s)
- Sonia Sudiwala
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, University of California, San Francisco, California
| | - Sarah M Knox
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, University of California, San Francisco, California
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Wang DK, Zhang SE, Su YX, Zheng GS, Yang WF, Liao GQ. Microvascular Submandibular Gland Transplantation for Severe Keratoconjunctivitis Sicca: A Single-Institution Experience of 61 Grafts. J Oral Maxillofac Surg 2018; 76:2443-2452. [DOI: 10.1016/j.joms.2018.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/19/2018] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
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Suzuki A, Iwata J. Molecular Regulatory Mechanism of Exocytosis in the Salivary Glands. Int J Mol Sci 2018; 19:E3208. [PMID: 30336591 PMCID: PMC6214078 DOI: 10.3390/ijms19103208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 12/12/2022] Open
Abstract
Every day, salivary glands produce about 0.5 to 1.5 L of saliva, which contains salivary proteins that are essential for oral health. The contents of saliva, 0.3% proteins (1.5 to 4.5 g) in fluid, help prevent oral infections, provide lubrication, aid digestion, and maintain oral health. Acinar cells in the lobular salivary glands secrete prepackaged secretory granules that contain salivary components such as amylase, mucins, and immunoglobulins. Despite the important physiological functions of salivary proteins, we know very little about the regulatory mechanisms of their secretion via exocytosis, which is a process essential for the secretion of functional proteins, not only in salivary glands, but also in other secretory organs, including lacrimal and mammary glands, the pancreas, and prostate. In this review, we discuss recent findings that elucidate exocytosis by exocrine glands, especially focusing on the salivary glands, in physiological and pathological conditions.
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Affiliation(s)
- Akiko Suzuki
- Department of Diagnostic & Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX 77054, USA.
- Center for Craniofacial Research, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX 77054, USA.
| | - Junichi Iwata
- Department of Diagnostic & Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX 77054, USA.
- Center for Craniofacial Research, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX 77054, USA.
- Program of Biochemistry and Cell Biology, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX 77030, USA.
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Lasisi TJ, Shittu ST, Alada AR. Switching to normal diet reverses kwashiorkor-induced salivary impairments via increased nitric oxide level and expression of aquaporin 5 in the submandibular glands of male Wistar rats. Appl Physiol Nutr Metab 2018; 44:365-372. [PMID: 30212637 DOI: 10.1139/apnm-2018-0282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Kwashiorkor, a form of malnutrition, has been shown to cause impaired salivary secretion. However, there is dearth of information on the mechanism that underlies this complication. Also, whether returning to normal diet after kwashiorkor will reverse these complications or not is yet to be discerned. Thus, this study aimed at assessing the mechanisms that underlie kwashiorkor-induced salivary impairments and to evaluate the effects of switching back to normal-diet on kwashiorkor-induced salivary impairments. Weaning rats were randomly divided into 3 groups (control group, kwashiorkor group (KG), re-fed kwashiorkor group (RKG)) of 7 rats each. The control group had standard rat chow while the KG and RKG were fed 2% protein diet for 6 weeks to induce kwashiorkor. The RKG had their diet changed to standard rat-chow for another 6 weeks. Blood and stimulated saliva samples were collected for the analysis of total protein, electrolytes, amylase, immunoglobulin A (IgA) secretion rate, leptin, and ghrelin. Tissue total protein, nitric oxide level, expressions of Na+/K+-ATPase, muscarinic (M3) receptor, and aquaporin 5 in the submandibular glands were also determined. Data were presented as means ± SEM and compared using ANOVA with Tukey's post hoc test. RKG showed improved salivary function evidenced by reduced salivary lag-time and potassium and increased flow rate, sodium, amylase, IgA secretion rate, leptin, submandibular nitric oxide level, and aquaporin 5 expression compared with KG. This study for the first time demonstrated that kwashiorkor caused significant reduction in salivary secretion through reduction of nitric oxide level and aquaporin 5 expression in submandibular salivary glands. Normal-diet re-feeding after kwashiorkor returned salivary secretion to normal.
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Affiliation(s)
- Taye Jemilat Lasisi
- a Department of Physiology, College of Medicine, University of Ibadan, PO Box 22040, Ibadan 200284, Nigeria.,b Department of Oral Pathology, College of Medicine, University of Ibadan, Ibadan 200284, Nigeria
| | - Shehu Tijani Shittu
- a Department of Physiology, College of Medicine, University of Ibadan, PO Box 22040, Ibadan 200284, Nigeria
| | - Akinola Rasak Alada
- a Department of Physiology, College of Medicine, University of Ibadan, PO Box 22040, Ibadan 200284, Nigeria
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Wolff A, Koray M, Campisi G, Strietzel FP, Lafaurie GI, Beiski BZ, Ekström J. Electrostimulation of the lingual nerve by an intraoral device may lead to salivary gland regeneration: A case series study. Med Oral Patol Oral Cir Bucal 2018; 23:e552-e559. [PMID: 30148471 PMCID: PMC6167107 DOI: 10.4317/medoral.22597] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/30/2018] [Indexed: 11/18/2022] Open
Abstract
Background Salivary gland function is controlled by the salivary reflex, whose efferent arm is composed by the parasympathetic and the sympathetic divisions of the autonomic nervous system. Parenchymal injury is the main salivary gland involvement of Sjögren’s syndrome and head and neck radiotherapy, but neural damage has been reported as well. Recently an intraoral device for electrostimulation of the lingual nerve in vicinity to the lower third molar has been introduced. At this point this nerve carries efferent fibers for the innervation of the submandibular, sublingual and several minor salivary glands and afferent fibers of the salivary reflex. Therefore, excitation of these fibers potentially leads to increased secretion of all salivary glands. Thus, the study objective was to assess whether comprehensive neural activation by electrostimulation of the lingual nerve carries the potential to induce the regeneration of damaged salivary glands. Material and Methods The device was tested on three patients with no collectable resting and stimulated secretion of saliva during a double blind, sham controlled period of two months and nine open-label months. Results All three subjects developed the capacity to spit saliva, not only in direct response to the electrostimulation but also after free intervals without electrostimulation. In addition, their symptoms of dry mouth severity and frequency improved. Conclusions This recovery is probably due to the combined effect of increase in secretory functional gland mass and regain of nervous control of the secretory elements and blood vessels. Both are phenomena that would contribute to gland regeneration. Key words:Xerostomia, dry mouth, saliva, electrostimulation, regeneration.
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Affiliation(s)
- A Wolff
- 65 Hatamar St., Harutzim 60917, Israel,
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Zhang X, Yang N, Liu X, Su J, Cong X, Wu L, Zhang Y, Yu G. Autonomic reinnervation and functional regeneration in autologous transplanted submandibular glands in patients with severe keratoconjunctivitis sicca. Int J Oral Sci 2018; 10:14. [PMID: 29695713 PMCID: PMC5944256 DOI: 10.1038/s41368-018-0014-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/25/2017] [Accepted: 01/22/2018] [Indexed: 12/14/2022] Open
Abstract
Autologous submandibular gland (SMG) transplantation has been proved to ameliorate the discomforts in patients with severe keratoconjunctivitis sicca. The transplanted glands underwent a hypofunctional period and then restored secretion spontaneously. This study aims to investigate whether autonomic nerves reinnervate the grafts and contribute to the functional recovery, and further determine the origin of these nerves. Parts of the transplanted SMGs were collected from the epiphora patients, and a rabbit SMG transplantation model was established to fulfill the serial observation on the transplanted glands with time. The results showed that autonomic nerves distributed in the transplanted SMGs and parasympathetic ganglionic cells were observed in the stroma of the glands. Low-dense and unevenly distributed cholinergic axons, severe acinar atrophy and fibrosis were visible in the patients’ glands 4–6 months post-transplantation, whereas the cholinergic axon density and acinar area were increased with time. The acinar area or the secretory flow rate of the transplanted glands was statistically correlated with the cholinergic axon density in the rabbit model, respectively. Meanwhile, large cholinergic nerve trunks were found to locate in the temporal fascia lower to the gland, and sympathetic plexus concomitant with the arteries was observed both in the adjacent fascia and in the stroma of the glands. In summary, the transplanted SMGs are reinnervated by autonomic nerves and the cholinergic nerves play a role in the morphological and functional restoration of the glands. Moreover, these autonomic nerves might originate from the auriculotemporal nerve and the sympathetic plexus around the supplying arteries. Regenerated nerves play a role in restoring the function of transplanted submandibular glands (SMGs) in treating dry eye syndrome. Dry eye syndrome, or keratoconjunctivitis sicca (KCS), is a leading cause of patients visiting ophthalmologists, and one effective treatment in severe cases is transplanting SMGs (to the temporal area). Autonomic nerves have an important function in maintaining the secretory function of salivary glands, and a team headed by Yan Zhang and Guang-Yan Yu at Peking University, China investigated whether those nerves underwent reinnervation (restoration of nerve control) with transplanted SMGs in KCS patients and in a rabbit model. The authors found that in both the patients and rabbit model, the transplanted SMGs were reinnervated and the regenerated nerves played a role in restoring the glands’ function. The findings offer new insights into managing SMG transplantation.
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Affiliation(s)
- Xueming Zhang
- Center for Salivary Gland Diseases and Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ningyan Yang
- Center for Salivary Gland Diseases and Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.,Department of Pediatric Dentistry, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
| | - Xiaojing Liu
- Center for Salivary Gland Diseases and Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jiazeng Su
- Center for Salivary Gland Diseases and Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xin Cong
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China
| | - Liling Wu
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China
| | - Yan Zhang
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China.
| | - Guangyan Yu
- Center for Salivary Gland Diseases and Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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