1
|
Redman RS. On approaches to the functional restoration of salivary glands damaged by radiation therapy for head and neck cancer, with a review of related aspects of salivary gland morphology and development. Biotech Histochem 2009; 83:103-30. [PMID: 18828044 DOI: 10.1080/10520290802374683] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Radiation therapy for cancer of the head and neck can devastate the salivary glands and partially devitalize the mandible and maxilla. As a result, saliva production is drastically reduced and its quality adversely altered. Without diligent home and professional care, the teeth are subject to rapid destruction by caries, necessitating extractions with attendant high risk of necrosis of the supporting bone. Innovative techniques in delivery of radiation therapy and administration of drugs that selectively protect normal tissues can reduce significantly the radiation effects on salivary glands. Nonetheless, many patients still suffer severe oral dryness. I review here the functional morphology and development of salivary glands as these relate to approaches to preventing and restoring radiation-induced loss of salivary function. The acinar cells are responsible for most of the fluid and organic material in saliva, while the larger ducts influence the inorganic content. A central theme of this review is the extent to which the several types of epithelial cells in salivary glands may be pluripotential and the circumstances that may influence their ability to replace cells that have been lost or functionally inactivated due to the effects of radiation. The evidence suggests that the highly differentiated cells of the acini and large ducts of mature glands can replace themselves except when the respective pools of available cells are greatly diminished via apoptosis or necrosis owing to severely stressful events. Under the latter circumstances, relatively undifferentiated cells in the intercalated ducts proliferate and redifferentiate as may be required to replenish the depleted pools. It is likely that some, if not many, acinar cells may de-differentiate into intercalated duct-like cells and thus add to the pool of progenitor cells in such situations. If the stress is heavy doses of radiation, however, the result is not only the death of acinar cells, but also a marked decline in functional differentiation and proliferative capacity of all of the surviving cells, including those with progenitor capability. Restoration of gland function, therefore, seems to require increasing the secretory capacity of the surviving cells, or replacing the acinar cells and their progenitors either in the existing gland remnants or with artificial glands.
Collapse
Affiliation(s)
- R S Redman
- Oral Pathology Research Laboratory, Department of Veterans Affairs Medical Center, Washington, DC, USA.
| |
Collapse
|
2
|
Cabras T, Pisano E, Boi R, Olianas A, Manconi B, Inzitari R, Fanali C, Giardina B, Castagnola M, Messana I. Age-Dependent Modifications of the Human Salivary Secretory Protein Complex. J Proteome Res 2009; 8:4126-34. [DOI: 10.1021/pr900212u] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tiziana Cabras
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Elisabetta Pisano
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Roberto Boi
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Alessandra Olianas
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Barbara Manconi
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Rosanna Inzitari
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Chiara Fanali
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Bruno Giardina
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Massimo Castagnola
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| | - Irene Messana
- Dipartimento di Scienze Applicate ai Biosistemi, Sezione di Biochimica e Biologia Molecolare, Università di Cagliari, Cagliari, Italy, Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università di Cagliari, Cagliari, Italy, Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica, Rome, Italy, Istituto per la Chimica del Riconoscimento Molecolare, Consiglio Nazionale delle Ricerche (C.N.R.), Rome, Italy, and Istituto Scientifico Internazionale “Paolo VI”, Rome, Italy
| |
Collapse
|
3
|
Wolff MS, Mirels L, Lagner J, Hand AR. Development of the rat sublingual gland: a light and electron microscopic immunocytochemical study. THE ANATOMICAL RECORD 2002; 266:30-42. [PMID: 11748569 DOI: 10.1002/ar.10027] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cell differentiation in the rat sublingual gland occurs rapidly and is largely complete by birth. To study differentiation of the serous and mucous cells of the sublingual gland, we used antibodies to the secretory proteins CSP-1, SMGB, PSP, and SMGD, and sublingual mucin as specific cell markers. Glands from rats at ages 18, 19, and 20 days in utero, and postnatal days 0, 1, 5, 9, 14, 18, 25, 40, and 60 were fixed and prepared for morphological analysis and immunocytochemical labeling. At age 18 days in utero, a few cells in the developing terminal bulbs contained mucous-like apical granules that labeled with anti-mucin. Other cells had mixed granules with a peripheral lucent region and a dense core of variable size that occasionally labeled with anti-SMGD. Additionally, presumptive serous cells with small dense granules that contained CSP-1 and SMGB were present. At age 19 days in utero, the dense granules of these cells also labeled with anti-SMGD. By age 20 days in utero, mucous cells were filled with large, pale granules that labeled with anti-mucin, and serous cells had numerous dense granules containing CSP-1, SMGB, PSP, and SMGD. Fewer cells with mixed granules were seen, but dense regions present in some mucous granules (MGs) labeled with anti-SMGD. After birth, fewer MGs had dense regions, and serous cells were organized into well-formed demilunes. Except for PSP, which was undetectable after the fifth postnatal day, the pattern of immunoreactivity observed in glands of neonatal and adult animals was similar to that seen by age 20 days in utero. These results suggest that mucous and serous cells have separate developmental origins, mucous cells differentiate earlier than serous cells, and cells with mixed granules may become mucous cells.
Collapse
Affiliation(s)
- M S Wolff
- Department of Pediatric Dentistry, School of Dental Medicine, University of Connecticut Health Center, Farmington, Connecticut 06030, USA
| | | | | | | |
Collapse
|
4
|
Abstract
The rat parotid gland produces a number of well-characterized secretory proteins. Relatively little is known, however, about the onset of their synthesis and cellular localization during gland development. Secretory protein expression was studied in parotid glands of fetal and postnatal rats using light and electron microscopic immunocytochemistry and Northern blotting. Amylase, parotid secretory protein (PSP), common salivary protein-1 (CSP-1), and SMGB were first detected by immunofluorescence in parotid glands of 18 day fetuses. By 5 days after birth, light and electron microscopic immunolabeling localized all of these proteins to the secretory granules of developing acinar cells. Labeling of acinar cells for DNAse I, however, was not observed until 18 days after birth. Between 9 and 25 days, CSP-1 and SMGB reactivity of acinar cells declined, but increased in intercalated duct cells. After 25 days, CSP-1 and SMGB were found only in intercalated ducts, and amylase, PSP, and DNAse I were restricted to acinar cells. Levels of CSP-1 and SMGB mRNA were relatively constant through 21 postnatal days, but declined significantly after that. Amylase and PSP mRNA increased rapidly and continuously from five days after birth to the adult stage. In contrast, DNAse I mRNA was not detectable until 18 days after birth. The immunocytochemical and molecular analyses define three basic patterns of protein expression in the rat parotid gland: proteins whose synthesis is initiated early in development and is maintained in the acinar cells, such as amylase and PSP; proteins that are initially synthesized by immature acinar cells but are restricted to intercalated ducts in the adult gland, such as CSP-1 and SMGB; and proteins that are synthesized only by mature acinar cells and first appear during the third postnatal week, such as DNAse I. The parotid gland exhibits four distinct developmental stages: prenatal, from initiation of the gland rudiment until birth; neonatal, from 1 day up to about 9 days postnatal; transitional, from 9 days to 25 days of age; and adult, from 25 days on. Although differences exist in timing and in the specific proteins expressed, these developmental stages are similar to those seen in the rat submandibular gland. Additionally, the results support the suggestion that intercalated ducts may differentiate from the neonatal acini.
Collapse
Affiliation(s)
- S Sivakumar
- Department of Pediatric Dentistry, University of Connecticut Health Center, Farmington 06030, USA
| | | | | | | |
Collapse
|