ABSTRACT
@#IgG4⁃related sialadenitis (IgG4⁃RS) is a type of autoimmune disease that has been recognized in recent years, and the pathogenesis remains unclear. IgG4⁃RS mainly affects the submandibular gland and parotid gland and is characterized by diffuse painless swelling of the bilateral salivary glands and/or lacrimal glands, usually lasting more than 3 months. Some patients have accompanying hearing loss or hearing impairment, sinusitis, lymphadenopathy and other symptoms; nearly half of patients have different degrees of salivary gland secretion disorders. Most patients have elevated serum IgG4 levels, but they cannot be used as the only marker for diagnosis. Histopathology remains the“gold standard”for diagnosis. Presently, submandibular gland biopsy is often used for diagnosis. Histopathology showed lym⁃phoplasmacytic infiltration, occlusive phlebitis, striated fibrosis; immunohistochemistry showed IgG4 + /IgG + plasma cells >40%, and IgG4 + plasma cell/high⁃power field vision > 10. Glucocorticoids are regarded as first⁃line drugs for the treat⁃ment of this disease. Clinically, glucocorticoids are often combined with immunosuppressive agents such as cyclophos⁃phamide, but no standard drug regimen exists. Most patients have a significant short⁃term treatment effect, and the long⁃term prognosis requires further study. Patients with a recurrence tendency should adjust the hormone dose over time. In the future, further research is needed regarding the pathogenesis and treatment of the disease to improve the clinical di⁃agnosis rate and therapeutic effect.
ABSTRACT
Objective To establish a submandibular gland(SMG) cell model of radiation injury, and to observe the effect of compatibility of Fructus Mume(Wumei) and Radix Glycyrrhizae(Gancao) on the proliferation of the modeled cells. Methods SMG cells were primarily cultured in vitro for the experiment. After immunofluorescence identification and growth curve analysis, SMG cells were given one-time exposure to X electron-ray at dose of 0.1, 0.2, 1, 2, 4 Gy respectively, and then were cultured with Wumei-Gancao solution at the concentration of 500, 50, 5, 0.5 μg/mL separately. Methyl thiazolyl tetrazolium (MTT) was used to determine the survival rate of SMG cells exposed to different doses of X electron-ray and proliferation vitality of SMG cells treated with different concentrations of Wumei-Gancao solution for 24 h. Results The survival rate of SMG cells was decreased gradually with the increase of X electron-ray dose. When the concentrations of Wumei-Gancao solution were in the range of 50 ～ 0.5 μg/mL, the cell proliferation rate showed an increasing trend with the increase of drug concentration, the effect being dose-dependent. When the solution concentration arrived to 500 μg/mL, the cell proliferation rate was declined. Conclusion The SMG cell model of radiation injury has been established successfully under the conditions of 0.1 Gy of one-time exposure, 9 Mev of energy at dose rate 3 Gy/min, hop count at 12 MU and source-skin distance being 100 cm. The concentration of the solution with the compatibitity ratio of Wumei to Gancao being 3:1 has certain effects on repairing the modeled cells.
ABSTRACT
Objective To compare the therapeutic effect of dark plum mixture on rats with radiation-induced xerostomia, given by gastric gavage and oral spray. Methods Rat model of radiation-induced xerostomia were developed by electron linear accelerator. Wistar rats were randomly divided into spray group and gastric gavage group, and normal group, positive control group and normal control group were set up within these two groups. The dark plum mixture was administered for 14 days. After treated for 7 days and 14 days, saliva was collected and submandibular gland samples were collected. The salivary secretion, Sorgan index, component analysis and pathological changes of submaxillary glands between the groups were assessed. Results On the 7thday after irradiation, the saliva secretion and gland coefficient of the dark plum spray group were significantly higher than the positive control group and normal control group (P＜ 0. 05). The saliva secretion, gland coefficient and saliva amylase activity of the dark plum mixture spray group were significantly higher than the dark plum mixture gastric gavage group (P＜ 0. 05). On the 14th day after irradiation, the saliva secretion and gland coefficient of the oral spray group were significantly higher than the gastric gavage group (P ＜ 0. 05 ). The pathological examination of submandibular gland tissues showed that 7 days after irradiation, there were less interglandular space and inflammatory cell infiltration in the oral spray group than the gastric gavage group. On the 14th day after irradiation, the ductal damage and cell nuclear pyknosis in the oral spray group were milder than the gastric gavage group. Vacuolated necrosis and nuclear pyknosis of some glandular cells were visible in the gastric gavage group 7 and 14 days after irradiation. Conclusions Compared with gastric gavage, the oral spray of dark plum mixture increases more saliva and salivary α-amylase secretion, effectively promote the repair of submandibular glandular cells after salivary gland irradiation, and indicates a better therapeutic effect on radiation-induced xerostomia.
ABSTRACT
The salivary glands produce 1.5L of fluid per day. As in other exocrine organs, the general mechanism in the salivary glands is that water movement occurs secondary to osmotic driving forces created by active salt transport. Therefore, high water permeability in the salivary glands is expected to have a variety of aquaporin (AQP), a water channel. Although some AQPs have been known to be present in the salivary glands, roles of parasympathetic nerve in AQP expression have not yet been examined. This study was designed to examine the changes of AQPs and extracellular signal-regulated kinase (ERK) in the submandibular glands after parasympathetic denervation. Right chorda-lingual nerve was cut, and each right (experiment) and left (control) submandibular gland was excised at 1, 3, 7, 14, 30 days after denervation. The denervated right submandibular glands were resulted in weight loss and morphologic changes, including cell loss and atrophy, as the time elapsed after parasympathetic denervation increased, whereas there were no histologic alteration in control side. AQP5 which is known to reside in apical membrane and secretory caraliculi of the submandibular acini were gradually underexpressed according, as the time after denervation increased. Expression of AQP4 in submandibular ductal epithelium was down-regulated after denervation. Besides, AQP3 and 8, which is known to be present in basolateral membrane of the glandular acini, were gradually underexpressed after denervation, similar to the pattern of other types. Expression of ERK, a mitogen-activated protein kinase, was downregulated after parasympathetic denervation in the submandibular gland. These results suggest that parasympathetic nervous system regulates the expression of AQPs in salivary glands, and is in part mediated by ERK pathway.