A histochemical study of catecholamines and cholinesterases in the autonomic nerves of the human minor salivary glands

The human major sublingual gland and its neuropeptidergic and nitrergic innervations

BACKGROUND

What textbooks usually call the sublingual gland in humans is in reality a tissue mass of two types of salivary glands, the anteriorly located consisting of a cluster of minor sublingual glands and the posteriorly located major sublingual gland with its outlet via Bartholin's duct. Only recently, the adrenergic and cholinergic innervations of the major sublingual gland was reported, while information regarding the neuropeptidergic and nitrergic innervations is still lacking.

METHODS

Bioptic and autoptic specimens of the human major sublingual gland were examined by means of immunohistochemistry for the presence of vasoactive intestinal peptide (VIP)-, neuropeptide Y (NPY)-, substance P (SP)-, calcitonin gene related-peptide (CGRP)-, and neuronal nitric oxide synthase (nNOS)-labeled neuronal structures.

RESULTS

As to the neuropeptidergic innervation of secretory cells (here in the form of mucous tubular and seromucous cells), the findings showed many VIP-containing nerves, few NPY- and SP-containing nerves and a lack of CGRP-labeled nerves. As to the neuropeptidergic innervation of vessels, the number of VIP-containing nerves was modest, while, of the other neuropeptide-containing nerves under study, only few (SP and CGRP) to very few (NPY) nerves were observed. As to the nitrergic innervation, nNOS-containing nerves were very few close to secretory cells and even absent around vessels.

CONCLUSION

The various innervation patterns may suggest potential transmission mechanisms involved in secretory and vascular responses of the major sublingual gland.

Saliva biomarkers in oral disease

Saliva is a versatile biofluid that contains a wide variety of biomarkers reflecting both physiologic and pathophysiologic states. Saliva collection is noninvasive and highly applicable for tests requiring serial sampling. Furthermore, advances in test accuracy, sensitivity and precision for saliva has improved diagnostic performance as well as the identification of novel markers especially in oral disease processes. These include dental caries, periodontitis, oral squamous cell carcinoma (OSCC) and Sjögren's syndrome (SS). Numerous growth factors, enzymes, interleukins and cytokines have been identified and are the subject of much research investigation. This review highlights current procedures for successful determination of saliva biomarkers including preanalytical factors associated with sampling, storage and pretreatment as well as subsequent analysis. Moreover, it provides an overview of the diagnostic applications of these salivary biomarkers in common oral diseases.

Effect of propofol on salivary secretion from the submandibular, sublingual, and labial glands during intravenous sedation

Background

Recent animal studies have suggested the role of GABA type A (GABA-_A) receptors in salivation, showing that GABA-_A receptor agonists inhibit salivary secretion. This study aimed to evaluate the effects of propofol (a GABA-_A agonist) on salivary secretions from the submandibular, sublingual, and labial glands during intravenous sedation in healthy volunteers.

Methods

Twenty healthy male volunteers participated in the study. They received a loading dose of propofol 6 mg/kg/h for 10 min, followed by 3 mg/kg/h for 15 min. Salivary flow rates in the submandibular, sublingual, and labial glands were measured before, during, and after propofol infusion, and amylase activity was measured in the saliva from the submandibular and sublingual glands.

Results

We found that the salivary flow rates in the submandibular, sublingual, and labial glands significantly decreased during intravenous sedation with propofol (P < 0.01). Similarly, amylase activity in the saliva from the submandibular and sublingual glands was significantly decreased (P < 0.01).

Conclusion

It can be concluded that intravenous sedation with propofol decreases salivary secretion in the submandibular, sublingual, and labial glands via the GABA-_A receptor. These results may be useful for dental treatment when desalivation is necessary.

Salivary Proteome Changes in Response to Acute Psychological Stress Due to an Oral Exam Simulation in University Students: Effect of an Olfactory Stimulus

The autonomic nervous system (ANS) plays a crucial role both in acute and chronic psychological stress eliciting changes in many local and systemic physiological and biochemical processes. Salivary secretion is also regulated by ANS. In this study, we explored salivary proteome changes produced in thirty-eight University students by a test stress, which simulated an oral exam. Students underwent a relaxation phase followed by the stress test during which an electrocardiogram was recorded. To evaluate the effect of an olfactory stimulus, half of the students were exposed to a pleasant odor diffused in the room throughout the whole session. Saliva samples were collected after the relaxation phase (T0) and the stress test (T1). State anxiety was also evaluated at T0 and T1. Salivary proteins were separated by two-dimensional electrophoresis, and patterns at different times were compared. Spots differentially expressed were trypsin digested and identified by mass spectrometry. Western blot analysis was used to validate proteomic results. Anxiety scores and heart rate changes indicated that the fake exam induced anxiety. Significant changes of α-amylase, polymeric immunoglobulin receptor (PIGR), and immunoglobulin α chain (IGHA) secretion were observed after the stress test was performed in the two conditions. Moreover, the presence of pleasant odor reduced the acute social stress affecting salivary proteome changes. Therefore, saliva proteomic analysis was a useful approach to evaluate the rapid responses associated to an acute stress test also highlighting known biomarkers.

Salivary Biomarkers for Alzheimer's Disease and Related Disorders

The search for accessible and cost-effective biomarkers to complement current cerebrospinal fluid (CSF) and imaging biomarkers in the accurate detection of Alzheimer disease (AD) and other common neurodegenerative disorders remains a challenging task. The advances in ultra-sensitive detection methods has highlighted blood biomarkers (e.g. amyloid-β and neurofilament light) as a valuable and realistic tool in a diagnostic or screening process. Saliva, however, is also a rich source of potential biomarkers for disease detection and offers several practical advantages over biofluids that are currently examined for neurodegenerative disorders. However, while this may be true for the general population, challenges in collecting saliva from an elderly population should be seriously considered. In this review, we begin by discussing how saliva is produced and how age-related conditions can modify saliva production and composition. We then focus on the data available which support the concept of salivary amyloid-β, tau species and novel biomarkers in detecting AD and alpha-synuclein (α-syn) in Parkinson's disease (PD).

Tyrosine-hydroxylase, dopamine β-hydroxylase and choline acetyltransferase-like immunoreactive fibres in the human major sublingual gland

OBJECTIVE

To study the innervation of the major sublingual gland by means of immunohistochemistry.

DESIGN

Bioptic and autoptic specimens of the major sublingual gland of humans were examined for the presence of immunoreactivity to tyrosine hydroxylase and dopamine-β-hydroxylase, on one hand, and choline acetyltransferase, on the other, to indicate adrenergic and cholinergic nerves, respectively.

RESULTS

Acini and ducts were supplied by both divisions of the autonomic nervous system.

CONCLUSIONS

Mucous and seromucous cells of the human major sublingual glands may respond with secretion not only to parasympathetic activity but also to sympathetic activity. The major sublingual gland is therefore a potential contributor to the mucin secretion recently reported in the literature in response to high sympathetic activity during physical exercise.

Distribution of nerve fibers during the development of palatine glands in rats

BACKGROUND

Salivary gland maturation and function are modulated by the nervous system. Nevertheless, little is known about salivary gland innervation during development, particularly minor salivary glands. This study investigated the development of the innervation of the palatine glands of rat.

MATERIALS AND METHODS

Frozen sections of rat palatine glands at different stages were immunohistochemically labeled for detection of the general nerve markers protein gene product 9.5 (PGP 9.5) and growth associated protein 43 (GAP-43), and the autonomic nerve markers calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY).

RESULTS

PGP 9.5 and GAP-43-immunoreactive fibers (IRF) were present in the mesenchyme and in association with developing acini, ducts and blood vessels. GAP-43-IRF were more abundant and diffuse than PGP 9.5-IRF at early stages, but showed similar distribution with growth, ramifying out from thick bundles in connective tissues until encircling the secretory units observed around postnatal day 21 (PN21). CGRP-IRF were detected in the mesenchyme at embryonic day 20 (E20) and PN0. CGRP-IRF became numerous around PN7 and PN10. They then decreased to the adult level at PN21, mainly located around ducts and infrequently blood vessels. NPY-IRF were sparsely detected in the mesenchyme at E20, then detected in close proximity to acini in addition to blood vessels at PN3. NPY-IRF increased till reaching the adult stage, and were mainly associated with blood vessels and around mucous cells and some serous demilunes.

CONCLUSION

The findings indicated a developmental modification of the sensory and autonomic innervation which may play a role in the functional maturation of the palatine salivary glands.

Effects and Mechanisms of Tastants on the Gustatory-Salivary Reflex in Human Minor Salivary Glands

The effects and mechanisms of tastes on labial minor salivary gland (LMSG) secretion were investigated in 59 healthy individuals. Stimulation with each of the five basic tastes (i.e., sweet, salty, sour, bitter, and umami) onto the tongue induced LMSG secretion in a dose-dependent manner. Umami and sour tastes evoked greater secretion than did the other tastes. A synergistic effect of umami on LMSG secretion was recognized: a much greater increase in secretion was observed by a mixed solution of monosodium glutamate and inosine 5′-monophosphate than by each separate stimulation. Blood flow (BF) in the nearby labial mucosa also increased following stimulation by each taste except bitter. The BF change and LMSG secretion in each participant showed a significant positive correlation with all tastes, including bitter. Administration of cevimeline hydrochloride hydrate to the labial mucosa evoked a significant increase in both LMSG secretion and BF, while adrenaline, atropine, and pirenzepine decreased LMSG secretion and BF. The change in LMSG secretion and BF induced by each autonomic agent was significantly correlated in each participant. These results indicate that basic tastes can induce the gustatory-salivary reflex in human LMSGs and that parasympathetic regulation is involved in this mechanism.

Characteristics of the saliva flow rates of minor salivary glands in healthy people

OBJECTIVES

To investigate the normal range and characteristics of saliva secretion in the minor salivary glands (MSGs).

DESIGN

The flow rates of MSGs were measured in 4 anatomical locations of oral mucosa, and the relationship between MSG flow rates and whole saliva flow rates were assessed in 300 healthy subjects stratified by age and sex. An additional 30 young females were further evaluated for flow symmetry, effects of stimulation, circadian effects in MSGs, and the relationship with the flow rates of major salivary glands.

RESULTS

(1) The mean saliva flow rates were 2.10 ± 0.66 (lower labial glands), 2.14 ± 0.62 (upper labial glands), 2.88 ± 0.72 (buccal glands) and 2.15 ± 0.51 (palatal glands) μl/min/cm(2), respectively. The flow rate of buccal glands was significantly higher than the rates of SMGs in other locations (P < 0.01). (2) 5-year-old children had the lowest MSG flow rates (P < 0.0001) while the 10-14-year-old group had the highest (P < 0.001). (3) MSG flow rates were independent of sex (P > 0.05), right vs. left (P > 0.05), and citric acid (2.5%) stimulation (P > 0.05). (4) Only labial MSG displayed a significant secretory circadian rhythm with the highest rate in the evening (P < 0.05). (5) A weak correlation was found between the flow rate of palatal glands and that of unstimulated whole saliva (r = 0.195, P = 0.007).

CONCLUSIONS

Our findings provide a reference for functional evaluation of MSGs and for donor site selection of MSG transplantation for treatment of severe dry eye syndrome.

Dysfunction of the locus coeruleus-norepinephrine system and related circuitry in Parkinson's disease-related dementia

Although resting tremor, cogwheel rigidity, hypokinesia/bradykinesia and postural instability usually dominate the clinical picture of sporadic Parkinson's disease (PD), both clinical and epidemiological data reveal that a wide variety of additional symptoms impair patients' quality of life considerably, parallel to the chronic progressive neurodegenerative movement disorder. Autopsy based retrospective studies have shown that α-synuclein immunoreactive Lewy pathology (LP) develops in the locus coeruleus (LC) of patients with neuropathologically confirmed sporadic PD, as well as in individuals with incidental (prodromal or premotor) Lewy body disease but not in age and gender matched controls. Using five case studies, this review discusses the possible role of LP (axonopathy, cellular dysfunction and nerve cell loss) in the LC, catecholaminergic tract and related circuitry in the development of PD-related dementia. The contribution of noradrenergic deficit to cognitive dysfunction in PD has been underappreciated. Noradrenergic therapeutic interventions might not only alleviate depressive symptoms and anxiety but also delay the onset of cognitive decline.

An update on minor salivary gland secretions

In this article, the literature on minor salivary gland secretion rates, composition, and function is reviewed. Measurements of the minor salivary gland secretion rates and composition are complicated, and the secretions display large biological variability. Despite this, some characteristics of these secretions have been found repeatedly in independent investigations. Minor gland saliva varies between different oral sites. Buccal saliva flow is higher than labial saliva flow, which in turn is usually higher than the palatal gland secretion rate. It is generally agreed that minor gland saliva is important for the whole saliva composition, and especially for the secretory immunoglobulin A and mucins. The secretion from these glands seems also important for subjective feelings of dry mouth and general wellbeing. Further research is essential for understanding the role of these secretions for oral, as well as for general, health.

The cholinesterase inhibitor physostigmine for the local treatment of dry mouth: a randomized study

Application of physostigmine to the oromucosal surface with the aim of stimulating underlying mucin-producing glands while reducing cholinergic systemic effects might be a strategy for treating dry mouth. Subjects suffering from dry mouth and with hyposalivation participated in a crossover, double-blind, randomized study. A gel containing physostigmine (0.9, 1.8, 3.6, and 7.2 mg) or placebo was applied to the inside of the lips and distributed with the tongue. The feeling of dryness was assessed using a visual analogue scale (VAS) (where a score of 100 = extremely dry) and systemic effects were registered. Based on assessments of efficacy and safety, the dose of 1.8 mg of physostigmine was selected for use in the second part of the study to make objective measurements of saliva volumes. Physostigmine (1.8 mg) produced long-lasting (120 min) relief (evident as a score reduction of 25 on the VAS) in the feeling of dryness. Judging from AUC values related to baseline over 180 min, the improvement for both mouth and lips in response to physostigmine was six times greater than that to placebo. At higher doses of physostigmine, gastrointestinal discomfort predominantly occurred. The volume of saliva collected in response to physostigmine was five times higher over 180 min than that collected in response to placebo. Physostigmine, applied locally, therefore appears to be a promising modality for dry-mouth treatment.

Intraoral stimulation of salivary secretion with the cholinesterase inhibitor physostigmine as a mouth spray: A pilot study in healthy volunteers

Dry mouth produces a deterioration in oral health and impairs quality of life. There is a need for a novel approach to the pharmacological treatment of dry mouth. With a view to enhancing the cholinergic drive on minor salivary glands, whilst at the same time minimising adverse systemic effects, the cholinesterase inhibitor physostigmine was therefore sprayed, in a fixed volume, onto the oral mucosa of seven healthy subjects. Three concentrations (0.5%, 1% and 2%) were tested. The mean salivary output over time (0-105 min) was higher than that of placebo (p<0.05), as the area under the curve increased by 61%, 91% and 66% at physostigmine 0.5%, 1% and 2%, respectively. Two subjects experienced nausea at the highest physostigmine concentration, thus reflecting systemic effects. Heart rate, blood pressure and respiration were unaffected by the physostigmine treatment.

Regulation of salivary gland function by autonomic nerves

Oral homeostasis is dependent upon saliva and its content of proteins. Reflex salivary flow occurs at a low 'resting' rate and for short periods of the day more intense taste or chewing stimuli evoke up to ten fold increases in salivation. The secretion of salivary fluid and proteins is controlled by autonomic nerves. All salivary glands are supplied by cholinergic parasympathetic nerves which release acetylcholine that binds to M3 and (to a lesser extent) M1 muscarinic receptors, evoking the secretion of saliva by acinar cells in the endpieces of the salivary gland ductal tree. Most salivary glands also receive a variable innervation from sympathetic nerves which released noradrenaline from which tends to evoke greater release of stored proteins, mostly from acinar cells but also ductal cells. There is some 'cross-talk' between the calcium and cyclic AMP intracellular pathways coupling autonomic stimulation to secretion and salivary protein secretion is augmented during combined stimulation. Other non-adrenergic, non-cholinergic neuropeptides released from autonomic nerves evoke salivary gland secretion and parasympathetically derived vasointestinal peptide, acting through endothelial cell derived nitric oxide, plays a role in the reflex vasodilatation that accompanies secretion. Neuronal type, calcium-activated, soluble nitric oxide within salivary cells appears to play a role in mediating salivary protein secretion in response to autonomimetics. Fluid secretion by salivary glands involves aquaporin 5 and the extent to which the expression of aquaporin 5 on apical acinar cell membranes is upregulated by cholinomimetics remains uncertain. Extended periods of autonomic denervation, liquid diet feeding (reduced reflex stimulation) or duct ligation cause salivary gland atrophy. The latter two are reversible, demonstrating that glands can regenerate provided that the autonomic innervation remains intact. The mechanisms by which nerves integrate with salivary cells during regeneration or during salivary gland development remain to be elucidated.

Stimulation of minor salivary glands by intraoral treatment with the cholinesterase inhibitor physostigmine in man

A large number of the population, especially the elderly, suffers from dry mouth. The aim of the present investigation was to stimulate the minor salivary glands by the topical application of the cholinesterase inhibitor physostigmine. In eight healthy subjects. 100 microl of the substance, in the concentration interval 2-8 mg/ml, was applied locally to the inside of the lower lip for 1 min. In a separate study comprising 12 dry-mouth patients. 10 ml of 0.4 1.6 mg/ml physostigmine was administered as a mouth rinse solution for 2 min. Secretion from the labial glands. assessed using the Periotron method, increased in a dose-dependent manner in response to physostigmine in both groups. Average peak secretion exceeded baseline by more than 50% throughout the 30- to 45-min observation period; from 1.71 to 2.62 microl cm(-2) min(-1) among the healthy subjects and from 1.17 to 1.84 microl cm 2 min among the dry mouth patients. No systemic effects were registered as reflected by ECG, heart rate or blood pressure. It is assumed that intraorally applied physostigmine diffuses through the oral mucosa and acts by preserving acetylcholine released from the cholinergic, parasympathetic nerves that innervate the minor salivary glands. The topical application of physostigmine to the oral mucosa may, therefore, be an interesting approach for the treatment of dry mouth.

Histochemical phenotypes of von Ebner's gland of ferret and their functional implications

Von Ebner's gland of ferret was examined by means of light microscopy, protein, mucosubstance and enzyme histochemistry, and neurohistology. Acinar cells were replete with granules containing neutral mucosubstances and disulphides, and showed strong diffuse acid phosphatase activity and weak granular staining for peroxidase. Staining for cytochrome oxidase, succinate dehydrogenase, and NADH and NAD(P)H dehydrogenases was also seen. Basolateral plasmalemma of acinar cells showed weak, ouabain-sensitive Na+,K+-ATPase activity. Ductal cells were of a simple appearance, contained thiols and showed variable staining for acid phosphatase, dehydrogenases and cytochrome oxidase. Variable amounts of beta-glucuronidase reaction product were localized in the glandular parenchyma, being marked in atrophic areas. Prominent stellate myoepithelial cells embracing acini and also basal ductal cells were demonstrated by alkaline phosphatase. Thiamine pyrophosphatase reaction product was concentrated in blood vessels around parenchyma, with little Golgi-like staining in acinar cells. Acetylcholinesterase activity was associated with an extensive network of nerve fibres embracing parenchyma, whereas catecholamine fluorescence was not seen. The results suggest that the acini of von Ebner's gland of ferret synthesise neutral secretory glycoproteins and peroxidase. Water mobilization is inconspicuous. Lysosomal activities feature in the parenchyma, possibly a consequence of processing secretory products in acini, absorption in ducts and/or adaptation atrophy. The gland receives a rich cholinergic-type innervation, and has extensive myoepithelial and microvascular networks.

Innervation and myoepithelial arrangements in the submandibular salivary gland of ferret investigated by enzyme, catecholamine and filament histochemistry

Although the submandibular gland of ferret is useful for studying salivary secretory processes which are regulated by nerves and involve myoepithelial activity, little attention has been paid to its parenchymal innervation and myoepithelial arrangements. Therefore, glands obtained postmortem from mature ferrets of both sexes were here examined with the use of light-microscopic histochemical techniques for cholinesterases, phosphatases and phosphorylase, histofluorescence for catecholamines, and milling dyes. Acetylcholinesterase staining was associated with nerve trunks in the interlobular stroma and an extensive intralobular network of nerve fibres, presumably of a cholinergic type, embracing acini and ducts. There were fewer fibres containing fluorescing catecholamines, presumably adrenergic. They were largely associated with acini. Numerous stellate cells with fine branching processes embracing acini, presumably myoepithelial cells, and a few spindle-shaped basal cells, investing striated ducts, were demonstrated on frozen tissue by alkaline phosphatase, but not by adenosine triphosphatase, inosine diphosphatase and phosphorylase. Cells of similar shape and distribution were also demonstrated by staining with milling dyes on fixed tissues, indicating possibly a filamentous constituent conferring mechanical stability and/or contractile ability. Together, these results suggest, firstly, that a cholinergic-type parenchymal innervation is prominent in the submandibular gland of ferret, although many adrenergic nerves are also present, and, secondly that the gland has a very extensive myoepithelial network which is possibly involved in membrane transport, and the support and or contraction of the secretory parenchyma.

Studies on human minor salivary gland secretions using the Periotron method

Secretions from minor salivary glands were estimated in 127 individuals by the Periotron method of measuring fluid output from different mucosal sites, and outputs were related to different variables. Large intra- and interindividual variations in secretions (expressed as microliter/cm2 per min) were observed, with means of 0.9 for the palatal, 4.8 for the labial and 16.0 for the buccal mucosal sites. Age had no influence on the secretion rate, but women had 10-20% lower values from all three sites than men (p < 0.05). Individuals wearing upper dentures or using tobacco had 300 and 27% increased palatal secretion rates, respectively (p < 0.001, p < 0.05). In addition, those being treated with diuretics had 15% lower rates of secretion from buccal mucosal glands (p < 0.05), and those complaining of oral dryness had 21% lower fluid output from the labial mucosa (p < 0.05). These results support the use of minor salivary glands in combination with the Periotron method to study mucosal secretions and functions.

Regulation of mucous acinar exocrine secretion with age

Denny and co-workers (Navazesh et al., 1992) recently reported decreased concentrations of MG1 and MG2 mucins in resting and stimulated whole human saliva with age. The current study was therefore conducted to examine whether there is a corresponding attenuation with age in stimulus secretion coupling regulating mucous cell exocrine secretion. We utilized an in vitro model system, isolated rat sublingual acini, to evaluate the regulation of mucous cell exocrine secretion. Rat sublingual glands are similar to human sublingual and minor mucous glands, both histologically and in terms of their pattern of innervation, which is predominantly parasympathetic. Mucin secretion is thus activated primarily by muscarinic cholinergic agonist and to a lesser extent by vasoactive intestinal peptide (VIP), which is co-localized with acetylcholine in parasympathetic nerve terminals. We isolated sublingual mucous acini from five-month-old and 24-month-old rats and compared the concentration responses for mucin secretion induced by VIP and the muscarinic agonist, arecaidine propargyl ester (APE). Concentration-response curves for VIP were nearly identical for mucous acini from the five-month-old and 24-month-old animals. Values for basal secretion, maximal secretion, and EC50 (approximately equal to 200 nmol/L VIP) were statistically equivalent between both age groups. Concentration-response curves for APE were also very similar between age groups, with no statistically significant difference in basal secretion or EC50 values (approximately equal to 50 nmol/L APE). Maximal secretion was slightly less but statistically different for 24-month-old vs. five-month-old animals, 158% vs. 169% above basal secretion, respectively. Collectively, we found no substantial age-related changes in the secretory responsiveness of salivary mucous cells.

Immunocytochemical correlation of peptides and tyrosine hydroxylase in nerve fibres of the human parotid gland

The peptidergic innervation of parenchymal and vascular components in the human parotid gland was investigated by double-labelling fluorescence. Peptide immunoreactivity in nerve fibres was correlated with the presence of tyrosine hydroxylase (TH). By light microscopy, acinar innervation consisted of fibres with the combinations neuropeptide Y (NPY)/TH and NPY/vasoactive intestinal polypeptide (VIP). Some fibres were solely NPY, TH or VIP immunoreactive. Rarely, substance P (SP)/calcitonin gene-related (CGRP)-immunolabelled fibres were associated with acini. Intercalated ducts were often approached by NPY/TH- and VIP-containing fibres. VIP innervation of excretory ducts was sparse. Intralobular and intralobar excretory ducts, in addition to NPY and TH, revealed CGRP and CGRP/SP innervation, whereas nerve fibres on interlobar excretory ducts very rarely contained NPY and none of the other mediators. Vascular innervation consisted of NPY/TH and SP/CGRP fibres; in a few fibres SP was colocalized with leu-enkephalin. Large arteries were encircled by some VIP-positive fibres. The findings suggest a specific participation of neuropeptides and of peptide combinations in the regulation of parotid exocrine function.

The innervation of salivary glands as revealed by morphological methods

Salivary secretion is nerve mediated. The salivary glands are supplied by parasympathetic and sympathetic efferent nerves which travel to the glands by separate routes. Once in the glands the axons from each type of nerve intermingle and travel together in association with Schwann cells, forming Schwann-axon bundles. Two types of neuro-effector relationships exist with salivary parenchymal and myoepithelial cells: epilemmal (outside the parenchymal basement membrane) and hypolemmal (within the parenchymal basement membrane). Their relative frequencies with either type of nerve differ greatly between glands and species. Salivary blood vessels receive epilemmal innervations by both sympathetic and parasympathetic axons. The classical transmitters--acetylcholine in parasympathetic and noradrenaline in sympathetic axons--are stored in small vesicles. A variety of non-conventional neuropeptide transmitters have also been found in salivary nerves by immunohistochemistry, and they occur in large dense-cored vesicles. Prolonged high frequency stimulation has been found to cause depletion of large dense-cored vesicles from glandular nerves. In recent years afferent nerves have started to be identified and are found in greatest numbers around the main salivary ducts, where they may form a hypolemmal association with the epithelial cells. Functional studies demonstrate complex interactions between parasympathetic and sympathetic nerves. Morphological assessments of changes in the parenchymal cells after nerve stimulations or denervations add greatly to our understanding of the nerve functions. At least four types of influence can be exerted on salivary parenchymal cells by the nerves: hydrokinetic (water mobilizing), proteokinetic (protein secreting), synthetic (inducing synthesis), and trophic (maintaining normal functional size and state). In respect to each role, wide glandular and species differences exist between the relative contributions made by each type of nerve.

Ultrastructural changes in salivary glands after different adrenergic and cholinergic stimulations. A long-term morphological study in the rat

We have compared four different sialogogues and their degranulating effect on serous and mucous cells, and their long-term effects. From this and earlier experiments, even within the groups of alpha- and beta-adrenergic agents used, the effects varied on the serous and mucous cells. Previous studies have shown that cyclocytidine effectively degranulates serous cells without signs of cellular damage, while carbachol predominantly affects mucous acinar cells but gives early rise to permanent gland damage. Noradrenaline affects both serous and mucous cells, predominantly affecting serous cells with initial mitochondrial damage. Clonidine partially depletes both serous and mucous cells of their granules, producing permanent cellular damage. One month after a single injection of cyclocytidine the early findings described had disappeared. Carbachol showed permanent damage to salivary gland parenchyma, and both noradrenaline and clonidine demonstrated a long-term effect on acinar mucinous cells.

Rat sublingual gland as a model to study glandular mucous cell secretion

To study the regulation of mucous cell secretion, we have developed an in vitro cell model consisting of enzymatically dispersed mucous acinar structures (cell aggregates) from rat sublingual glands. Histological and ultrastructural evidence demonstrates that the cell aggregates are highly enriched in mucous cells, retain the morphological and ultrastructural features observed in intact glands, and undergo transition to an extensive secretory state when stimulated by 10 microM carbachol. The secretory responsiveness of the cell aggregates was verified in pharmacological studies. Carbachol stimulated secretion in a dose-dependent manner with high affinity (concentration causing half-maximal response = 0.3 microM) and was completely inhibited by atropine. Secretion was also stimulated by vasoactive intestinal peptide and substance P but not by alpha- or beta-adrenergic agonists. Biochemical characterization of secretion during nonstimulated and carbachol-stimulated conditions (after preincubation in [3H]glucosamine) demonstrated that, in response to carbachol, cell aggregates synthesized and secreted mucins which were similar to mucin glycoproteins isolated from whole glands. Collectively, our results establish that the rat sublingual cell aggregate model is a viable and pharmacologically responsive cell system to study the regulation of mucous cell secretion.

Morphological changes in salivary glands after treatment with sialagogues. An electronmicroscopical study

A dual innervation in salivary glands has been discussed. It is unclear how alpha-adrenergic and cholinergic agents stimulate the secretory cells. Different effects on serous and mucous cells are reported after stimulating with carbachol, clonidine, noradrenaline, cyclocytidine and pilocarpine, respectively. In the rat, carbachol and clonidine predominantly affect the mucous cells, however, with different morphological effects. Cyclocytidine exclusively degranulates the serous cells. Noradrenaline stimulates both serous and mucous cells and gives rise to vast cytoplasmic changes. Pilocarpine only shows effect on the mucous cells with formation of intracytoplasmic vacuoles. The effects reported are discussed with regard to experiments on salivary gland radiosensitivity.

Autonomic regulation of potassium release from human labial salivary glands in vitro

Labial salivary-gland slices from normal human subjects were incubated in vitro according to various protocols. The autonomic regulation of these was significantly different from that of most major salivary glands. K release was stimulated by incubation with a cholinergic agonist but not with alpha- or beta-adrenergic agonists. The cholinergically-induced K release was dependent on agonist concentration and was inhibited by the addition of atropine, and by the removal of Ca in the presence of EGTA.

A histological study of the effects of different alpha-adrenergic and cholinergic agonists on the rat submandibular gland

Rat submandibular glands were exposed to various sialagogues, including carbachol, clonidine, noradrenaline and cyclocytidine. The effects of these drugs were morphologically compared. Clonidine, which is an alpha-2-agonist, caused no depletion of granules in the serous cells examined. Noradrenaline and cyclocytidine, which are alpha-1-agonists, showed remarkable depletion of secretory granules in the serous cells. Carbachol caused visible and abundant salivation in the animals, but was found to produce only partial granular depletion of both serous and mucous cells. To induce experimentally a complete depletion of granular serous cells, cyclocytidine was found to be an excellent choice as a sialagogue with no side-effects on the cardiac and respiratory system.

Nerve interactions in salivary glands

In the salivary reflex, not only secretory cells are activated, but also myo-epithelial cells are contracted to support these cells and promote the flow of saliva, and blood vessels dilate to meet the increased demands of the tissues. The various effector cells often receive nerves from both parts of the autonomic system, and interactions may occur when the nerves act on the same type of effector, or on different types of effectors. While in an experiment electrical stimulation of the sympathetic trunk may decrease a parasympathetic salivary flow by causing marked vasoconstriction, this does not occur in the salivary reflex, since the vasoconstrictors do not take part. On the contrary, the normal sympathetic vasoconstrictor tone of the resting gland is easily overcome by activity in parasympathetic vasodilator nerves when secretion starts. Pronounced synergism can be demonstrated between sympathetic and parasympathetic secretory nerves. In dogs, for instance, in which sympathetic secretion is beta-adrenoceptor-mediated, this is marked in the case of fluid secretion. In rats and rabbits, in which beta-receptors elicit secretion of amylase, the potentiating interaction among the nerves is striking when amylase secretion is considered. Even the random release of acetylcholine from the post-ganglionic parasympathetic axons, by itself insufficient to evoke secretion, can increase the sympathetic effects. Motor nerves interact with secretory nerves by causing myo-epithelial contraction, mechanically promoting secretion. Interactions between the nerves in their long-term regulatory function on the sensitivity of the acinar secretory and myo-epithelial cells can also be demonstrated.

Autonomic innervation of salivary glands in the armadillo, anteater, and sloth (Edentata)

The intraglandular distribution of adrenergic and cholinergic nerve fibers was studied histochemically in the parotid, mandibular, and sublingual glands of six species of edentates belonging to the three families that comprise the order; namely the Dasypodidae (armadillos), the Myrmecophagidae (anteaters), and the Bradipodidae (sloths). The following histochemical techniques were used: (a) acetylcholinesterase reaction for the demonstration of cholinergic fibers; (b) formaldehyde- and glyoxylic acid-induced fluorescence for the demonstration of adrenergic fibers. In addition, norepinephrine (NE) was assayed fluorimetrically in the mandibular and parotid glands of the armadillo. A network of acetylcholinesterase-positive nerve fibers surrounds the intra- and interlobular ducts and endpieces of all glands; it is of low density in the mandibular and sublingual gland of the sloth, of high density in the sublingual gland of the anteater and of moderate density in the remaining glands. A vascular cholinergic innervation occurs in all salivary glands. Although present around the vessels, adrenergic new fibers were virtually absent from the parenchyma of all glands, even after in vitro incubation of glandular tissue with NE or after administration of NE to armadillos previously treated with a monoamine oxidase (MAO) inhibitor. Consistent with this fact, the amount of NE present in the parotid and mandibular gland of the armadillo was extremely low. These findings may indicate that the salivary secretion in the edentates is regulated by the parasympathetic rather than by the sympathetic nervous system.