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Lactoferrin and the development of salivary stones: a pilot study. Biometals 2022; 36:657-665. [PMID: 36396778 PMCID: PMC10181970 DOI: 10.1007/s10534-022-00465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/05/2022] [Indexed: 11/19/2022]
Abstract
AbstractSalivary stones (sialoliths) are calcified structures located in the ductal system of the major salivary glands. Their exact cause is not clear but in general they are characterized by concentric inorganic (hydroxyapatite) layers. The formation is a slow intermittent process which may result in enlargement of the sialolith causing obstruction of saliva secretion resulting in mealtime related pain and swelling of the affected salivary gland. Various studies reported the presence of organic material such as proteins and lipids in the core of sialoliths. In the present study the protein composition of twenty submandibular sialoliths was analyzed. It was found that proteins contributed on average 5% to the dry weight of submandibular stones whereby small salivary stones contained more extractable proteins than large salivary stones. Using a combination of SDS-PAGE gel electrophoresis and Western blotting, we identified α-amylase (in all stones; 100%), lysozyme (95%), lactoferrin (85%), secretory-IgA (75%), MUC7 (60%), complement C4 (60%) and C-reactive protein (35%). The presence, and the combinations, of lactoferrin, lysozyme, s-IgA and α-amylase in sialoliths was confirmed by ELISA. The gradually increasing size of a sialolith might provoke a local inflammatory response in the duct of the submandibular gland whereby the relatively low concentrations of lactoferrin and lysozyme may originate from neutrophils. The interaction of lactoferrin with s-IgA could contribute to the accumulation of lactoferrin in sialoliths. In summary, these results suggest a new pathophysiological role for lactoferrin, in the formation of sialoliths.
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Kraaij S, de Visscher JGAM, Apperloo RC, Nazmi K, Bikker FJ, Brand HS. Lactoferrin and the development of salivary stones: a pilot study. Biometals 2022. [PMID: 36396778 DOI: 10.1007/s10534-022-00465-7/tables/2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Salivary stones (sialoliths) are calcified structures located in the ductal system of the major salivary glands. Their exact cause is not clear but in general they are characterized by concentric inorganic (hydroxyapatite) layers. The formation is a slow intermittent process which may result in enlargement of the sialolith causing obstruction of saliva secretion resulting in mealtime related pain and swelling of the affected salivary gland. Various studies reported the presence of organic material such as proteins and lipids in the core of sialoliths. In the present study the protein composition of twenty submandibular sialoliths was analyzed. It was found that proteins contributed on average 5% to the dry weight of submandibular stones whereby small salivary stones contained more extractable proteins than large salivary stones. Using a combination of SDS-PAGE gel electrophoresis and Western blotting, we identified α-amylase (in all stones; 100%), lysozyme (95%), lactoferrin (85%), secretory-IgA (75%), MUC7 (60%), complement C4 (60%) and C-reactive protein (35%). The presence, and the combinations, of lactoferrin, lysozyme, s-IgA and α-amylase in sialoliths was confirmed by ELISA. The gradually increasing size of a sialolith might provoke a local inflammatory response in the duct of the submandibular gland whereby the relatively low concentrations of lactoferrin and lysozyme may originate from neutrophils. The interaction of lactoferrin with s-IgA could contribute to the accumulation of lactoferrin in sialoliths. In summary, these results suggest a new pathophysiological role for lactoferrin, in the formation of sialoliths.
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Affiliation(s)
- Saskia Kraaij
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers, Location VUmc, and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Room 12N-37, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers, Location VUmc, and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Ruben C Apperloo
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
| | - Kamran Nazmi
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Floris J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Avishai G, Younes M, Gilat H, Gillman L, Reiser V, Rosenfeld E, Chaushu G, Masri D. Anatomical Features of the Parotid Duct in Sialography as an Aid to Endoscopy—A Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12081868. [PMID: 36010218 PMCID: PMC9406592 DOI: 10.3390/diagnostics12081868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/22/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Sialography is used for diagnosis of obstructive salivary gland diseases and prior to sialendoscopy. Three-dimensional cone beam computerized tomography (CBCT) sialography allows imaging and measurement of salivary duct structures. Salivary gland endoscopy has a long learning curve. The aim of this retrospective study is to create an anatomical quantitative guide of different distances and angles significant for endoscopy. Twenty-six CBCT sialographies of healthy parotid ducts were included. Outcome parameters included diameters, distances, angles and number of minor tributaries. Results show the average distance from the papilla to the curvature of the gland was 41.5 mm (Q1 36.97 mm–Q3 45.32 mm), with an angle of 126.9° (Q1 107.58°–Q3 135.6°) of the curvature and a distance of 35.25 mm (±7.81 mm) between the curvature and the hilus. The mean width of the duct was 0.8 mm (Q1 0.7 mm–Q3 1.15 mm) at its narrowest and 2 mm (Q1 1.4 mm–Q3 2.2 mm) at its widest. This is the first anatomical quantitative study of the parotid duct in relation to sialendoscopy.
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Affiliation(s)
- Gal Avishai
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
- Correspondence:
| | - Muhammad Younes
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Hanna Gilat
- Rabin Medical Center, Department of Otolaryngology-Head and Neck Surgery, Beilinson Hospital, Petach Tikva 49414, Israel;
| | - Leon Gillman
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Vadim Reiser
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Eli Rosenfeld
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Gavriel Chaushu
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
| | - Daya Masri
- Rabin Medical Center, Department of Oral and Maxillofacial Surgery, Beilinson Hospital, Petach Tikva 49414, Israel; (L.G.); (V.R.); (E.R.); (G.C.); (D.M.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 69978, Israel;
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Surgical Treatment of Sialolithiasis Leads to Improvement in the Complete Blood Count. BIOLOGY 2021; 10:biology10050414. [PMID: 34067048 PMCID: PMC8150388 DOI: 10.3390/biology10050414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 04/23/2021] [Accepted: 05/01/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary Sialolithiasis is a disease in which inflammation and infection are caused in a salivary gland and its duct secretion system due to a formation of a sialolith (salivary stone) in the gland. Anemia of inflammation is a well described pathology where chronic inflammation causes a reduction in the red blood cell count is. In this study, we examined the complete blood count results of patients who underwent surgical removal of a sialolith and found that removal of the stone and cessation of the symptoms lead to an improvement in the complete blood count results. We believe that the improvement in blood count values after surgery is due to resolution of the anemia of inflammation. To our knowledge, this is the first report about the relationship between surgery for removal of a salivary stone and improvement in the wellbeing of patient expressed by blood count values. Abstract Sialolithiasis is a chronic disease in which a sialolith (salivary stone) causes recurrent inflammation of the affected salivary gland. Anemia of inflammation is a well-described pathology in which a chronic inflammatory disease leads to a reduction in the red blood cell count, hemoglobin and hematocrit values. In this retrospective cohort study, we aim to find whether removal of the sialolith and alleviation of the inflammation affect the complete blood count results. We examined data regarding forty-nine patients who underwent surgery for the removal of a submandibular gland sialolith using the duct-stretching technique. Complete blood counts two years before and after the surgical procedure were collected. The average pre-procedure and post-procedure values were calculated for each patient to establish the average blood profile. The pre- and post-procedure values were compared to evaluate the effect of the surgical treatment on the blood profile. We found that the average blood count values for patients with sialolithiasis were towards the lower end of the normal range. Post-surgery, a significant increase in hematocrit, hemoglobin and red blood cell count was observed, which was more pronounced in the older age group and in patients with co-morbidities. We conclude that sialolith removal surgery is associated with significant improvement in the complete blood count values, especially in the elderly and in patients and with co-morbidities. The speculated pathogenesis is relative anemia of inflammation.
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