Increase of microliths in inactive salivary glands of cat

Bacterial Biofilm in Salivary Gland Stones: Cause or Consequence?

OBJECTIVE

The pathogenesis of salivary calculi is not yet clear; however, 2 theories have been formulated: (1) "the classic theory," based on calcium microdeposits in serous and ductal acinous cells, successively discharged into the ducts; (2) "the retrograde theory," based on a retrograde migration of food, bacteria, and so on from the oral cavity to the salivary duct. The aim of the present study is to highlight the role of bacteria and biofilm in stone formation.

STUDY DESIGN

Case series without comparison.

SETTING

Laboratory of the Department of Anatomical Pathology.

SUBJECTS AND METHODS

Traditional optic microscopy and scanning electron microscopy were carried out on 15 salivary gland calculi that were collected from 12 patients. A qPCR (quantitative real-time polymerase chain reaction) assay was performed to highlight the presence of bacterial DNA on each stone.

RESULTS

Optic microscopy showed formations that-due to their size, shape, and Gram and Giemsa staining-seemed to be Gram-positive bacterial cells. PAS- (periodic acid-Schiff) and alcian-PAS-positive staining matrix was present around them. The ultrastructural observation of the material processed for scanning electron microscopy showed the presence of structures resembling bacterial cells in the middle of the stones, surrounded by soft, amorphous material. Results of qPCR showed the presence of bacterial DNA in the internal part of the tissue sample.

CONCLUSIONS

The presence of bacteria and/or bacterial products resembling biofilm in salivary gland stones supports the "retrograde theory." This evidence may support the hypothesis that biofilm could be the causative effect of lithiasic formations.

Microliths in the parotid of ferret investigated by electron microscopy and microanalysis

The present investigation is an attempt to determine the occurrence, elemental composition and formation of microliths in the parotid of ferret. Parotids from four normal ferrets were examined by electron microscopy and X-ray microanalysis. Crystalline microliths were found in phagosomes of acinar cells, which occasionally contained secretory material, and in phagosomes situated between mitochondria of striated ductal cells. Crystalline microliths and microliths that consisted of granular material either without crystals or mixed with a component of crystals were found in lumina, where they were often associated with cellular debris. The crystals contained calcium and phosphorus. Phagy and stagnation related to pockets of inefficient secretory activity have been previously found to be features of the parotid of ferret. Thus, possibly persistent degradation of redundant cellular material, particularly secretory granules, in phagosomes results in accumulation of calcium and leads to calcified microliths, whereas consolidation of stagnant debris extracellularly does not involve such accumulation and leads to non-calcified or mixed microliths.

The effects of obstruction and secretory stimulation on microlithiasis in salivary glands of cat: light and electron microscopy

Obstruction and increased secretory activity are considered to be important aetiological factors of salivary microlithiasis, which may itself be an aetiological factor of sialadenitis. However, there is a lack of substantial evidence for the importance of obstruction, and investigations on increased secretory activity used pathological doses of pharmacological agents. Therefore further investigation of these factors is essential. Feline parotid, submandibular and sublingual salivary glands, in which microliths occur normally as in man, were examined after ductal ligation to produce obstruction, electrical stimulation of the glandular nerves to produce increased secretory activity, or both. Microliths were detected in: 0 out of 38 untreated, 1 out of 55 ligated, 2 out of 17 stimulated and 2 out of 17 stimulated ligated submandibular glands; 6 out of 29 untreated, 7 out of 46 ligated, 3 out of 12 stimulated and 4 out of 14 stimulated ligated sublingual glands; and no parotid glands. The chi 2 test confirmed that the experimental procedures did not produce an increased occurrence of microliths. Microliths were detected in parenchymal cells, intercellularly in atrophic parenchyma, intraluminally, interstitially and in macrophages. The present investigation indicates that obstruction and increased secretory activity are not important aetiological factors of salivary microlithiasis.

Histochemical and biochemical determination of calcium in pleomorphic adenoma

Although calcification seldom occurs in pleomorphic adenoma, it often occurs in salivary glands, and so we decided to investigate the possible role of calcium in this difference. A histochemical method using glyoxal bis(2-hydroxyanil) demonstrated a small amount of calcium outlining lumina and separated cells of epithelial structures and associated with cells of myxoid and chondroid regions in pleomorphic adenoma, and a conspicuous amount in the acini of the associated salivary glands. A biochemical method using dry ashing demonstrated a significantly higher level of calcium in the glands than in pleomorphic adenoma. The results indicate that the calcium is mainly associated with secretory granules, which are scarce in pleomorphic adenoma, and with proteoglycan present intercellularly and in stromal regions of pleomorphic adenoma. The calcium in secretory granules is of possible importance in calcification in lumina and epithelium, and that bound to proteoglycan is possibly released following necrosis to be of importance in stromal calcification. However, the overall low level of calcium in pleomorphic adenoma is the likely explanation for the usual lack of calcification.

Ultrastructural localization of microliths in salivary glands of cat

Although microliths occur in normal human salivary glands and may be an aetiological factor of sialadenitis, little is known of their natural history. In an attempt to remedy this, we investigated a large archival collection of normal and experimental feline parotid, submandibular and sublingual salivary glands. In submandibular and sublingual glands, microliths were detected ultrastructurally in: all types of acinar secretory cells; myoepithelial cells; ductal cells; lumina; intercellular spaces; basement membrane; stroma; macrophages; multinuclear giant cells; and neutrophils. Microliths were not detected ultrastructurally in parotid glands. Microliths appear to form in acinar cells during autophagy and in stagnant secretory material in lumina. Microliths appear to be removed by secretion in the saliva, discharge from cells laterally and basally, and engulfment by macrophages. There appears to be a turnover of microliths, which possibly is upset by secretory inactivity with a resulting accumulation that leads to localized obstruction and sialadenitis.

Histochemical and biochemical determination of calcium in salivary glands of cat

Although feline salivary glands have been used in investigations on secretion and microlithiasis and both processes involved calcium, nothing is known about its distribution in these glands. Therefore we have demonstrated the presence of calcium by a histochemical technique using glyoxal bis(2-hydroxyanil) and a biochemical technique using dry ashing. The histochemical technique stained serous acinar cells weakly and rarely found mucous acinar cells strongly in the parotid gland, mucous acinar cells moderately to strongly and serous acinar cells weakly in the sublingual gland, and central and demilunar acinar cells moderately to strongly in the submandibular gland. The biochemical technique revealed less calcium in the parotid than in the submandibular and sublingual glands. Both techniques revealed a decrease of calcium in submandibular and sublingual glands following parasympathetic stimulation. The histochemical distribution of calcium, which corresponds to that of acinar secretory glycoprotein, and the loss of calcium following parasympathetic stimulation, which causes release of secretory granules, indicate the presence of calcium in secretory granules. The concentration of calcium in the different types of acinar cell corresponds to the acidity of the secretory glycoprotein and suggests that calcium is present as a cationic shield to allow the condensation of polyionic glycoprotein in secretory granules.

The effect of sympathectomy on the occurrence of microliths in salivary glands of cat as studied by light and electron microscopy

Parasympathectomy is followed by a greatly increased occurrence of microliths in the feline submandibular gland, which appears to be because of secretory inactivity. The sympathetic nerves are also important in secretory processes, and so feline submandibular, sublingual and parotid glands subjected to postganglionic sympathectomy for periods from 1 day to 1 yr have now been investigated. Microliths were detected in two out of 28 sympathectomized submandibular glands and four out of 27 untreated glands, and in 10 out of 22 sympathectomized sublingual glands and seven out of 19 untreated glands. There were no significant differences between the occurrence of microliths in sympathectomized and untreated glands. Microliths were not detected in any of 29 sympathectomized and 30 untreated parotid glands. The appearance of the sympathectomized glands was similar to that of the untreated glands. The failure of sympathectomy to affect the occurrence of microliths or the appearance of the glands is possibly because of parasympathetic nerve impulses, which produce continuing secretory activity, and also the spontaneous secretion of the sublingual gland. The results support the concept that secretory inactivity is an aetiological factor of microlithiasis.

Histochemical and biochemical determination of calcium in salivary glands with particular reference to chronic submandibular sialadenitis

Although salivary calcification is relatively common, little is known about the localization and content of the calcium of normal and diseased human salivary glands. We investigated this in chronic submandibular sialadenitis with a variable mixture of relatively normal and extremely atrophic parenchyma and in normal submandibular, parotid and palatal glands. Calcium was localized histochemically in mucous acinar cells of submandibular and palatal glands at moderate to high levels, in serous acinar cells of submandibular and parotid glands at low to moderate or occasionally high levels, in mucous ductal cells at moderate to high levels, and in extremely atrophic parenchyma at low levels or not at all. Calcium was determined biochemically at relatively high levels in the different glands in the order palatal, submandibular, sialadenitis and parotid. However, the differences were small. The results indicate that most salivary calcium is associated with secretory granules; this is the likely source of the calcium involved in salivary calcification.