Induction of hyperplasia in mouse salivary gland isografts

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

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.

Regeneration of submandibular gland autografts in sympathectomized rats

This morphologic study compares the regenerative response in submandibular gland (SMG) autografts placed in the tongues of previously sympathectomized rats to autografts placed in tongues of sham-sympathectomized rats. We hypothesized that sympathectomy would alter the process of cellular proliferation and inhibit cytodifferentiation in regenerating SMG autografts. Either 1 week, or 8 to 11 weeks following the SMG autografting procedure, the rats were sacrificed and their tongues were removed and sectioned in a cryostat. Frozen tissue sections containing the SMG autografts were either reacted for cholinesterase activity, treated with a glyoxylic acid mixture to induce histofluorescence, or stained for histologic examination. In addition, 3H-thymidine labeled and unlabeled cells were counted in autoradiographs of 1-week autografts, and these counts were used to calculate labeling indices. The 1-week SMG autografts from both the sympathectomized and the sham-sympathectomized rats were similar in histologic appearance, and neither group of autografts contained cholinesterase-positive or monoaminergic nerve fibers. The 8- to 11-week autografts from sympathectomized and sham-sympathectomized rats contained cholinesterase-positive fibers, but monoaminergic fibers were present in the autografts only from the sham-operated rats. Acinar cells were observed in one-third of the 8- to 11-week autografts of both the sympathectomized and sham-sympathectomized rats. This finding suggests that sympathectomy did not prelude cytodifferentiation in the autografts. The autoradiographic data revealed no statistically significant difference between the mean labeling indices of the 1-week autografts from the sympathectomized and sham-sympathectomized rats, which suggests that sympathectomy also did not alter the level of cellular proliferation in the autografts.

Effects of prior culture or isoproterenol injections on the regeneration of rat submandibular gland autografts

This study compares the acinar cell regenerative response in submandibular gland (SMG) autografts that were cultured before grafting to the rat tongue with the acinar cell regenerative response in direct SMG autografts to the tongue. In addition, the effects of isoproterenol on direct SMG autografts were studied. A portion of the left SMG was excised from each rat and cut into fragments which were autografted either immediately into the middle one-third of the rat's tongue; or were cultured for 1, 4, or 7 days and then autografted to the donor's tongue. After 8 weeks the rats were killed and the tongues were removed and processed for light microscopic study. The histologic preparations showed evidence of cytodifferentiation into acinar cells in four of the previously cultured SMG autografts. Some of the direct SMG autografts did not contain acinar cells, whereas other direct SMG autografts contained numerous acinar cells and even striated ducts. In the SMG autografts that were cultured for 1 day before autografting and in the direct SMG autografts, the most pronounced regenerative responses were seen in autografts that contained ductlike structures that were apparently connected to the epithelial surface of the tongue. Lastly, isoproterenol appeared to accelerate the regenerative response in some of the direct SMG autografts, and the drug caused acinar cell hypertrophy in two of the direct SMG autografts.

Regeneration of submandibular salivary gland autografted in the rat tongue

Autologous SMG fragments were implanted in tongues of male rats which were sacrificed 15-20 min, 24 hr, 72 hr, 1 week, or 8 weeks after implantation. The tongues were excised, fixed, and processed for light and electron microscopy. In addition, some rats were injected with [3H]-thymidine 1 hr before sacrifice and the labeling indices (L.I.) of the salivary epithelial and interstitial cells were calculated. Twenty-four hours after implantation, SMG autografts showed massive central necrosis with some acini and ducts surviving at the periphery of the lobules. There was marked infiltration of the autografts with neutrophils and macrophages. Also the basal laminae surrounding the necrotic acini and ducts remained intact. The morphology of the autografts after 72 hr was similar to that after 24 hr except that there was additional necrosis and acini and ducts could no longer be identified in the autografts. By 1 week after implantation, the autografts showed lobular morphogenesis, ductal branching, and revascularization. At this time, the regenerating salivary epithelium appeared undifferentiated with no evidence of secretory granules. The L.I. of interstitial and ductlike structures showed significant increases over control values at 1 week after implantation, and then declined toward control levels by 3 weeks after implantation. By 8 weeks after implantation, there was evidence of acinar and striated ductal cytodifferentiation in two autografts. The results emphasize the potential of SMG autografts to regenerate subsequent to severe tissue necrosis.

Regeneration of acini in submandibular gland autografts

Regeneration of submandibular gland (SMG) secretory parenchyma is remarkably impaired in salivary gland diseases and under experimental conditions such as in tissue culture and after isografting. In our study acinar regeneration was found to depend on the site where the SMG tissue was implanted. Implantation of several 2-3 mm3 fragments of SMG subcutaneously in the back of the same donor adult male rat resulted in initial necrosis and mononuclear cell infiltration of the autograft. Then there was epithelial proliferation with the appearance within 28 days of lobules which contained numerous duct-like structures and only a few or no acini. In contrast, implanting SMG fragments in the anatomical bed of the donor gland resulted in the appearance of a more differentiated autograft. Although the initial tissue changes were similar to those seen in the autografts in the subcutaneous tissues of the back, the SMG autograft in the neck also contained numerous acini by 42 and 56 days after implantation. These data support the view that the implantation site influences the course of cytodifferentiation in SMG autografts.