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Roy J, Warner BM, Basuli F, Zhang X, Zheng C, Goldsmith C, Phelps T, Wong K, Ton AT, Pieschl R, White ME, Swenson R, Chiorini JA, Choyke PL, Lin FI. Competitive blocking of salivary gland [ 18F]DCFPyL uptake via localized, retrograde ductal injection of non-radioactive DCFPyL: a preclinical study. EJNMMI Res 2021; 11:66. [PMID: 34287731 PMCID: PMC8295433 DOI: 10.1186/s13550-021-00803-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/09/2021] [Indexed: 12/28/2022] Open
Abstract
Background PSMA-targeted radionuclide therapy (TRT) is a promising treatment for prostate cancer (PCa), but dose-limiting xerostomia can severely limit its clinical adaptation, especially when using alpha-emitting radionuclides. With [18F]DCFPyL as a surrogate for PSMA-TRT, we report a novel method to selectively reduce salivary gland (SG) uptake of systemically administered [18F]DCFPyL by immediate prior infusion of non-radioactive standard of [18F]DCFPyL (DCFPyL) directly into the SG via retrograde cannulation. Methods A dose-finding cohort using athymic nude mice demonstrated proof of principle that SG uptake can be selectively blocked by DCFPyL administered either locally via cannulation (CAN group) or systemically (SYS group). The experiments were repeated in a validation cohort of 22RV1 tumor-bearing mice. Submandibular glands (SMG) of CAN mice were locally blocked with either saline or DCFPyL (dose range: 0.01× to 1000× molar equivalent of the radioactive [18F]DCFPyL dose). The radioactive dose of [18F]DCFPyL was administered systemically 10 min later and the mice euthanized after 1 h for biodistribution studies. Toxicity studies were done at up to 1000× dose. Results In the dose-finding cohort, the SYS group showed a dose-dependent 12–40% decrease in both the SMG T/B and the kidney (tumor surrogate). Mild blocking was observed at 0.01× , with maximal blocking reached at 1× with no additional blocking up to 1000× . In the CAN group, blocking at the 0.1× and 1× dose levels resulted in a similar 42–53% decrease, but without the corresponding decrease in kidney uptake as seen in the SYS group. Some evidence of “leakage” of DCFPyL from the salivary gland into the systemic circulation was observed. However, experiments in 22RV1 tumor-bearing mice at the 0.1× and 1× dose levels confirm that, at the appropriate blocking dose, SG uptake of [18F]DCFPyL can be selectively reduced without affecting tumor uptake and with no toxicity. Conclusion Our results suggest that direct retrograde instillation of DCFPyL into the SG could predictably and selectively decrease salivary uptake of systemically administered [18F]DCFPyL without altering tumor uptake, if given at the appropriate dose. This novel approach is easily translatable to clinical practice and has the potential to mitigate xerostomia, without compromising the therapeutic efficacy of the PSMA-TRT. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-021-00803-9.
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Affiliation(s)
- Jyoti Roy
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, NCI/NIH, Building 10, Room # B3B69F, Bethesda, MD, 20892, USA
| | - Blake M Warner
- National Institute of Dental and Craniofacial Research, NIH, Building 10, 1A08, Bethesda, MD, 20892, USA
| | - Falguni Basuli
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, NIH, Rockville, MD, USA
| | - Xiang Zhang
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, NIH, Rockville, MD, USA
| | - Changyu Zheng
- National Institute of Dental and Craniofacial Research, NIH, Building 10, 1A08, Bethesda, MD, 20892, USA
| | - Corrine Goldsmith
- National Institute of Dental and Craniofacial Research, NIH, Building 10, 1A08, Bethesda, MD, 20892, USA
| | - Tim Phelps
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, NCI/NIH, Building 10, Room # B3B69F, Bethesda, MD, 20892, USA
| | - Karen Wong
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, NCI/NIH, Building 10, Room # B3B69F, Bethesda, MD, 20892, USA
| | - Anita T Ton
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, NCI/NIH, Building 10, Room # B3B69F, Bethesda, MD, 20892, USA
| | - Rick Pieschl
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, NIH, Rockville, MD, USA
| | - Margaret E White
- Laboratory of Genitourinary Cancer Pathogenesis, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Rolf Swenson
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, NIH, Rockville, MD, USA
| | - John A Chiorini
- National Institute of Dental and Craniofacial Research, NIH, Building 10, 1A08, Bethesda, MD, 20892, USA
| | - Peter L Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, NCI/NIH, Building 10, Room # B3B69F, Bethesda, MD, 20892, USA
| | - Frank I Lin
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, NCI/NIH, Building 10, Room # B3B69F, Bethesda, MD, 20892, USA.
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Heynickx N, Herrmann K, Vermeulen K, Baatout S, Aerts A. The salivary glands as a dose limiting organ of PSMA- targeted radionuclide therapy: A review of the lessons learnt so far. Nucl Med Biol 2021; 98-99:30-39. [PMID: 34020337 DOI: 10.1016/j.nucmedbio.2021.04.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/25/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022]
Abstract
At present, prostate cancer remains the second most occurring cancer in men, in Europe. Treatment efficacy for therapy of advanced metastatic disease, and metastatic castration-resistant prostate cancer in particular is limited. Prostate-specific membrane antigen (PSMA) is a promising therapeutic target in prostate cancer, seeing the high amount of overexpression on prostate cancer cells. Clinical investigation of PSMA-targeted radionuclide therapy has shown good clinical efficacy. However, adverse effects are observed of which salivary gland hypofunction and xerostomia are among the most prominent. Salivary gland toxicity is currently the dose-limiting side effect for PSMA-targeted radionuclide therapy, and more specifically for PSMA-targeted alpha therapy. To date, mechanisms underlying the salivary gland uptake of PSMA-targeting compounds and the subsequent damage to the salivary glands remain largely unknown. Furthermore, preventive strategies for salivary gland uptake or strategies for treatment of salivary gland toxicity are needed. This review focuses on the current knowledge on uptake mechanisms of PSMA-targeting compounds in the salivary glands and the research performed to investigate different strategies to prevent or treat salivary gland toxicity.
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Affiliation(s)
- Nathalie Heynickx
- Institute for Environment, Health and Safety, Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium; Department of Molecular Biotechnology, Ghent University, Ghent, Belgium
| | - Ken Herrmann
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America; Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, Essen, Germany
| | - Koen Vermeulen
- Institute for Environment, Health and Safety, Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
| | - Sarah Baatout
- Institute for Environment, Health and Safety, Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium; Department of Molecular Biotechnology, Ghent University, Ghent, Belgium.
| | - An Aerts
- Institute for Environment, Health and Safety, Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
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Lan X, Chan JYK, Pu JJ, Qiao W, Pang S, Yang WF, Wong KCW, Kwong DLW, Su YX. Saliva electrolyte analysis and xerostomia-related quality of life in nasopharyngeal carcinoma patients following intensity-modulated radiation therapy. Radiother Oncol 2020; 150:97-103. [PMID: 32544605 DOI: 10.1016/j.radonc.2020.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/18/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Nasopharyngeal carcinoma (NPC) is one of the most common cancers in southern China and the first-line treatment is radiotherapy. Intensity-modulated radiation therapy (IMRT) can deliver high dose to cancer and low dose to normal tissue, but xerostomia is still one of the complications after IMRT. However, how the concentration of saliva electrolytes be affected by IMRT and the effects on the quality of life are still unknown. In this prospective study, 76 NPC patients were recruited from hospitals in Hong Kong to identify the change of saliva electrolytes and xerostomia-related quality of life before and after IMRT. METHODS AND MATERIALS Saliva and questionnaire were collected before IMRT, 1 month, 3 months, 6 months and 12 months after IMRT. The concentration of saliva electrolytes was detected using inductively coupled plasma-optical emission spectroscopy (ICP-OES). RESULTS Saliva flow rate significantly decreased after IMRT. Decrease in the mean value of pH was observed but the difference is not statistically significant. The concentrations of potassium, iodine, and calcium decreased and chloride concentration increased after IMRT, while the concentrations of sodium, magnesium, copper or zinc were kept at the same level before and after treatment. Xerostomia-related quality of life was adversely affected by IMRT, but partially recovered after 1 year. CONCLUSIONS Our study revealed the change of saliva electrolytes and xerostomia-related quality of life in patients undergone IMRT for NPC.
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Affiliation(s)
- Xinmiao Lan
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jason Y K Chan
- Department of Otorhinolaryngology-Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Jingya Jane Pu
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Wei Qiao
- Dental Materials Science, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Siling Pang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Wei-Fa Yang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Kenneth C W Wong
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong Special Administrative Region
| | - Dora L W Kwong
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
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Zhang T, Liu C, Ma S, Gao Y, Wang R. Protective Effect and Mechanism of Action of Rosmarinic Acid on Radiation-Induced Parotid Gland Injury in Rats. Dose Response 2020; 18:1559325820907782. [PMID: 32127788 PMCID: PMC7036515 DOI: 10.1177/1559325820907782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/02/2020] [Accepted: 01/19/2020] [Indexed: 12/16/2022] Open
Abstract
The parotid glands are damaged by oxidative stress and a series of
pathophysiological changes after irradiation. Rosmarinic acid (RA) is a natural
antioxidant that provides a radioprotective effect against harmful damage from
ionizing radiation. The present study aims to explore the protective effects of
RA on radiation-induced parotid gland injury and its underlying mechanism.
Sprague-Dawley rats were irradiated with 15 Gy X-ray and treated with different
concentrations of RA (30, 60, and 120 mg/kg) or amifostine (AMI, 250 mg/kg).
Saliva secretion function, oxidative stress, apoptosis, the inflammatory
response, and fibrosis were determined by the measurement of the salivary flow
rate, enzyme-linked immunosorbent assay, transferase-mediated DUTP Nick end
labeling, Western blot, quantitative real time polymerase chain reaction, and
hematoxylin and eosin staining. Here, we show that RA treatment significantly
attenuated reactive oxygen species by a direct hindrance effect and the indirect
activation of peroxisome proliferator-activated receptor gamma coactivator
1-alpha/nicotinamide adenine dinucleotide phosphate oxidase 4 signaling.
Rosmarinic acid not only reduced apoptosis by inhibiting p53/jun N-terminal
kinase activation but also reduced parotid gland tissue fibrosis by
downregulating inflammatory factor levels. Compared to AMI, RA has the obvious
advantages of late efficacy and convenient usage. Moreover, 60 mg/kg is the
minimum effective dose of RA. Therefore, RA can potentially be applied as a
therapeutic radioprotective agent to treat radiation-induced parotid gland
injury in the future.
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Affiliation(s)
- Tingting Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Chang Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shanshan Ma
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yirong Gao
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Rensheng Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Mesenchymal Stem Cell Therapy in Submandibular Salivary Gland Allotransplantation: Experimental Study. Transplantation 2019; 103:1111-1120. [DOI: 10.1097/tp.0000000000002612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Yilmaz B, Nisli S, Ergul N, Gursu RU, Acikgoz O, Çermik TF. Effect of External Cooling on 177Lu-PSMA Uptake by the Parotid Glands. J Nucl Med 2019; 60:1388-1393. [PMID: 30850503 DOI: 10.2967/jnumed.119.226449] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/04/2019] [Indexed: 12/13/2022] Open
Abstract
Recent years have seen the start of treatment of metastatic castration-resistant prostate cancer with prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (PRLT), especially 177Lu-PSMA-617. However, PRLT has side effects on the salivary glands that limit the safety of the treatment. The current study aimed to show the effect of external cooling with ice packs on 177Lu-PSMA-617 uptake by the parotid glands (PGs). Methods: The study included 19 patients (mean age, 72.9 y) with metastatic castration-resistant prostate cancer who had been referred for the first time for 177Lu-PSMA-617 treatment and underwent pretreatment 68Ga-PSMA-11 PET/CT. Before the initiation of PRLT, the SUVmax and SUVmean of the right and left PGs were measured on 68Ga-PSMA PET/CT. Frozen ice packs were then affixed over the right PG of each patient for approximately 5 h; 1 h after they were affixed, PRLT was administered. At 4 h after PRLT, head-and-neck SPECT/CT was performed, and at both 4 and 24 h after PRLT, whole-body planar scintigraphy was performed. Regions and volumes of interest were applied for the right and left PGs, and the counts and volumes were determined. Results: Before PRLT, 68Ga-PSMA-11 PET/CT showed no significant difference in SUVmax or SUVmean between the right and left PGs (P > 0.05). At 4 and 24 h after PRLT, planar imaging showed no significant difference in counts between the cooled and noncooled PGs (P > 0.05). Furthermore, at 4 h after PRLT, SPECT/CT showed no significant difference in counts or volumes between the cooled and noncooled PGs (P > 0.05). Conclusion: External cooling does not reduce uptake of 177Lu-PSMA-617 by the PGs.
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Affiliation(s)
- Burcak Yilmaz
- Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serap Nisli
- Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nurhan Ergul
- Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Riza Umar Gursu
- Medical Oncology Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey; and
| | - Ozgur Acikgoz
- Medical Oncology Department, Kanuni Sultan Suleyman Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tevfik Fikret Çermik
- Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
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7
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Pilocarpine effect on dose rate of salivary gland in differentiated thyroid carcinoma patients treated with radioiodine. Nucl Med Commun 2018. [PMID: 29517578 DOI: 10.1097/mnm.0000000000000820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Although different methods have been suggested on reducing salivary gland radiation after radioiodine administration, an effective preventive or therapeutic measure is still up for debate. The aim of this study was to evaluate the effect of pilocarpine, as a sialagogue drug on the radioiodine content of the salivary gland, and radioiodine-induced symptoms of salivary gland dysfunction. PATIENTS AND METHODS Patients who were referred for radioiodine therapy were randomized into pilocarpine and placebo groups. The patients as well as the nurse who administered the tablets, and the specialist who analyzed the images, were all unaware of the patients' group. Anterior and posterior planar images including that of both the head and neck were obtained 2, 6, 12, 24, and 48 h after the administration of radioiodine in all patients, and round regions of interest were drawn for both left and right parotid glands, with a rectangular region of interest in the region of the cerebrum as background. All patients were interrogated once, 6 months after radioiodine administration, by a phone call for subjective evaluation of symptoms related to salivary gland damage. RESULTS There was no significant difference between the two groups with regard to the mean age, sex, and initial iodine activity. The geometric mean of background-corrected count per administered dose and acquisition time was calculated for the bilateral parotid glands. This normalized parotid count showed a significant reduction in net parotid count in both groups during the first 48 h after radioiodine administration. However, no significant difference was found between the groups according to the amount and pattern of dose reduction in this time period. CONCLUSION This study revealed that pilocarpine had no significant effect on the radioiodine content of parotid glands during the first 48 h after radioiodine administration. No significant difference was found in the incidence of symptoms between the two groups treated with placebo and pilocarpine.
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Langbein T, Chaussé G, Baum RP. Salivary Gland Toxicity of PSMA Radioligand Therapy: Relevance and Preventive Strategies. J Nucl Med 2018; 59:1172-1173. [PMID: 29903929 DOI: 10.2967/jnumed.118.214379] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/07/2018] [Indexed: 11/16/2022] Open
Affiliation(s)
- Thomas Langbein
- Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Zentralklinik, Bad Berka, Germany; and
| | - Guillaume Chaussé
- Division of Nuclear Medicine, Department of Radiology, McGill University, Montreal, Canada
| | - Richard P Baum
- Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Zentralklinik, Bad Berka, Germany; and
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Haghighatafshar M, Nowshad R, Etemadi Z, Ghaedian T. The effect of chewing-gum on dose rate of salivary gland in differentiated thyroid carcinoma patients treated with radioiodine. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2018; 64:321-325. [PMID: 29696945 DOI: 10.23736/s1824-4785.18.03078-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although, different methods have been suggested on reducing salivary gland radiation after radioiodine administration, an effective preventive or therapeutic measure is still debated. To the best of our knowledge this is the second study that aimed to evaluate the effect of chewing-gum as a sialagogue on the radioiodine content of salivary gland, and radioiodine-induced symptoms of salivary gland dysfunction. METHODS Twenty-two patients who were referred to radioiodine therapy were randomized into chewing-gum (group A) and control (group B) groups. Anterior and posterior planar images including both head and neck were obtained 2, 6, 12, 24 and 48 hours after the administration of radioiodine in all patients and round regions of interest (ROI) were drawn for both left and right parotid glands with a rectangular ROI in the region of cerebrum as the background. All patients were followed once, 6 months after radioiodine administration via a phone call for subjective evaluation of symptoms related to salivary gland damage. RESULTS There was no significant difference between the two groups regarding the mean age, gender and initial iodine activity. The geometric mean of background-corrected count per administrated dose and acquisition time was calculated for bilateral parotid glands. This normalized parotid count showed a significant reduction in net parotid count in both groups during the first 48 hours after the radioiodine administration. However, no significant difference was found between the groups according to the amount and pattern of dose reduction in this time period. CONCLUSIONS This study revealed that chewing-gum had no significant effect on the radioiodine content of parotid glands during the first 48 hours after radioiodine administration. Also, no significant difference was found in the incidence of relevant symptoms after 6 months comparing both groups.
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Affiliation(s)
- Mahdi Haghighatafshar
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran -
| | - Reza Nowshad
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Etemadi
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Ghaedian
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Liu YJ, Lee YH, Chang HC, Chiu HC, Chiu TW, Hsu K, Pen CM, Hsu HH, Juan CJ. Proton change of parotid glands after gustatory stimulation examined by magnetic resonance imaging. NMR IN BIOMEDICINE 2018; 31:e3885. [PMID: 29315960 DOI: 10.1002/nbm.3885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to investigate proton changes of the parotid gland after gustatory stimulation by semi-quantitative parameters and an empirical mathematical model (EMM) using high-temporal-resolution, double-echo, echo-planar imaging (EPI). Approved by a local institutional review board, this study examined 20 parotid glands from 10 healthy volunteers (male:female = 6: 4; age ± standard deviation =35.1 ± 14.1 years) with written informed consent obtained. All participants underwent 1.5-T, double-echo EPI with gustatory stimulation. Semi-quantitative parameters, including maximal drop ratio (MDR), time to peak (TTP), drop slope (DS), recovery slope (RS) and recovery ratio (RR), were calculated. The effect of temporal resolution on parotid functional parameters was evaluated. An EMM comprising an output function ( Sot=Aoe-kot+B) and an input function ( Sint=Ain1-e-kint) was also applied to fit all dynamic curves. Kruskal-Wallis test, Wilcoxon test, linear regression analysis and goodness of fit were used for statistical analysis. p < 0.05 was considered to be statistically significant. The signal intensity dropped significantly after gustatory stimulation on the proton density (PD) image (p < 0.01). MDR was 8.26% in the PD image. MDR and RR were negatively associated with time interval, whereas DS and TTP were significantly positively associated with time interval (all p < 0.05). EMM parametric values derived from PD-time curves of parotid glands were 12.04 ± 6.81%, 6.43 ± 4.23 min-1 , 88.73 ± 6.18%, 8.41 ± 4.86 min-1 and 1.09 ± 1.35 for Ao , ko , B, Ain and kin , respectively. Semi-quantitative functional parameters and EMM parameters using high-temporal-resolution, double-echo EPI allow the quantification of parotid proton changes after gustatory stimulation.
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Affiliation(s)
- Yi-Jui Liu
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
| | - Yi-Hsiung Lee
- PhD Program in Electrical and Communication Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
- Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Hing-Chiu Chang
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
| | - Hui-Chu Chiu
- PhD Program of Technology Management, Chung Hua University, Hsinchu, Taiwan, Republic of China
| | - Ta-Wei Chiu
- Department of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Kang Hsu
- Department of Dentistry, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Cheng-Ming Pen
- PhD Program in Electrical and Communication Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Hsian-He Hsu
- Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- Department of Radiology, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chun-Jung Juan
- Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- Department of Radiology, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Almansoori AA, Khentii N, Hei WH, Seo N, Lee SH, Kim SM, Lee JH. Rabbit submandibular salivary gland replantation. J Korean Assoc Oral Maxillofac Surg 2017; 43:299-304. [PMID: 29142863 PMCID: PMC5685858 DOI: 10.5125/jkaoms.2017.43.5.299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/23/2017] [Accepted: 07/05/2017] [Indexed: 11/11/2022] Open
Abstract
Objectives To test the feasibility of submandibular salivary gland (SMG) replantation techniques and the survival of the replanted glands. Such a study can provide a rationale for later allotransplantation procedures, along with implementation of conventional and advanced immunosuppression therapy. Materials and Methods Six SMG replantations were performed in New Zealand white rabbits. One week postoperatively, 99mTc scintigraphy was performed and the uptake ratio and salivary excretion fraction were calculated. Two to four weeks later, submandibular glands were excised, fixed, and stained with H&E for histomorphometric evaluation. Results Intraoperatively, all glands showed patent blood perfusion except gland 5. Positive tracer uptake and saliva excretion were documented by scintigraphy. On excision, all of the glands except glands 4 and 5 looked viable, with a red color and patent pedicles. Gland 4 was infected and filled with creamy pus, while gland 5 looked pale and necrotic. Histologically, glands 1, 2, 3, and 6 had preserved normal glandular tissue with slight variations from the contralateral normal glands, as their parenchyma was composed of mildly atrophic acini. Conclusion Four out of six replanted SMGs successfully survived. The glands maintained good viability and function. Such success depends on safe harvesting, short anastomosis time, and strict control of infection.
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Affiliation(s)
- Akram A Almansoori
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Namuun Khentii
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Wei-Hong Hei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Nari Seo
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Sung-Ho Lee
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jong Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea.,Oral Cancer Center, Seoul National University Dental Hospital, Seoul, Korea
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Galvão-Moreira LV, Santana T, da Cruz MCFN. A closer look at strategies for preserving salivary gland function after radiotherapy in the head and neck region. Oral Oncol 2016; 60:137-41. [DOI: 10.1016/j.oraloncology.2016.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/30/2016] [Accepted: 07/09/2016] [Indexed: 11/26/2022]
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Nejaim Y, I V Silva A, V Vasconcelos T, J N L Silva E, M de Almeida S. Evaluation of radioprotective effect of aloe vera and zinc/copper compounds against salivary dysfunction in irradiated rats. J Oral Sci 2016; 56:191-4. [PMID: 25231144 DOI: 10.2334/josnusd.56.191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this study was to evaluate the radioprotective and reparative effects of compounds based on aloe vera, zinc, and copper against salivary gland dysfunction in Wistar rats. A total of 150 Wistar rats were randomly divided into 12 groups, in which the animals received aloe vera and/or zinc and copper. In eight of these groups the animals were also subjected to irradiation before or after administration of the substances. After 27 days, sialometry tests were performed. Data were analyzed using ANOVA and the Tukey test (P < 0.05). Rats that had been administered aloe vera before or after irradiation showed a significantly higher salivary flow rate than rats that had been simply irradiated. When both substances were administered, a statistically significant difference in the salivary flow rate was observed in comparison with the irradiation alone group seven days after irradiation. The present results suggest that aloe vera exerts positive protective and reparative effects, and can be considered a potential radioprotective substance.
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Affiliation(s)
- Yuri Nejaim
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas
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Acauan MD, Figueiredo MAZ, Cherubini K, Gomes APN, Salum FG. Radiotherapy-induced salivary dysfunction: Structural changes, pathogenetic mechanisms and therapies. Arch Oral Biol 2015; 60:1802-10. [DOI: 10.1016/j.archoralbio.2015.09.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 09/18/2015] [Accepted: 09/20/2015] [Indexed: 01/01/2023]
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Xiang B, Li XX, Zhang FY. Underlying protective mechanism of α1-adrenoceptor activation against irradiation-induced damage in rat submandibular gland. Arch Oral Biol 2013; 58:1238-45. [PMID: 23668807 DOI: 10.1016/j.archoralbio.2013.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/31/2012] [Accepted: 03/20/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Damage to salivary gland after radiotherapy for head and neck malignant tumours can lead to irreversible oral complaints, which severely impair quality of life. The protective effect of α1-adrenoceptor activation on the salivary glands after irradiation has previously been demonstrated. However, the exact mechanism remains unclear. In this study, we investigated the underlying cytoprotective mechanism of α1-adrenoceptor activation in rat submandibular glands after irradiation. STUDY DESIGN Rats were locally irradiated using a linear accelerator in the head and neck region with a dose of 20Gy. After irradiation, phenylephrine (5mg/kg) was injected intraperitoneally for 7 successive days and the submandibular glands were then collected. The antiapoptotic effect of phenylephrine on the gland was examined by TUNEL, the proliferative cellular nuclei antigen (PCNA) was determined by immunohistochemistry, and the activation of c-Jun N-terminal kinase (JNK) was detected by Western blot. RESULTS The irradiation only group showed severe atrophy, increased apoptosis, enhanced cell proliferation, and the phosphorylation of JNK was markedly increased by 26.89% (P<0.05), compared to the control. The phenylephrine-treated group, however, showed remarkably alleviated atrophy, decreased apoptosis, and further increased cell proliferation, and the phosphorylation of JNK was markedly decreased by 36.00% (P<0.05), compared to the irradiation only group. CONCLUSIONS The data showed that the underlying protective mechanism of α1-adrenoceptor activation in irradiated gland might be related to improved cell proliferation, inhibited cell apoptosis, and depressed activation of JNK. It could be helpful in protecting salivary glands against irradiation damage.
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Affiliation(s)
- Bin Xiang
- Department of Oral Medicine and Medical Research Center, Medical College, Dalian University, Dalian, Liaoning, China
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Su YX, Benedek GA, Sieg P, Liao GQ, Dendorfer A, Meller B, Rades D, Klinger M, Hakim SG. Radioprotective effect of lidocaine on neurotransmitter agonist-induced secretion in irradiated salivary glands. PLoS One 2013; 8:e60256. [PMID: 23555936 PMCID: PMC3612107 DOI: 10.1371/journal.pone.0060256] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Accepted: 02/24/2013] [Indexed: 02/04/2023] Open
Abstract
Background Previously we verified the radioprotective effect of lidocaine on the function and ultrastructure of salivary glands in rabbits. However, the underlying mechanism of lidocaine's radioprotective effect is unknown. We hypothesized that lidocaine, as a membrane stabilization agent, has a protective effect on intracellular neuroreceptor-mediated signaling and hence can help preserve the secretory function of salivary glands during radiotherapy. Methods and Materials Rabbits were irradiated with or without pretreatment with lidocaine before receiving fractionated radiation to a total dose of 35 Gy. Sialoscintigraphy and saliva total protein assay were performed before radiation and 1 week after the last radiation fraction. Isolated salivary gland acini were stimulated with either carbachol or adrenaline. Ca2+ influx in response to the stimulation with these agonists was measured using laser scanning confocal microscopy. Results The uptake of activity and the excretion fraction of the parotid glands were significantly reduced after radiation, but lidocaine had a protective effect. Saliva total protein concentration was not altered after radiation. For isolated acini, Ca2+ influx in response to stimulation with carbachol, but not adrenaline, was impaired after irradiation; lidocaine pretreatment attenuated this effect. Conclusions Lidocaine has a radioprotective effect on the capacity of muscarinic agonist-induced water secretion in irradiated salivary glands.
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Affiliation(s)
- Yu-xiong Su
- Department of Oral and Maxillofacial Surgery, University of Luebeck, Luebeck, Germany.
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