Gene therapy

Generation of Bioartificial Salivary Gland Using Whole-Organ Decellularized Bioscaffold

Salivary gland hypofunction resulting in xerostomia occurs as a result of various pathological conditions such as radiotherapy for head and neck cancers, Sjögren's syndrome or salivary gland tumor resection. It can induce a large number of problems, including dental decay, periodontitis, dysgeusia, difficulty with mastication and swallowing and a reduced quality of life. Current therapies for xerostomia mostly focus on saliva substitutes, oral lubricants and medications which stimulate salivation from residual glands. However, these treatments are not sufficient to restore gland secretory function. Tissue engineering-based organ regeneration has emerged as a potential therapeutic alternative for end- organ failure. Here, we decellularized rat submandibular glands (SMG) by detergent immersion. Histological, immunofluorescent, Western blot, DNA and collagen quantitative analyses demonstrated that our protocol effectively removed cellular components and that extracellular matrix proteins and native structures were well preserved. We then reseeded the decellularized SMG as scaffolds with rat primary SMG cells in a rotary cell culture system. Histological staining and electron microscopy analyses illustrated that the decellularized SMG could support cellular adhesion. Furthermore, with immunofluorescent staining, we proved that bioartificially generated SMG showed some differentiation markers in vitro. Taken together, our findings might provide a potential scaffold for tissue-engineered regeneration of the salivary glands.

Salivary Secretory Disorders, Inducing Drugs, and Clinical Management

BACKGROUND

Salivary secretory disorders can be the result of a wide range of factors. Their prevalence and negative effects on the patient's quality of life oblige the clinician to confront the issue.

AIM

To review the salivary secretory disorders, inducing drugs and their clinical management.

METHODS

In this article, a literature search of these dysfunctions was conducted with the assistance of a research librarian in the MEDLINE/PubMed Database.

RESULTS

Xerostomia, or dry mouth syndrome, can be caused by medication, systemic diseases such as Sjögren's Syndrome, glandular pathologies, and radiotherapy of the head and neck. Treatment of dry mouth is aimed at both minimizing its symptoms and preventing oral complications with the employment of sialogogues and topical acting substances. Sialorrhea and drooling, are mainly due to medication or neurological systemic disease. There are various therapeutic, pharmacologic, and surgical alternatives for its management. The pharmacology of most of the substances employed for the treatment of salivary disorders is well-known. Nevertheless, in some cases a significant improvement in salivary function has not been observed after their administration.

CONCLUSION

At present, there are numerous frequently prescribed drugs whose unwanted effects include some kind of salivary disorder. In addition, the differing pathologic mechanisms, and the great variety of existing treatments hinder the clinical management of these patients. The authors have designed an algorithm to facilitate the decision making process when physicians, oral surgeons, or dentists face these salivary dysfunctions.