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Paldor M, Levkovitch-Siany O, Eidelshtein D, Adar R, Enk CD, Marmary Y, Elgavish S, Nevo Y, Benyamini H, Plaschkes I, Klein S, Mali A, Rose-John S, Peled A, Galun E, Axelrod JH. Single-cell transcriptomics reveals a senescence-associated IL-6/CCR6 axis driving radiodermatitis. EMBO Mol Med 2022; 14:e15653. [PMID: 35785521 PMCID: PMC9358397 DOI: 10.15252/emmm.202115653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 12/22/2022] Open
Abstract
Irradiation‐induced alopecia and dermatitis (IRIAD) are two of the most visually recognized complications of radiotherapy, of which the molecular and cellular basis remains largely unclear. By combining scRNA‐seq analysis of whole skin‐derived irradiated cells with genetic ablation and molecular inhibition studies, we show that senescence‐associated IL‐6 and IL‐1 signaling, together with IL‐17 upregulation and CCR6+‐mediated immune cell migration, are crucial drivers of IRIAD. Bioinformatics analysis colocalized irradiation‐induced IL‐6 signaling with senescence pathway upregulation largely within epidermal hair follicles, basal keratinocytes, and dermal fibroblasts. Loss of cytokine signaling by genetic ablation in IL‐6−/− or IL‐1R−/− mice, or by molecular blockade, strongly ameliorated IRIAD, as did deficiency of CCL20/CCR6‐mediated immune cell migration in CCR6−/− mice. Moreover, IL‐6 deficiency strongly reduced IL‐17, IL‐22, CCL20, and CCR6 upregulation, whereas CCR6 deficiency reciprocally diminished IL‐6, IL‐17, CCL3, and MHC upregulation, suggesting that proximity‐dependent cellular cross talk promotes IRIAD. Therapeutically, topical application of Janus kinase blockers or inhibition of T‐cell activation by cyclosporine effectively reduced IRIAD, suggesting the potential of targeted approaches for the treatment of dermal side effects in radiotherapy patients.
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Affiliation(s)
- Mor Paldor
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Orr Levkovitch-Siany
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Dana Eidelshtein
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Revital Adar
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Claes D Enk
- Department of Dermatology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Yitzhak Marmary
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Sharona Elgavish
- Info-CORE, Bioinformatics Unit of the I-CORE, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Nevo
- Info-CORE, Bioinformatics Unit of the I-CORE, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hadar Benyamini
- Info-CORE, Bioinformatics Unit of the I-CORE, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inbar Plaschkes
- Info-CORE, Bioinformatics Unit of the I-CORE, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shiri Klein
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Alex Mali
- Department of Pathology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Stefan Rose-John
- Institut für Biochemie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Amnon Peled
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Eithan Galun
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Jonathan H Axelrod
- The Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
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Marmary Y, Adar R, Gaska S, Wygoda A, Maly A, Cohen J, Eliashar R, Mizrachi L, Orfaig-Geva C, Baum BJ, Rose-John S, Galun E, Axelrod JH. Radiation-Induced Loss of Salivary Gland Function Is Driven by Cellular Senescence and Prevented by IL6 Modulation. Cancer Res 2016; 76:1170-80. [PMID: 26759233 DOI: 10.1158/0008-5472.can-15-1671] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/19/2015] [Indexed: 11/16/2022]
Abstract
Head and neck cancer patients treated by radiation commonly suffer from a devastating side effect known as dry-mouth syndrome, which results from the irreversible loss of salivary gland function via mechanisms that are not completely understood. In this study, we used a mouse model of radiation-induced salivary hypofunction to investigate the outcomes of DNA damage in the head and neck region. We demonstrate that the loss of salivary function was closely accompanied by cellular senescence, as evidenced by a persistent DNA damage response (γH2AX and 53BP1) and the expression of senescence-associated markers (SA-βgal, p19ARF, and DcR2) and secretory phenotype (SASP) factors (PAI-1 and IL6). Notably, profound apoptosis or necrosis was not observed in irradiated regions. Signs of cellular senescence were also apparent in irradiated salivary glands surgically resected from human patients who underwent radiotherapy. Importantly, using IL6 knockout mice, we found that sustained expression of IL6 in the salivary gland long after initiation of radiation-induced DNA damage was required for both senescence and hypofunction. Additionally, we demonstrate that IL6 pretreatment prevented both senescence and salivary gland hypofunction via a mechanism involving enhanced DNA damage repair. Collectively, these results indicate that cellular senescence is a fundamental mechanism driving radiation-induced damage in the salivary gland and suggest that IL6 pretreatment may represent a promising therapeutic strategy to preserve salivary gland function in head and neck cancer patients undergoing radiotherapy.
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Affiliation(s)
- Yitzhak Marmary
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Revital Adar
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Svetlana Gaska
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Annette Wygoda
- Department of Oncology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Jonathan Cohen
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Ron Eliashar
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Lina Mizrachi
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Carmit Orfaig-Geva
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Bruce J Baum
- Molecular Physiology and Therapeutics Branch National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland
| | - Stefan Rose-John
- Institut für Biochemie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Eithan Galun
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Jonathan H Axelrod
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel.
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Katz J, Marmary Y, Lugassy G, Ruchlemer R, Abrahamov A, Gez E, Nitzan DW, Polliack A. Primary Lymphoma of the Parotid Gland: A Report of Twelve Cases with a Review of the Literature. Leuk Lymphoma 2009; 5:133-7. [DOI: 10.3109/10428199109068116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Shai E, Palmon A, Panet A, Marmary Y, Sherman Y, Curran MA, Galun E, Condiotti R. Prolonged transgene expression in murine salivary glands following non-primate lentiviral vector transduction. Mol Ther 2006; 12:137-43. [PMID: 15963929 DOI: 10.1016/j.ymthe.2005.02.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2004] [Revised: 02/07/2005] [Accepted: 02/07/2005] [Indexed: 10/25/2022] Open
Abstract
Salivary glands are an accessible organ for gene therapy, enabling expression of recombinant proteins for both exocrine and endocrine secretion. Lentivirus-based vectors have many advantages for gene therapy, including their ability to infect nondividing cells and to stably integrate into the host genome, enabling long-term transgene expression without eliciting an inflammatory immune response. In the present study, murine salivary glands were inoculated with feline immunodeficiency virus (FIV)-based lentiviral vectors expressing various reporter genes. Luciferase expression was observed as early as 24 h posttransduction, peaked at 17-21 days, and remained stable for more than 80 days. Staining with X-gal suggested that mucous acinar cells were effectively transduced. FIV vector transduction with the secreted alkaline phosphatase gene increased serum levels in treated animals for up to 45 days, and the FIV vector harboring the interferon-gamma (IFN-gamma) expression cassette induced an increase in IFN-gamma serum levels as well as in the supernatant of salivary gland explant cultures. These results demonstrate that the transduction of salivary glands with nonprimate lentiviral vectors may provide a novel and highly effective vehicle for long-term endocrine transgene expression.
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Affiliation(s)
- Ela Shai
- Goldyne Savad Institute of Gene Therapy, Hadassah University Hospital, Jerusalem, Israel
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Levy S, Nagler A, Okon S, Marmary Y. Parotid salivary gland dysfunction in chronic graft-versus-host disease (cGVHD): a longitudinal study in a mouse model. Bone Marrow Transplant 2000; 25:1073-8. [PMID: 10828868 DOI: 10.1038/sj.bmt.1702383] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chronic graft-versus-host disease (cGVHD) is an autoimmune-like phenomenon resulting in morbidity and mortality following allogeneic bone marrow transplantation (BMT). Major salivary gland dysfunction and hyposalivation is one of the prevalent manifestations of cGVHD. We have used the B10.D2 to Balb/C cGVHD mice model in order to assess major salivary gland function in cGVHD, evaluating sialometric, sialochemical and histopathological parameters for almost 3 months. As cGVHD is a chronic debilitating disease it is of vast importance to evaluate these parameters on a prolonged longitudinal basis. We observed significant reduction in parotid salivary flow rate and disturbance in the salivary dynamic function in cGVHD mice in comparison to the normal and syngeneic transplanted controls. On days 18, 25, 46, 56 and 88 the mean flow rates of the cGVHD group were 37.4 +/- 4.4 microl/30 min, 40.5 +/- 4.6 microl/30 min, 32.5 +/- 2.3 microl/30 min, 22.2 +/- 3.2 microl/30 min and 14.8 +/- 3.8 microl/30 min, respectively, values which were lower than those of the syngeneic transplanted controls group by 42% (P < 0.04), 32% (P < 0.03), 44% (P < 0.01), 49% (P < 0.01) and 64% (P < 0.01), respectively. These changes in flow rates were paralleled by changes in the biochemical composition of the saliva. Moreover, the reduction in flow rates correlated with the degree of salivary gland destruction observed in the pathological slides. An inverse correlation was observed between the mean parotid salivary flow rate and the degree of fibrosis observed in the histopathological evaluation of the cGVHD mice (P < 0.01). Maximal flow rate 34.8 +/- 4.6 microl/30 min was observed when no fibrosis was observed while in mice with maximal fibrosis flow rates were minimal. This may point to the pathological mechanism leading to the major salivary gland dysfunction and hyposalivation observed in cGVHD. Thus, it may broaden our knowledge and provide the scientific background for designing better therapeutic strategies for this complication. Bone Marrow Transplantation (2000).
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Affiliation(s)
- S Levy
- Department of Oral Medicine and Radiology, Hadassah University Hospital, Jerusalem, Israel
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6
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Baum BJ, Berkman ME, Marmary Y, Goldsmith CM, Baccaglini L, Wang S, Wellner RB, Hoque AT, Atkinson JC, Yamagishi H, Kagami H, Parlow AF, Chao J. Polarized secretion of transgene products from salivary glands in vivo. Hum Gene Ther 1999; 10:2789-97. [PMID: 10584925 DOI: 10.1089/10430349950016528] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Previously (Kagami et al. Hum. Gene Ther. 1996;7:2177-2184) we have shown that salivary glands are able to secrete a transgene-encoded protein into serum as well as saliva. This result and other published data suggest that salivary glands may be a useful target site for vectors encoding therapeutic proteins for systemic delivery. The aim of the present study was to assess in vivo if transgene-encoded secretory proteins follow distinct, polarized sorting pathways as has been shown to occur "classically" in cell biological studies in vitro. Four first-generation, E1-, type 5 recombinant adenoviruses were used to deliver different transgenes to a rat submandibular cell line in vitro or to rat submandibular glands in vivo. Subsequently, the secretory distribution of the encoded proteins was determined. Luciferase, which has no signal peptide, served as a cell-associated, negative control and was used to correct for any nonspecific secretory protein release from cells. The three remaining transgene products tested, human tissue kallikrein (hK1), human growth hormone (hGH), and human alpha1-antitrypsin (halpha1AT), were predominantly secreted (>96%) in vitro. Most importantly, in vivo, after a parasympathomimetic secretory stimulus, both hK1 and hGH were secreted primarily in an exocrine manner into saliva. Conversely, halpha1AT was predominantly secreted into the bloodstream, i.e., in an endocrine manner. The aggregate results are consistent with the recognition of signals encoded within the transgenes that result in specific patterns of polarized protein secretion from rat submandibular gland cells in vivo.
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Affiliation(s)
- B J Baum
- Gene Therapy and Therapeutics Branch, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD 20892, USA.
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Marmary Y, Koter T, Heling I. The effect of periapical rarefying osteitis on cortical and cancellous bone. A study comparing conventional radiographs with computed tomography. Dentomaxillofac Radiol 1999; 28:267-71. [PMID: 10490743 DOI: 10.1038/sj/dmfr/4600453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To determine whether erosion of the cortical plate is necessary for successful radiographic identification of periapical rarefying osteitis. METHODS Forty-two periapical osteitic lesions were diagnosed from periapical radiographs of 26 patients who were subsequently examined by cross-sectional computed tomography (CT). The relation of the lesions to the buccal and lingual cortical plates was determined and their size measured. RESULTS The 42 lesions varied in size from 2 - 10 mm. Thirty one (74%) lesions diagnosed on the periapical radiographs were limited on CT to the cancellous bone with no erosion of the cortical plates. The 11 lesions with cortical erosion were randomly located throughout the jaws. Erosion was due to either the eccentric buccal or lingual location of the tooth apex, large size (>6 mm) of the lesion or narrowness of the jaw. CONCLUSIONS Periapical lesions can be diagnosed from periapical radiographs while they are limited to the cancellous bone and before they have eroded the cortices.
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Affiliation(s)
- Y Marmary
- Department of Oral Medicine and Radiology, Hebrew University - Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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Baum BJ, Wang S, Cukierman E, Delporte C, Kagami H, Marmary Y, Fox PC, Mooney DJ, Yamada KM. Re-engineering the functions of a terminally differentiated epithelial cell in vivo. Ann N Y Acad Sci 1999; 875:294-300. [PMID: 10415576 DOI: 10.1111/j.1749-6632.1999.tb08512.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Because of their easy access, and important role in oral homeostasis, mammalian salivary glands provide a unique site for addressing key issues and problems in tissue engineering. This manuscript reviews studies by us in three major directions involving re-engineering functions of salivary epithelial cells. Using adenoviral-mediated gene transfer in vivo, we show approaches to i) repair damaged, hypofunctional glands and ii) redesign secretory functions to include endocrine as well as exocrine pathways. The third series of studies show our general approach to develop an artificial salivary gland for clinical situations in which all glandular tissue has been lost.
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Affiliation(s)
- B J Baum
- Gene Therapy and Therapeutics Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland 20892, USA.
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9
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Marmary Y, Parlow AF, Goldsmith CM, He X, Wellner RB, Satomura K, Kriete MF, Robey PG, Nieman LK, Baum BJ. Construction and in vivo efficacy of a replication-deficient recombinant adenovirus encoding murine growth hormone. Endocrinology 1999; 140:260-5. [PMID: 9886833 DOI: 10.1210/endo.140.1.6400] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have constructed a recombinant, replication-deficient, first-generation adenovirus-encoding mouse GH (mGH), AdCMVmGH. This virus directed mGH production from an epithelial cell line in vitro in a dose-dependent manner. When injected into the quadriceps muscle or submandibular ducts of mGH-deficient Snell dwarf mice, AdCMVmGH resulted in the production of significantly elevated serum mGH levels. Furthermore, after i.m. injection, dwarf mice increased in weight by 8% over 4 days and close to 100% by 30 days. When AdCMVmGH was administered to 3- to 4-week-old rats by i.v. injection to assess general metabolic responses, serum mGH, insulin-like growth factor 1, triglycerides and cholesterol levels were significantly elevated. AdCMVmGH should be a valuable experimental tool for the controlled, directed expression of mGH in preclinical mouse model studies.
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Affiliation(s)
- Y Marmary
- Gene Therapy and Therapeutics Branch, National Institute of Dental and Craniofacial Research, Bethesda, Maryland 20892, USA
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10
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Baum BJ, Atkinson JC, Baccaglini L, Berkman ME, Brahim JS, Davis C, Lancaster HE, Marmary Y, O'Connell AC, O'Connell BC, Wang S, Xu Y, Yamagishi H, Fox PC. The mouth is a gateway to the body: gene therapy in 21st-century dental practice. J Calif Dent Assoc 1998; 26:455-60. [PMID: 9791282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Gene therapy may become an integral tool in dental practice early in the 21st century. It and other biological therapies are expected to be applied to oral diseases and disorders during the midpractice lifetime of today's dental students. If the applications of oral gene transfer are expanded to systemic diseases, oral health care providers in the future could routinely be "gene therapists" with therapeutic targets well outside the oral cavity.
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He X, Goldsmith CM, Marmary Y, Wellner RB, Parlow AF, Nieman LK, Baum BJ. Systemic action of human growth hormone following adenovirus-mediated gene transfer to rat submandibular glands. Gene Ther 1998; 5:537-41. [PMID: 9614579 DOI: 10.1038/sj.gt.3300622] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We have previously suggested that although salivary glands function in an exocrine manner they might none the less offer a useful way to deliver therapeutic proteins systemically. As a direct functional test of this hypothesis, we constructed a recombinant adenovirus (AdCMVhGH) encoding human growth hormone (hGH) and then studied the biological action of hGH produced following transfer of the hGH gene to rat submandibular glands. At 48 h following infusion of AdCMVhGH into these glands via cannulation of the main excretory duct, serum levels of hGH were approximately 16 ng/ml and rat insulin-like growth factor-1 was elevated approximately 25%. Moreover, serum chemistry profiles of rats subjected to in vivo gene transfer displayed alterations in the BUN:creatinine ratio and triglyceride levels presumably reflecting the anabolic actions of the hGH. These results provide the first demonstration of systemic biological action from a transgene product secreted in an endocrine fashion from the salivary glands.
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Affiliation(s)
- X He
- Gene Therapy and Therapeutics Branch, National Institute of Dental Research, Bethesda, MD 20892, USA
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13
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Nagler R, Marmary Y, Golan E, Chevion M. Novel protection strategy against X-ray-induced damage to salivary glands. Radiat Res 1998; 149:271-6. [PMID: 9496890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Exposure of the major salivary glands to ionizing radiation often results in severe alterations in structure and function. The mechanism of these effects is still unknown, and no adequate prevention or treatment is yet available. The purpose of this study was to examine a mechanism based on the assumption that redox-active metal ions, which propagate the production of highly reactive free radicals, are responsible for the unique radiosensitivity of salivary glands. Zinc-desferrioxamine (Zn-DFO) was recently reported to be a very potent protector against the injuries induced by such metal ions in the vicinity of sensitive cellular targets. We chose to examine its protective potential against the damage to salivary glands induced by X rays. Head and neck irradiation (15 Gy) was delivered to rats 90 min after the intraperitoneal administration of 20 mg/kg Zn-DFO. This group was compared to two control groups, irradiated and nonirradiated. At 2 months after irradiation, both systemic and salivary parameters were analyzed. The results demonstrated that X irradiation induced a profound attenuation of body weight (30%) and a reduction of parotid gland saliva flow rate (74%), parotid gland weight (36%), submandibular gland/sublingual gland saliva flow rate (46%), and submandibular/sublingual gland weight (24%) (P < 0.01 for all parameters). The content of potassium in parotid gland saliva was increased by 46% (P < 0.01), while the protein content was unaltered. The increase in the potassium concentration of the saliva is considered to be another indication of salivary gland hypofunction. Administration of Zn-DFO prior to irradiation resulted in partial protection against radiation-induced injury to the parotid gland but not the submandibular gland. In the Zn-DFO-treated and irradiated group, the parotid gland saliva flow rate was reduced by 42%, the weight of the parotid gland was reduced by 13%, and the potassium concentration in the parotid gland saliva was increased by 21% (P < 0.05 for all parameters). These results give credence to the validity of the hypothesis which correlates radiation-induced damage of the salivary glands with the injurious role of intracellular redox-active metal ions. Furthermore, the results offer prospects in the clinical setting, as Zn-DFO is a modification of DFO, which is a clinically approved and widely used medication. Further examination of the clinical use of Zn-DFO is currently under way, focusing on its beneficial protective effect on healthy non-neoplastic tissue.
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Affiliation(s)
- R Nagler
- Department of Oral & Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel
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Katz J, Fischer D, Marmary Y. [Sialography in the diagnosis of salivary gland lesions]. Harefuah 1998; 134:124-7. [PMID: 9517298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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15
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Nagler A, Nagler R, Ackerstein A, Levi S, Marmary Y. Major salivary gland dysfunction in patients with hematological malignancies receiving interleukin-2-based immunotherapy post-autologous blood stem cell transplantation (ABSCT). Bone Marrow Transplant 1997; 20:575-80. [PMID: 9337059 DOI: 10.1038/sj.bmt.1700928] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
lnterleukin-2 (IL-2) is known to cause xerostomia and skin manifestations similar to graft-versus-host disease (GVHD). We therefore evaluated major salivary gland function in patients with hematological malignancies treated with IL-2 and interferon-alpha (IFN-alpha) after ABSCT. Eleven patients (seven male, four female) of median age 40 (24-47) were evaluated, seven with non-Hodgkin lymphoma (NHL); one with Hodgkin's disease (HD) and three with acute myelogenous leukemia (AML). Parotid and submandibular salivary gland function was assessed before, during and after IL-2/IFN-alpha administration by evaluation of the salivary flow rate and the composition of secreted saliva. Significant reductions in both the resting and stimulated parotid and submandibular salivary flow rates were observed during IL-2/IFN-alpha immunotherapy compared with the pre- and post-therapy values (P < 0.01), while no hyposalivation was observed in the control patients who underwent ABSCT and did not received IL-2. Sialochemical evaluation revealed a significant increase in potassium concentration (24.4+/-0.6 mEq/l to 28.9+/-1.4 mEq/l) and a significant decrease in sodium concentration (6.7+/-2.1 mEq/l to 3.3+/-1.0 mEq/l) (P < 0.05) in the stimulated parotid gland saliva secreted during IL-2/IFN-alpha administration. Salivary protein concentrations were not altered by the IL-2/IFN-alpha immunotherapy. Similar changes were previously observed in mice and humans with chronic GVHD. We conclude that IL-2 immunotherapy induces major salivary gland dysfunction in humans, similar to our previous observations in patients with chronic GVHD, which may indicate similar pathophysiologic mechanisms.
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Affiliation(s)
- A Nagler
- Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel
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Abstract
Impaired salivary function with resultant severe dryness of the mouth, or xerostomia, may occur in association with a variety of systemic disorders or therapies. No adequate treatment exists for this debilitating condition, which impedes normal oral function, in particular alimentation and phonation. This study explores the feasibility of salivary gland autotransplantation, using a canine model. A salivary gland with its duct and surrounding blood vessels still attached was excised and reimplanted in the dog's thigh by anastomosing the graft's blood vessels to the femoral artery and vein. The duct was sutured to an artificial orifice cut in the thigh's skin, from which the saliva was collected. Salivary secretion was induced by a single intravenous bolus of pilocarpine (5 mg). Preoperative (normal) salivation was measured by collecting saliva from the gland in situ. Periodic functional studies showed normal saliva production during the first month after grafting, after which the salivary flow was reduced by 35% over the next 2 months. This reduction was interpreted as a sign of disuse atrophy resulting from the lack of autonomic innervation. To overcome this impediment, oral pilocarpine (5 mg/day) was administered to the recipient dog, after which normal levels of saliva were excreted through the graft during the 3-month follow-up period. The quality of the graft saliva was assessed by its protein and electrolyte levels, which showed close to normal values.
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Affiliation(s)
- A Eid
- Department of Surgery, The Hebrew University-Hadassah Faculty of Medicine, Jerusalem, Israel
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Nitzan DW, Marmary Y. The "anchored disc phenomenon": a proposed etiology for sudden-onset, severe, and persistent closed lock of the temporomandibular joint. J Oral Maxillofac Surg 1997; 55:797-802; discussion 802-3. [PMID: 9251606 DOI: 10.1016/s0278-2391(97)90335-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This article establishes a rationale for a particular type of sudden and severely restricted mouth opening caused by anchoring of the disc to the fossa termed anchored disc phenomenon, describes the possible pathogenesis of this disorder, and recommends appropriate treatment. The clinical characteristics supporting the proposed pathogenesis, and treatment of the disorder are based on data published in the literature and clinical experience with the diagnosis and treatment of this disorder.
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Affiliation(s)
- D W Nitzan
- Department of Oral & Maxillofacial Surgery, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel
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18
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Kohavi D, Bar-Ziv J, Marmary Y. Effect of axial plane deviation on cross-sectional height in reformatted computed tomography of the mandible. Dentomaxillofac Radiol 1997; 26:189-91. [PMID: 9442606 DOI: 10.1038/sj.dmfr.4600242] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To assess the effect of angular deviation on the measured height of the mandible in reformatted cross-sectional CT scans. METHODS Reformatted cross-sectional CT scans were obtained from three dried mandibles, at three angulations, in a special holding and positioning device for perpendicular measurements. The radiographic lengths of 321 measurements were compared with the actual bone length. RESULTS The mean difference between actual bone length and image length, with transaxial planes parallel to the lower border, was 0% (s.d. 3.6). Deviations of 10 degrees and 20 degrees from the lower border of the mandible resulted in a mean error of 1% (s.d. 4.5) and 2.8% (s.d. 8.0) respectively. When the angulation between the deviated transaxial plane and the lower border was greater than 10 degrees, the maximum error was about +/- 30%. CONCLUSION The use of different transaxial planes along the mandible may result, in a small proportion of cases, in discrepancies in height when measured from the cross-sectional images obtained. This may lead to incorrect interpretation of the depth of bone available for implants.
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Affiliation(s)
- D Kohavi
- Department of Prosthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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19
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Nagler R, Marmary Y, Fox PC, Baum BJ, Har-El R, Chevion M. Irradiation-induced damage to the salivary glands: the role of redox-active iron and copper. Radiat Res 1997; 147:468-76. [PMID: 9092927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The mechanism of irradiation-induced hypofunction of the salivary glands is a process that is not fully understood. Here we examine the hypothesis that intracellular and redox-active ions of iron and copper, which are associated with the secretion granules, play a catalytic role in the irradiation-induced damage. Rats were subjected to head and neck irradiation (15 Gy X rays) and allowed to recover for 2 months. The function of the parotid and submandibular glands was then determined by pilocarpine-stimulated salivary secretion. A 45% decrease in the function of both glands was obtained when compared to nonirradiated controls. Treatment prior to irradiation (90 min) with cyclocytidine (200 mg/kg) led to a massive degranulation of the parotid gland and yielded nearly complete protection from radiation-induced damage. In contrast, pilocarpine stimulation prior to irradiation led to a marginal degranulation of the parotid gland and yielded only 13% protection. Neither agent caused degranulation of the submandibular gland mucous cells or yielded functional protection of this gland. Treatment with both agents yielded a marked increase in iron, copper and manganese levels in the parotid gland saliva. An analogous marked increase in the redox activity of iron and copper ions was recorded for the parotid saliva stimulated by pilocarpine and cyclocytidine. Pilocarpine-stimulated submandibular gland saliva contained metal levels similar to those of the parotid gland saliva. However, no redox activity and no increase in metal mobilization could be demonstrated in the submandibular gland saliva stimulated by both agents. The correlation between the patterns of gland degranulation, mobilization of redoxactive metals and the protection of gland function, for both parotid and submandibular glands, focuses attention on the catalytic roles played by transition metal ions in promoting free radical reactions, which likely participate in the process of injury to the tissue.
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Affiliation(s)
- R Nagler
- The Department of Cellular Biochemistry, The Hebrew University-Hadassah School of Medicine, Jerusalem, Israel
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20
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Nagler R, Marmary Y, Fox PC, Baum BJ, Har-El R, Chevion M. Irradiation-Induced Damage to the Salivary Glands: The Role of Redox-Active Iron and Copper. Radiat Res 1997. [DOI: 10.2307/3579504] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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21
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Nagler R, Marmary Y, Krausz Y, Chisin R, Markitziu A, Nagler A. Major salivary gland dysfunction in human acute and chronic graft-versus-host disease (GVHD). Bone Marrow Transplant 1996; 17:219-24. [PMID: 8640170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Salivary gland dysfunction is frequently observed in patients suffering from acute (a) and chronic (c) GVHD. We studied the influence of GVHD on the function of major salivary glands in 20 patients with GVHD (cGVHD, 15; aGVHD, 5). A subjective evaluation of salivary function was performed, in which the score ranged from 0-4 where a higher score indicated more oral dryness. Patients with aGVHD scored 4.0 while patients with cGVHD scored 2.1 (P < 0.01). In addition to this subjective evaluation, patient's salivary flow rates were measured and a reduction of 90% and 60% in aGVHD and cGVHD patients respectively, was observed as compared to controls (P < 0.01; P < 0.05). No hyposalivation was observed in patients who underwent bone marrow transplantation but did not develop GVHD as compared to normal individuals. A direct correlation was observed between the degree of hyposalivation and the severity of the GVHD. Hyposalivation was also documented by scintigraphy of the major salivary glands in the GVHD patients. Furthermore, hyposalivation was associated with extensive mucosal atrophy, erythema, tongue surface depapillation, lichenoid lesions of the buccal and labial mucosa as well as lupus-like lesions. Routine assessment of these glands in patients with GVHD could play a role in monitoring response to therapy.
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Affiliation(s)
- R Nagler
- Department of Oral Medicine, Hadassah University Hospital, Jerusalem, Israel
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22
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Brin I, Ben-Bassat Y, Blustein Y, Ehrlich J, Hochman N, Marmary Y, Yaffe A. Skeletal and functional effects of treatment for unilateral posterior crossbite. Am J Orthod Dentofacial Orthop 1996; 109:173-9. [PMID: 8638566 DOI: 10.1016/s0889-5406(96)70178-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Unilateral posterior crossbite (UPXB) is a common malocclusion, frequently presenting a lower midline deviation, accompanied by Class II subdivision relationships in final closure and a very high prevalence of the reverse sequencing (RS) pattern of jaw movement. These features often persist even after the elimination of the crossbite. The purpose of the present study was to examine in detail the morphologic, skeletal, and functional effects of the treatment for this malocclusion category. The experimental group consisted of 24 children in the mixed dentition stage with UPXB who were treated with removable expansion plates and a control group of 10 age-matched children with normal occlusion. Longitudinal follow-up revealed a stable dental maxillary arch expansion of at least 1.5 mm but a complete elimination of crossbite in only 50% of the cases. The frequent persistence of Class II subdivision relations and lower midline deviation that were not due to functional mandibular shift was striking. The pretreatment posteroanterior (P-A) cephalograms indicated reduced facial and maxillary widths. After treatment, the achieved maxillary width increase was greater than expected with normal growth. Longitudinal assessment of the mandibular movement response revealed by the electrognathograph showed a high prevalence of RS, which was reduced after treatment. In conclusion, (1) a higher than expected prevalence of skeletal transverse aberrations at the maxillary and zygomatic levels were found in the UPXB group; (2) the removable expansion appliance induces transverse growth of the maxilla; and (3) an inherent pattern of jaw movement is characteristic to the UPXB and does not change significantly with orthodontic treatment.
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Affiliation(s)
- I Brin
- Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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23
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Horowitz M, Kaspler P, Marmary Y, Oron Y. Evidence for contribution of effector organ cellular responses to the biphasic dynamics of heat acclimation. J Appl Physiol (1985) 1996; 80:77-85. [PMID: 8847335 DOI: 10.1152/jappl.1996.80.1.77] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The involvement of cellular processes in the biphasic dynamics of heat acclimation was studied. Key steps in the cholinergic signal transduction pathway for water secretion were measured in the submaxillary gland of acclimating [2-day short-term heat acclimation (STHA) and 30-day long-term heat acclimation (LTHA) at 34 degrees C] or acute heat-stressed (2 h at 40 degrees C) rats in vitro. Both the carbamylcholine (CCh)-induced maximal fractional rate and the total 86Rb+ efflux, reflecting K+ efflux and water transport, transiently decreased in STHA (P < 0.001). In LTHA, the total K+ efflux increased (P < 0.001), whereas the maximal fractional rate of efflux increased only slightly. During STHA, the density of the high-affinity binding site of the muscarinic receptors (MRs) increased by 50% and their affinity for the muscarinic antagonist [3H]-N-methylscopolamine decreased transiently by 87%. Basal cytosolic Ca2+ concentration ([Ca2+]i) decreased (P < 0.05), but the peak CCh-induced [Ca2+]i increase resembled the control values. In LTHA, MR density continued to increase (100%; P < 0.05), whereas affinity resumed control values. Basal and CCh-induced [Ca2+]i increases returned to control levels. We conclude that glandular cellular processes follow a biphasic pattern with major apparent changes attributable to events distal to the [Ca2+]i rise. This was further validated by employing heat stress, which produced qualitatively different effects on the MR profile with a decrease in 86Rb+ efflux comparable to STHA. Hence, although heat-induced changes in the proximal components of the signal transduction pathway may contribute to altered regulatory span, the predominant apparent cellular effect is on the distal part of the pathway.
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Affiliation(s)
- M Horowitz
- Department of Radiology, Hadassah Schools of Medicine and Dental Medicine, Hebrew University, Jerusalem, Israel
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24
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Katz J, Polliack A, Harushouski I, Ben Oliel R, Marmary Y. Bell's palsy as a sign of Burkitt's lymphoma in children. Blood 1995; 86:2052. [PMID: 7655035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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25
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Marmary Y, Okon E, Katz J, Shiloni E. Effect of interleukin-2 on salivary gland morphology and function in mice. Lymphokine Cytokine Res 1994; 13:197-201. [PMID: 7948428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
C57BL mice were injected intraperitoneally with 300,000 Cetus units/day of human recombinant interleukin-2 (rIL-2) for 2, 4, and 5 days to study its effect on salivary gland function and morphology. The pilocarpine-stimulated parotid salivary flow was collected via cannulation of the glandular duct. Total salivary protein was assayed spectrophotometrically, salivary electrolytes were determined by atomic absorption, and glandular lymphoid cell infiltration was evaluated histologically. After 5 days of rIL-2 administration salivary output and total salivary protein concentrations were reduced significantly. Similar changes, albeit to a lesser extent, were observed following 2 and 4 days of rIL-2 treatment. Increased lymphoid infiltration of the salivary glands was observed, and was directly related to the duration of rIL-2 administration. The effect of the lymphokine on the parotid gland gradually dwindled after cessation of treatment: 4 days posttreatment this salivary gland showed signs of recovery, which at 10 days proved to be complete. The possible use of this animal model in the study of lymphocyte-induced salivary gland diseases is discussed.
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Affiliation(s)
- Y Marmary
- Department of Oral Medicine, Oral Diagnosis and Oral Radiology, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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26
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Affiliation(s)
- D W Nitzan
- Department of Oral and Maxillofacial Surgery, Hadassah-Hebrew University, Faculty of Dental Medicine, Jerusalem, Israel
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27
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Abstract
Immunotherapy with high doses of interleukin-2 (IL-2) in patients with metastatic cancer is accompanied by multiorgan side effects. To determine the effect of this treatment on oral tissues, 5 cancer patients receiving a course of recombinant IL-2 (rIL-2) were followed. Oral pathology and subjective oral complaints were noted. Whole saliva parameters and routine blood and urine values were recorded daily before, during and after treatment. Mucositis and diminution of salivary flow occurred in all patients. Concomitantly, salivary sodium and protein were elevated.
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Affiliation(s)
- Y Marmary
- Department of Oral Diagnosis, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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28
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Nitzan DW, Dolwick FM, Marmary Y. The value of arthrography in the decision-making process regarding surgery for internal derangement of the temporomandibular joint. J Oral Maxillofac Surg 1991; 49:375-9; discussion 379-80. [PMID: 1741802 DOI: 10.1016/0278-2391(91)90374-u] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In this study, the clinical and arthrographic findings from 43 internally deranged temporomandibular joints (TMJs) were compared with the intra-surgical observations. In 40 of 43 joints, arthrography did not provide any additional information useful for diagnosis or treatment. In six joints, the problem was misdiagnosed. Only in three joints did arthrography demonstrate the existence of perforation in the posterior attachment that had not been suspected during the clinical examination. Because of the doubtful importance of arthrographic information for the decision-making process, it is suggested that the method be applied only in cases in which clinical examination and plain radiographs have failed to uncover the signs and symptoms indicative of a TMJ disorder.
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Affiliation(s)
- D W Nitzan
- Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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29
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30
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Abstract
Synovial chondromatosis of the temporomandibular joint was diagnosed and location of dens particles was assessed by means of computed tomography. Based upon the data collected, the joint was operated conservatively and most of the calcifications were removed leaving the patient symptom free. The importance of an accurate preoperative diagnosis of synovial chondromatosis by use of CT scan is stressed in view of numerous unnecessary condylectomies and parotidectomies reported in the literature.
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Affiliation(s)
- D W Nitzan
- Department of Oral Maxillofacial Surgery, Hadassah Medical Center-Hebrew University, Jerusalem, Israel
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31
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Marmary Y, Gomori JM, Nitzan DW. Lymphoepithelial parotid cysts as presenting symptom of immunodeficiency virus infection: clinical, sialographic, and magnetic resonance imaging findings. J Oral Maxillofac Surg 1990; 48:981-4. [PMID: 2395051 DOI: 10.1016/0278-2391(90)90014-s] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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32
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Nitzan DW, Livni N, Marmary Y, Ben-Baruch N, Sela J, Catane R. The use of monoclonal anti-CEA antibody immunohistochemistry in detecting the origin of oral cavity metastasis. Int J Oral Maxillofac Surg 1990; 19:162-4. [PMID: 2114461 DOI: 10.1016/s0901-5027(05)80136-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 75-year-old woman presented with a painless swelling in the right mandibular retromolar area and numbness of the left lower lip. Radiographic examination of the mandible demonstrated an osteolytic lesion of the ascending ramus. Biopsy revealed adenocarcinoma of obscure origin. Staining of the specimen with a monoclonal antibody specific to colon carcinoma revealed its origin. On subsequent examinations, a primary tumor in the rectosigmoid region with extensive lung, liver and skeletal metastases were diagnosed. This unusual case of colonorectal carcinoma, presenting as a metastatic lesion of the mandible, was readily diagnosed by a novel immunohistochemical technique that utilizes highly specific monoclonal antibodies.
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Affiliation(s)
- D W Nitzan
- Department of Oral Maxillofacial Surgery, Hadassah-Hebrew University Faculty of Dental Medicine, Jerusalem, Israel
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33
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Marmary Y, He XJ, Hand AR, Ship JA, Wellner RB. Beta-adrenergic responsiveness in a human submandibular tumor cell line (A253). In Vitro Cell Dev Biol 1989; 25:951-8. [PMID: 2572578 DOI: 10.1007/bf02624009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Salivary epithelial functions are regulated by the autonomic nervous system. In this regard, we have been studying the morphology and neuroreceptor composition of A253, an immortal cell line isolated from a human submandibular carcinoma (Giard et al., JNCI, 51:1417-1421, 1973). Phase contrast and electron microscopic observations indicate that A253 cells are of epithelial origin. Physiologically, A253 cells possess beta-adrenergic, but not alpha-adrenergic or muscarinic-cholinergic receptors. The beta-adrenergic receptors (BARs) are composed primarily of a single class of high affinity, beta 2-subtype receptors as judged by [3H]dihydroalprenolol antagonist binding studies. The BARs are functional inasmuch as isoproterenol stimulation increases both intracellular cAMP content and [3H]mannose incorporation into endogeneous glycoproteins. Differences in ultrastructure and neuroreceptor composition between A253 and other immortal salivary tumor cell lines are discussed.
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Affiliation(s)
- Y Marmary
- Clinical Investigations and Patient Care Branch, National Institute of Dental Research, Bethesda, Maryland 20892
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34
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Abstract
A 24-year-old woman presented for treatment of her distorted facial appearance. She showed marked widening of the face and skull, which had first become noticeable in childhood. Significant thickening of the cortical bone was seen radiographically throughout the skeleton. Routine laboratory and endocrinological tests showed normal results. These findings, together with a family history of bone disorder, led to the diagnosis of hyperostosis corticalis generalisata. The lower border of the mandible was resected, resulting in improved facial appearance. During the 8-year follow-up, no changes were seen with regard to the mandible.
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Affiliation(s)
- Y Marmary
- Department of Oral Medicine, Faculty of Dental Medicine, Hadassah University Hospital, Hebrew University, Jerusalem, Israel
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35
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Abstract
Like other cytotoxic drugs, methotrexate (MTX) produces adverse reactions in oral tissues. Parotid gland function was examined, in vivo and in vitro, 18 h after MTX administration (15 mg/kg, i.p.). No salivary effects could be detected consistently. In addition, the integrity of the oral mucosa remained intact. Thus, at this dose, MTX does not exert an acute cytotoxic effect either on a rapidly replicating oral tissue like the mucosa, or on tissue with a slow turnover rate like the parotid.
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Affiliation(s)
- A Wolff
- National Institute of Dental Research Bethesda, MD 20892
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36
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Affiliation(s)
- R B Wellner
- Clinical Investigations and Patient Care Branch, National Institute of Dental Research, Bethesda, MD 20892
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37
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Hughes CV, Baum BJ, Fox PC, Marmary Y, Yeh CK, Sonies BC. Oral-pharyngeal dysphagia: A common sequela of salivary gland dysfunction. Dysphagia 1987. [DOI: 10.1007/bf02406913] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Marmary Y, Fox PC, Baum BJ. Fluid secretion rates from mouse and rat parotid glands are markedly different following pilocarpine stimulation. Comp Biochem Physiol A Comp Physiol 1987; 88:307-10. [PMID: 2890470 DOI: 10.1016/0300-9629(87)90488-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
1. Parotid saliva production in two commonly employed laboratory animals, mouse and rat, was studied following pilocarpine stimulation. 2. When normalized to body wt, average parotid saliva output rates in mice were 3-4-fold greater than those observed in rats. When parotid salivary flow rates were normalized to gland weight, mice still displayed 2-3-fold higher values than rats. 3. The Na+ and K+ content of parotid saliva showed small differences between the two species, while saliva from rats contained 3-fold higher protein levels than observed with mice.
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Affiliation(s)
- Y Marmary
- Clinical Investigations and Patient Care Branch, National Institute of Dental Research, Bethesda, MD 20892
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40
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Abstract
A slowly progressing colloidal goiter of 20 years standing was excised in a 67-year old woman. Two years later, a metastatic tumor inducing facial swelling was diagnosed radiologically in the left parotid gland and left ascending mandibular ramus. The incisional biopsy confirmed papillary carcinoma of thyroid origin. The patient refused treatment. Six months later, she returned to the clinic and presented with advanced destructive changes of the involved structures. This rare case of unrestricted malignant growth may shed light upon the sequence and mode of metastatic invasion.
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41
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Abstract
A non-invasive method for salivary gland stone disintegration by shock waves is proposed. An in vitro experiment, in which a large sialolith was subjected to shock waves produced by a Dornier lithotriptor, demonstrated the complete destruction of the stone. The advantages of the method and the need for modification of the existing equipment is discussed.
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42
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Katz J, Marmary Y, Azaz B. "Iodide mumps" following parotid sialography. Case reports. J Oral Med 1986; 41:149-51. [PMID: 3463689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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43
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Galili D, Marmary Y. Juvenile recurrent parotitis: clinicoradiologic follow-up study and the beneficial effect of sialography. Oral Surg Oral Med Oral Pathol 1986; 61:550-6. [PMID: 3459982 DOI: 10.1016/0030-4220(86)90091-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In twenty-two children juvenile recurrent parotitis (JRP) was diagnosed on the basis of age at onset, duration of parotid swelling episodes, frequency of attacks, lack of pus formation, and typical sialograms. Age at onset and severity of the disease varied widely. There was a high incidence of upper respiratory tract infection, and in some cases a familial history of JRP was noted. The sialograms revealed acinar and ductal atrophy and severe sialectasis. A dominant feature was impaired glandular function. The follow-up period was notable for a striking decrease in the number of incidents of glandular swelling regardless of the patient's age at the time of his or her first visit to our clinic. Since drug treatment was administered prior to our first examination and no medicaments were prescribed by us, the improvement in the clinical status of the patients is attributed to the sialographic procedures.
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44
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Abstract
A radiographic survey of the jawbone adjacent to the teeth revealed a high incidence of bone pathosis in 889 randomly chosen patients. Jaw lesions, nearly all inflammatory, were present in every second person. Bone-destructive inflammatory processes (rarefying osteitis) were the most frequently encountered lesions, occurring in both the maxilla and the mandible. Bone-appositioning inflammatory processes (condensing osteitis), on the other hand, appeared mostly in the mandible, very often involving the first molar, thus indicating the differing biologic behavior of the two jawbones. Other bony manifestations in the mandible, such as enostosis and periapical cemental dysplasia, although relatively rare, also formed part of the picture. In light of the absence of related symptoms, the clinical significance of these widely prevalent periapical lesions has to be reconsidered.
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45
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Marmary Y, Brayer L, Tzukert A, Feller L. Alveolar bone repair following extraction of impacted mandibular third molars. Oral Surg Oral Med Oral Pathol 1986; 61:324-6. [PMID: 3458139 DOI: 10.1016/0030-4220(86)90409-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Bone regeneration following extraction of impacted mandibular third molars was measured on 83 preoperative and postoperative radiographs. The patient sample was divided into two age groups, 20 to 29 years and 30 to 50 years. Postoperatively, there was an average net gain of 2.15 mm in bone level. The degree of bone healing is affected primarily by age and, to a lesser extent, by the presence of generalized inflammation (periodontitis).
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46
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Galili D, Marmary Y. Spontaneous regeneration of the parotid salivary gland following juvenile recurrent parotitis. Oral Surg Oral Med Oral Pathol 1985; 60:605-7. [PMID: 3865131 DOI: 10.1016/0030-4220(85)90361-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Sialograms of an 18-year-old female patient known to suffer from juvenile recurrent parotitis (JRP) disclosed the destructive glandular changes typical of the disease. During the 10 years subsequent to the sialographic examination, the patient did not experience any further attacks of JRP. Sialograms carried out when the patient was 28 years of age demonstrated a normal gland. This case illustrates that a damaged parotid gland is capable of regeneration following JRP.
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47
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Abstract
Intraligamentary dental anesthesia has become a widely accepted technique. The periodontal ligament seems to provide easy access to the tooth apex. In the present study, radiopaque material was injected into baboon monkeys. Serial radiographs during incremental injections showed clouding of the crestal bone. The material was seen gradually advancing through the alveolar bone crest, apically. The spread was noticed through the marrow spaces, unexpectedly avoiding the PDL route.
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Goldfarb A, Nitzan DW, Marmary Y. Changes in the parotid salivary gland of beta-thalassemia patients due to hemosiderin deposits. Int J Oral Surg 1983; 12:115-9. [PMID: 6409823 DOI: 10.1016/s0300-9785(83)80007-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
2 patients afflicted with beta-thalassemia major presented with pain and swelling of the parotid salivary gland. In 1 patient, the symptoms were of long standing and particularly severe, with diminished and highly viscous salivation. In the other patient, the parotid glands had only recently become painful, while salivary output and quality remained normal. The parotid anatomy in both patients, as demonstrated by sialography, and the clearance of opaque material were normal. Tc99 scintigraphy revealed reduced uptake and rapid clearance of the isotope from the parotid serous glands into the oral cavity, in contrast to the increased uptake by the sublingual mucous glands. Iron deposits were demonstrated in the parotid secretory serous cells. It is postulated that the impaired function of the parotid is linked to iron deposits in the serous cells of this gland, as a sequella of beta-thalassemia.
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Abstract
A 15-year-old girl presented with swelling and spontaneous bleeding of the gingiva. The lower anterior teeth were sensitive to percussion, and the lower lip and chin showed lack of sensation. Radiographically, gross loss of the alveolar and basal bone in both jaws was evident. The lamina dura and periodontal ligament had lost their morphology. Based on the clinical, radiographic and laboratory findings, the diagnosis of Burkitt's lymphoma cell leukemia was made. While cytotoxic medication brought about an immediate clinical improvement, radiographically, jaw bone repair became evident one month following initiation of treatment.
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