Quantitative determination of immunologic components of salivary gland secretion in long-term, event-free pediatric oncology patients

Dens, F; Boute, P; Vinckier, Frans; Declerck, Dominique

doi:10.1016/s1079-2104(05)80303-8

Cited by 24 publications

(23 citation statements)

References 25 publications

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“…Similar to earlier studies 13,26 we observed a significant decrease in salivary secretory IgA level, which may promote bacterial growth and enhance mucosal ulcerations.…”

Section: Discussionsupporting

confidence: 91%

“…11 Earlier studies have suggested the development of a 'hostile,' immunodeficient salivary milieu after HDT, enhancing the direct impact of HDT on submucosal and epithelial cells. 12,13 However, there are almost no extensive studies investigating the precise role of salivary antioxidative mechanisms in overcoming the oxidative injury observed in HDT-related mucositis.…”

Section: Introductionmentioning

confidence: 99%

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Oral integrity and salivary profile in myeloma patients undergoing high-dose therapy followed by autologous SCT

Avivi

Avraham

Koren‐Michowitz

et al. 2008

Bone Marrow Transplant

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The underlying mechanism of high-dose therapy (HDT)-related oral mucositis (OM) may be partly mediated by alterations in the normal salivary composition. This study evaluated salivary antioxidant and immunological capacities observed in myeloma patients suffering from HDTrelated OM, and assessed potential contribution of these factors to OM development. Twenty-five consecutive myeloma patients treated with melphalan 200 mg/m 2 followed by autologous SCT were enrolled. Patients underwent a daily assessment for OM, and salivary samples were collected on days À3 and þ 7 of transplantation and analyzed for secretory IgA and antioxidant capacity. The degree of mucosal damage was assessed by measuring the salivary carbonyl and albumin (Alb) levels. OM, reported in 96% of patients, appeared to be most severe on 8 day after transplantation (range: þ 2 to þ 14). Clinical mucositis was associated with significant reduction in salivary secretory IgA (54%; P ¼ 0.05), and antioxidant activity, measured by total antioxidant status (40%; P ¼ 0.0004), antioxidant capacity (ImAnOx) (23%; P ¼ 0.002) and uric acid level (51%; P ¼ 0.006). The increase found in salivary Alb (119%; P ¼ 0.024) and carbonyl (28%; P ¼ 0.047) levels, indicates mucosal and oxidative damage, respectively. These salivary changes might enhance mucositis development and symptoms. Therapeutic interventions, enhancing antioxidative and immunological activities need to be investigated.

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“…Similar to earlier studies 13,26 we observed a significant decrease in salivary secretory IgA level, which may promote bacterial growth and enhance mucosal ulcerations.…”

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Oral integrity and salivary profile in myeloma patients undergoing high-dose therapy followed by autologous SCT

Avivi

Avraham

Koren‐Michowitz

et al. 2008

Bone Marrow Transplant

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“…[49][50][51][52] However, chemotherapy appears to cause less acute damage alone than in combination with cranial irradiation or total body irradiation. 16,53,54 It has also been suggested that the administration of anticholinergic anti-emetics during early phases of chemotherapy may also reduce salivary flow. 48 Autopsies on adult recipients of doxorubicin and cyclophosphamide showed histopathologic changes, such as ductal dilatation, cyst formation, acinar degeneration, and infiltration in inflammatory cells in salivary gland tissue, 48 which may, at least partly, explain the findings observed in our participants.…”

Section: Discussionmentioning

confidence: 99%

Association of cyclophosphamide use with dental developmental defects and salivary gland dysfunction in recipients of childhood antineoplastic therapy

Hsieh

Hibbert

Shaw

et al. 2010

Cancer

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BACKGROUND:The aim of this study was to examine the effect of antineoplastic therapy on dental development and saliva function in recipients of childhood antineoplastic therapy. METHODS: Patients attending the long-term follow-up clinic at Children's Hospital at Westmead, NSW, Australia, were included if they had received treatment prior to 16 years of age and were in remission for more than 5 years. A dental examination and saliva test were performed for each participant. Holtta's Defect Index (HDI) was used to assess tooth aplasia, microdontia, and root-crown ratio on an orthopantomogram (OPG). Multivariable-adjusted regression analyses were used to estimate the association of patient characteristics and treatment modalities with dental outcomes. RESULTS: One hundred six participants (61% male) were recruited (response rate ¼ 88%). The mean HDI score was 24.7 AE 17.8. A cumulative dose of cyclophosphamide >7500 mg/m 2 increased the HDI score by 13.06 (P ¼ .01). Recipients of cyclophosphamide also had significantly increased odds of exhibiting very low saliva flow (<0.7 mL/min) (odds ratio ¼ 12.43; 95% confidence interval, 2.08-74.35; P ¼ .006). CONCLUSIONS: Children and adolescents who received high doses of cyclophosphamide were at increased risk of dental disturbances. Cyclophosphamide recipients were also at greater risk of exhibiting very low saliva flow. This study applied the HDI to patients receiving all forms of antineoplastic treatment and highlights the dose-dependent relation between cumulative dose of cyclophosphamide and dental disturbances.

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“…[18][19][20]22,23,[49][50][51][52] Chemotherapy-induced changes in human salivary glands and the constituents of saliva have been proposed, 53,54 but the extent to which a decreased volume of saliva contributes to mucositis, and the extent to which individual elements in saliva are altered in concentration is unclear. 50,51,[55][56][57][58][59] A complaint of dry mouth, or xerostomia, is common during chemotherapy administration, although it is unclear to what extent this reflects a true decrease in salivary flow, or is the result of the influence of other medications (eg, antinausea), an indirect effect such as dehydration, or simply a subjective sensation of dryness. Restoring salivary function with a parasympathomimetic should result in the partial elimination of oxygen-free radicals, lipid peroxidation, and other oxidation debris, thus protecting the salivary glands and the oral mucosa.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of pilocarpine hydrochloride for the moderation of oral mucositis during autologous blood stem cell transplantation

Lockhart

Brennan

Kent

et al. 2005

Bone Marrow Transplant

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Summary:Pilocarpine hydrochloride has been reported to increase salivation and decrease oral mucositis in patients receiving head and neck radiotherapy, but there is only one report of its use in a cancer chemotherapy patient population. This prospective, double-blinded, randomized, placebo-controlled trial was undertaken to determine the efficacy of pilocarpine for the moderation of oral mucositis during autologous blood stem cell transplantation. Subjects were randomized to receive a 5 mg tablet of pilocarpine, or a placebo, during and following chemotherapy. Subjects were seen every other day and evaluated for gingival, oral, and oropharyngeal mucositis; nutrition; oral hygiene; eating; speaking; sleeping; pain at rest and/or with swallowing; and mouth dryness. We recorded the mean and highest scores and duration of problems, along with white blood cell counts and differentials, and the use of systemic narcotics for oral mucosal pain. We enrolled and randomized 36 subjects, and there were no statistically or clinically significant differences for the primary outcome of severity of mucositis and no clinically significant differences in any of the other outcome measures. Pilocarpine has no benefit for the moderation of the incidence, severity, or duration of mucositis in patients receiving autologous blood stem cell transplantation. Bone Marrow Transplantation (2005) 35, 713-720.

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Quantitative determination of immunologic components of salivary gland secretion in long-term, event-free pediatric oncology patients

Cited by 24 publications

References 25 publications

Oral integrity and salivary profile in myeloma patients undergoing high-dose therapy followed by autologous SCT

Oral integrity and salivary profile in myeloma patients undergoing high-dose therapy followed by autologous SCT

Association of cyclophosphamide use with dental developmental defects and salivary gland dysfunction in recipients of childhood antineoplastic therapy

Randomized controlled trial of pilocarpine hydrochloride for the moderation of oral mucositis during autologous blood stem cell transplantation

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