Clinical and biochemical evaluation of the saliva of patients with xerostomia induced by radiotherapy

Abstract

Clinical aspects and biochemical properties in the saliva of 21 patients prior to and following radiotherapy for head and neck cancer were evaluated (experimental group) and compared with the same properties in a control group of 21 subjects free of cancer. Salivary flow was evaluated by measuring the time necessary, in seconds, for the output of 2 ml of stimulated saliva; and the buffering capacity changes were determined using a simple colorimetric method. Total salivary protein concentration was determined by the Bradford4 method. Amylase activity was measured by reducing sugars released from a soluble starch substrate, quantified by the dinitrosalicylic method. The electrophoretic profile was evaluated in polyacrylamid gel (12% SDS-PAGE) using samples of 5 mg of salivary protein. A statistically significant reduction (p < 0.01) of the salivary flow was observed, (162.47 s ± 28.30 before and 568.71 s ± 79.75 after irradiation), as well as a reduction in the salivary buffering capacity (pH 5.45 ± 0.14 before and pH 4.40 ± 0.15 after irradiation). No statistically significant alteration was observed in total salivary protein concentration. A statistically significant reduction (p < 0.01) of salivary a-amylase activity (856.6 ng/mg ± 88.0 before and 567.0 ng/mg ± 120.6 after irradiation) was observed. Electrophoretic profile differences in salivary protein bands were also observed after radiotherapy, mainly in the range of molecular weight of 72,000 to 55,000 Daltons. Clinically, patients presenting xerostomia induced by radiotherapy presented an increase in oral tissue injury.

Delayed histological changes in cutaneous portion of pectoralis major flaps employed in upper aero-digestive tract reconstruction

“…This dermal inXammation was noticed in the buccal mucosa too but without the same intensity as observed in the Xap. This phenomenon may be secondary to the local conditions that these tissues are submitted, for example, the acid pH of saliva modiWed by radiotherapy [19], the recurrent trauma related to the xerostomy and the oral colonization by bacteria and fungi [5,7,12,14,18]. This intense inXammatory process may lead to the structural changes observed in the cutaneous portion of the Xaps.…”

Evaluation of some oral postradiotherapy sequelae in patients treated for head and neck tumors

“…A reduction in the quality and quantity of saliva also leads to an imbalance in the microbiota and consequent occurrence of diseases. 11,16,19 In the present study, most patients (89%) were irradiated with a dose higher than 5,000 cGy. This protocol involves a poor prognosis regarding the return of normal glandular function.…”

Tratamento para o Controle da Infecção pelo Vírus HTLV-1 e a Saúde Bucal dos Pacientes

“…Fatores que podem infl uenciar direta ou indiretamente a salivação comprometem a saúde bucal, já que fl uxo e composição salivar estão diretamente relacionados. As causas mais comuns para a hipossalivação e/ou mudanças na composição salivar são: medicação com efeito colateral na secreção, anti depressivos, diuréti cos, anti -histamínicos, antihipertensivos, anti eméti cos e narcóti cos, radioterapia de áreas da cabeça e pescoço, doenças auto-imunes, síndrome da imunodefi ciência adquirida (AIDS), menopausa, distúrbios da alimentação (bulimia, anorexia nervosa, desnutrição, jejum freqüente e desidratação), Diabete Melito, cálculo na glândula salivar 7,8,15,16 . Neste trabalho, todos os anti depressivos listados apresentam como efeito colateral boca seca.…”