Comprehensive investigation of saliva replacement liquids for the treatment of xerostomia

Spirk, Christina; Hartl, Sonja; Pritz, Elisabeth; Gugatschka, Markus; Kolb-Lenz, Dagmar; Leitinger, Gerd; Roblegg, Eva

doi:10.1016/j.ijpharm.2019.118759

Cited by 21 publications

(29 citation statements)

References 50 publications

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“…Thus management of chronic xerostomia is critical. Unfortunately, current management strategies are inadequate, relying on transient symptom relief afforded by artificial saliva products [41,42] or sialagogues that promote saliva production from residual acinar cells, as discussed in the therapeutics section of the present review [15]. However, there are some promising strategies for RT-induced salivary gland dysfunction, such as recently evaluated oral probiotic lozenges [30].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Despite human saliva consisting of approximately 99.5% water, the proteins, lipids, ions and other biomolecules that compose the remaining 0.5% are essential and have yet to be efficiently mimicked artificially [41]. Spirk et al conducted a small clinical study evaluating the three most utilized artificial saliva products, characterizing their physiochemical properties in comparison to unstimulated human saliva [42]. Their study demonstrated that these artificial saliva products differed significantly from human saliva in pH, osmolarity and/or electrical conductivity [42].…”

Section: Artificial Salivamentioning

confidence: 99%

“…Spirk et al conducted a small clinical study evaluating the three most utilized artificial saliva products, characterizing their physiochemical properties in comparison to unstimulated human saliva [42]. Their study demonstrated that these artificial saliva products differed significantly from human saliva in pH, osmolarity and/or electrical conductivity [42]. Their findings explain why the utility of artificial saliva or saliva substitutes is limited.…”

Section: Artificial Salivamentioning

confidence: 99%

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Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions

Jasmer

Gilman

Forti

et al. 2020

JCM

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Salivary glands sustain collateral damage following radiotherapy (RT) to treat cancers of the head and neck, leading to complications, including mucositis, xerostomia and hyposalivation. Despite salivary gland-sparing techniques and modified dosing strategies, long-term hypofunction remains a significant problem. Current therapeutic interventions provide temporary symptom relief, but do not address irreversible glandular damage. In this review, we summarize the current understanding of mechanisms involved in RT-induced hyposalivation and provide a framework for future mechanistic studies. One glaring gap in published studies investigating RT-induced mechanisms of salivary gland dysfunction concerns the effect of irradiation on adjacent non-irradiated tissue via paracrine, autocrine and direct cell–cell interactions, coined the bystander effect in other models of RT-induced damage. We hypothesize that purinergic receptor signaling involving P2 nucleotide receptors may play a key role in mediating the bystander effect. We also discuss promising new therapeutic approaches to prevent salivary gland damage due to RT.

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Section: Clinical Presentationmentioning

confidence: 99%

Section: Artificial Salivamentioning

confidence: 99%

Section: Artificial Salivamentioning

confidence: 99%

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Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions

Jasmer

Gilman

Forti

et al. 2020

JCM

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“…The samples were immediately stored on ice and transferred to the refrigerator. Finally, 30-min centrifugation at 2000 rpm at 4 • C was performed to remove residual cells [44,52]. UWS RT was collected from male and female patients (age 21 to 79 years, n = 40) under radiation therapy in the head and neck area.…”

Section: Saliva Collectionmentioning

confidence: 99%

“…Another therapeutic approach includes topical palliative agents such as saliva substitutes, mouth rinses, or gels [30,[39][40][41]. These formulations consist mainly of polymers such as polyethylene glycol, methylcellulose, chitosan or xylitol [42][43][44][45]. Another well-described polymer candidate that supports cell proliferation, anti-inflammatory processes and consequently wound healing is hyaluronic acid (HA) [30,46].…”

Section: Introductionmentioning

confidence: 99%

Investigation of Changes in Saliva in Radiotherapy-Induced Head Neck Cancer Patients

Winter

Keimel

Gugatschka

et al. 2021

IJERPH

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The intact function of the salivary glands is of utmost importance for oral health. During radiotherapy in patients with head and neck tumors, the salivary glands can be damaged, causing the composition of saliva to change. This leads to xerostomia, which is a primary contributor to oral mucositis. Medications used for protective or palliative treatment often show poor efficacy as radiation-induced changes in the physico-chemical properties of saliva are not well understood. To improve treatment options, this study aimed to carefully examine unstimulated whole saliva of patients receiving radiation therapy and compare it with healthy unstimulated whole saliva. To this end, the pH, osmolality, electrical conductivity, buffer capacity, the whole protein and mucin concentrations, and the viscoelastic and adhesive properties were investigated. Moreover, hyaluronic acid was examined as a potential candidate for a saliva replacement fluid. The results showed that the pH of radiation-induced saliva shifted from neutral to acidic, the osmolality increased and the viscoelastic properties changed due to a disruption of the mucin network and a change in water secretion from the salivary glands. By adopting an aqueous 0.25% hyaluronic acid formulation regarding the lost properties, similar adhesion characteristics as in healthy, unstimulated saliva could be achieved.

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Kaugummi zur Linderung der strahleninduzierten Xerostomie – eine randomisierte Phase-III-Studie

Hermann

Christiansen

2020

Strahlenther Onkol

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Comprehensive investigation of saliva replacement liquids for the treatment of xerostomia

Cited by 21 publications

References 50 publications

Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions

Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions

Investigation of Changes in Saliva in Radiotherapy-Induced Head Neck Cancer Patients

Kaugummi zur Linderung der strahleninduzierten Xerostomie – eine randomisierte Phase-III-Studie

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