Abstract
Saliva is an important compound produced by the salivary glands and performs numerous functions. Hyposalivation (dry mouth syndrome) is a deleterious condition often resulting from radiotherapy for patients with head and neck cancer, Sjogren’s Syndrome, or as a side effect of certain medications. Hyposalivation negatively affects speaking, mastication, and swallowing in afflicted patients, greatly reducing their quality of life. Current treatments for this pathology include modifying lifestyle, synthetic saliva supplementation, and the utilization of salivary gland stimulants and sialagogues. However, many of these treatments do not address the underlying issues and others are pervaded by numerous side effects. In order to address the shortcomings related to current treatment modalities, many groups have diverted their attention to utilizing tissue engineering and regenerative medicine approaches. Tissue engineering is defined as the application of life sciences and materials engineering toward the development of tissue substitutes that are capable of mimicking the structure and function of their natural analogues within the body. The general underlying strategy behind the development of tissue engineered organ substitutes is the utilization of a combination of cells, biomaterials, and biochemical cues intended to recreate the natural organ environment. The purpose of this review is to highlight current bioengineering approaches for salivary gland tissue engineering and the adult stem cell sources used for this purpose. Additionally, future considerations in regard to salivary gland tissue engineering strategies are discussed.
Highlights
Saliva is a watery substance produced by the salivary glands
mesenchymal stem cells (MSCs) injection preserved the saliva flow rate over the 14 week post-treatment period; when MSCs were administered in conjunction with complete Freund’s adjuvant (CFA), the salivary gland regenerative potential increased (Figure 3). These findings indicate that MSC therapy alone reduced inflammation, but there was additional tissue repair and regeneration when administered in conjunction with CFA
Stimulated salivary flow rate significantly increased at follow-up over the course of 12 months. These findings demonstrate that the MSC treatment in human patients was well tolerated, inhibited the inflammatory response, significantly increased salivary flow rate, and improved s Syndrome (SS) disease symptoms, indicating that allogeneic MSC treatment is a safe and effective therapy for patients with SS and xerostomia
Summary
Saliva is a watery substance produced by the salivary glands. It consists of mucus, various electrolytes, glycoproteins, enzymes, and antibacterial compounds such as lysozyme and IgA [1]. Irradiated mice that received MSCs showed significant increase in saliva flow rate and improvement in salivary gland weight compared to irradiated control mice that only received a PBS injection; the MSC treatment group had fewer apoptotic cells, higher numbers of functional acinar cells, and an increase in blood microvessel density These results indicate that transplanted MSCs are capable of grafting into radiation-damaged salivary glands and preserving salivary gland function while reducing apoptosis and increasing microvessel density. The study determined that intra-glandularly injected hAECs were capable of differentiating into acinar cells and restoring saliva production in irradiated mice, highlighting the potential of hAECs to serve as a stem cell source for salivary gland regeneration in clinical applications. It will be necessary to identify somatic and other tissue-derived stem cell populations from the patient that have the capability to reproduce salivary gland organogenesis via epithelial-mesenchymal interactions
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