Abstract

BackgroundThere are currently no effective treatments available for patients with irreversible loss of salivary gland (SG) function caused by radiation therapy for head and neck cancer. In this study, we have developed an effective culture method to enhance the anti-inflammatory and vasculogenic phenotypes of peripheral blood mononuclear cells (PBMNCs) and investigated whether such effectively conditioned PBMNCs (E-MNCs) could regenerate radiation-injured SGs and ameliorate salivary secretory function in mice.MethodsMouse PBMNCs were expanded in primary serum-free culture with five vasculogenic proteins for 5 days, and then the resulting cells (E-MNCs) were analyzed for their characteristics. Subsequently, 5 × 104 E-MNCs (labeled with EGFP in some experiments) were injected intra-glandularly into a mouse model of radiation-injured atrophic submandibular glands. After 2–3 weeks, the submandibular glands were harvested, and then the injected E-MNCs were tracked. Four, 8, and 12 weeks after irradiation (IR), salivary outputs were measured to evaluate the recovery of secretory function, and the gland tissues were harvested for histological and gene expression analyses to clarify the effects of cell transplantation.ResultsThe resulting E-MNCs contained an enriched population of definitive CD11b/CD206-positive (M2 macrophage-like) cells and showed anti-inflammatory and vasculogenic characteristics. Salivary secretory function in E-MNC-transplanted mice gradually recovered after 4 weeks post-irradiation (post-IR) and reached 3.8-fold higher than that of non-transplanted mice at 12 weeks. EGFP-expressing E-MNCs were detected in a portion of the vascular endothelium and perivascular gland tissues at 2 weeks post-IR, but mainly in some microvessels at 3 weeks. Between 4 and 12 weeks post-IR, mRNA expression and histological analyses revealed that E-MNC transplantation reduced the expression of inflammatory genes and increased the level of tissue-regenerative activities such as stem cell markers, cell proliferation, and blood vessel formation. At 12 weeks post-IR, the areas of acinar and ductal cells regenerated, and the glands had less fibrosis.ConclusionsThis effective conditioning of PBMNCs is a simple, rapid, and efficient method that provides a non-invasive source of therapeutic cells for regenerating radiation-injured atrophic SGs.

Highlights

  • There are currently no effective treatments available for patients with irreversible loss of salivary gland (SG) function caused by radiation therapy for head and neck cancer

  • I et al Stem Cell Research & Therapy (2019) 10:304 (Continued from previous page). This effective conditioning of peripheral blood mononuclear cells (PBMNCs) is a simple, rapid, and efficient method that provides a noninvasive source of therapeutic cells for regenerating radiation-injured atrophic SGs

  • We have previously focused on bone marrow-derived cells (BMDCs) including mesenchymal stem cells (MSCs) and found that BMDCs or cultured MSCs can improve the function of damaged SGs in both irradiation and Sjögren’s syndrome mouse models [6, 12]

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Summary

Introduction

There are currently no effective treatments available for patients with irreversible loss of salivary gland (SG) function caused by radiation therapy for head and neck cancer. Many patients with head and neck cancer are treated with radiotherapy either alone or in combination with surgery and/or chemotherapy After such treatment, the patient’s prognosis is improved, the radiogenic damage to the salivary glands (SGs) frequently causes severe salivary hypofunction. The patient’s prognosis is improved, the radiogenic damage to the salivary glands (SGs) frequently causes severe salivary hypofunction These patients suffer from severe xerostomia, dysphagia, dental caries, oropharyngeal infections, and oral mucositis [1, 2], and such complications lead to the reduction in quality of life [3]. Developing an adequate treatment is urgently needed for the restoration of radiation-induced atrophic SGs

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