Abstract
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.
Highlights
Saliva is of utmost importance for oral health, as it performs a variety of vital functions [1]
Saliva is produced by the major salivary glands and the minor glands, which are innervated by the autonomic nervous system [4]
In order to advance the development of therapeutics for the treatment of radiationinduced xerostomia and mucositis, the aim of this work was to carefully examine unstimulated whole saliva of radiation-induced head and neck cancer patients (UWSRT ) and compare it to healthy unstimulated whole saliva (UWS)
Summary
Saliva is of utmost importance for oral health, as it performs a variety of vital functions [1] It consists of water, enzymes, electrolytes and proteins that work together to assist in swallowing, digestion, protection, moisturization and other tasks [2,3]. Saliva is produced by the major salivary glands (submandibular, sublingual and parotid) and the minor glands, which are innervated by the autonomic nervous system [4]. External factors, such as radiotherapy treatment of head and neck cancer patients, can have a negative effect on salivary glands and saliva production [5].
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