Abstract

Fibrosis is presented in various physiologic and pathologic conditions of the salivary gland. Transforming growth factor beta (TGF-β) pathway has a pivotal role in the pathogenesis of fibrosis in several organs, including the salivary glands. Among the TGF-β superfamily members, TGF-β1 and 2 are pro-fibrotic ligands, whereas TGF-β3 and some bone morphogenetic proteins (BMPs) are anti-fibrotic ligands. TGF-β1 is thought to be associated with the pro-fibrotic pathogenesis of sialadenitis, post-radiation salivary gland dysfunction, and Sjögren’s syndrome. Potential therapeutic strategies that target multiple levels in the TGF-β pathway are under preclinical and clinical research for fibrosis. Despite the anti-fibrotic effect of BMPs, their in vivo delivery poses a challenge in terms of adequate clinical efficacy. In this article, we will review the relevance of TGF-β signaling in salivary gland fibrosis and advances of potential therapeutic options in the field.

Highlights

  • The transforming growth factor beta (TGF-β) signaling pathway is known for its pivotal role in human health and disease

  • TGF-β signaling has a pivotal role in fibrosis, including salivary gland fibrosis

  • Current and potential therapeutic strategies suggested for fibrosis in other organs hint at future therapeutic options for salivary gland fibrosis

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Summary

Introduction

The transforming growth factor beta (TGF-β) signaling pathway is known for its pivotal role in human health and disease. Altered TGF-β signaling leads to a wide spectrum of diseases, including fibrosis, autoimmune disease, inflammatory diseases, and cancer [7,8,9]. Exocrine glands that secrete saliva into the oral cavity, are among the many organs in which TGF-β signaling has significance in both physiologic homeostasis and disease. Salivary gland dysfunction is caused by aging, inflammation, infection, physical compression (by tumor or sialolith), medications, radiation therapy for head and neck cancer, and autoimmune disease [10,11]. We will focus on the role of TGF-β signaling in fibrosis of salivary glands and review recent developments relevant to potential therapeutic strategies in the field

TGF-β Family Members and Downstream Signaling
TGF-β Latency and Activation
TGF-β Signaling in Fibrosis
TGF-β Signaling in Salivary Gland Fibrosis
Sialadenitis
Post-Radiation Induced Salivary Gland Fibrosis
Sjögren’s Syndrome
Potential Therapeutic Strategies for Fibrosis
Inhibition of Pro-Fibrotic Ligand and Receptor Activity
Activation of Anti-Fibrotic Ligand and Receptor
Inhibition of the SMAD Pathway
Issues in Clinical Delivery of BMP
Findings
Conclusions
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