Minor Glands Research Articles

Agonists of Orally Expressed TRP Channels Stimulate Salivary Secretion and Modify the Salivary Proteome

Natural compounds that can stimulate salivary secretion are of interest in developing treatments for xerostomia, the perception of a dry mouth, that affects between 10 and 30% of the adult and elderly population. Chemesthetic transient receptor potential (TRP) channels are expressed in the surface of the oral mucosa. The TRPV1 agonists capsaicin and piperine have been shown to increase salivary flow when introduced into the oral cavity but the sialogogic properties of other TRP channel agonists have not been investigated. In this study we have determined the influence of different TRP channel agonists on the flow and protein composition of saliva. Mouth rinsing with the TRPV1 agonist nonivamide or menthol, a TRPM8 agonist, increased whole mouth saliva (WMS) flow and total protein secretion compared with unstimulated saliva, the vehicle control mouth rinse or cinnamaldehyde, a TRPA1 agonist. Nonivamide also increased the flow of labial minor gland saliva but parotid saliva flow rate was not increased. The influence of TRP channel agonists on the composition and function of the salivary proteome was investigated using a multi-batch quantitative MS method novel to salivary proteomics. Inter-personal and inter-mouth rinse variation was observed in the secreted proteomes and, using a novel bioinformatics method, inter-day variation was identified with some of the mouth rinses. Significant changes in specific salivary proteins were identified after all mouth rinses. In the case of nonivamide, these changes were attributed to functional shifts in the WMS secreted, primarily the over representation of salivary and nonsalivary cystatins which was confirmed by immunoassay. This study provides new evidence of the impact of TRP channel agonists on the salivary proteome and the stimulation of salivary secretion by a TRPM8 channel agonist, which suggests that TRP channel agonists are potential candidates for developing treatments for sufferers of xerostomia.

CANALICULAR ADENOMA IN UPPER LIP: A CASE REPORT IN YOUNG PATIENT

Canalicular adenoma (CA) is an uncommon benign neoplasm of salivary glands, which mainly affects the minor glands. This neoplasm is more prevalent in females, over 50 years old. The objective is to report the case of a CA in the oral cavity. A Caucasian 18-year-old female patient attended the stomatology service with complaint of swelling in the mouth. The intraoral examination revealed an asymptomatic nodular lesion, sessile and normochromic, with fibrous consistency, slow-growing, and localized to the upper labial mucosa. The clinical diagnosis was traumatic fibroma and an excisional biopsy was performed. Microscopic examination revealed neoplastic cells in a monomorphic pattern in single layered cords in parallel rows, resulting in a bilayered appearance of the tumor cords as well as canals. The anatomopathological examination established the diagnosis of CA. The patient is under a 2-year follow-up with no signs of recurrence.

COVID-19 and the Antiviral Effect of Saliva.

Human saliva is a complex fluid secreted by three major salivary glands, namely, parotid, submandibular, and sublingual as well as several minor glands located in the lips, tongue, palate, cheeks, and pharynx.[1] This brief letter focused on the antiviral function of saliva and its relationship with COVID-19.

Age-Associated Role of Lingual and Pharyngeal Glands in Local Immunity in Oral Cavity.

The macroscopic and histological methods were employed to examine the autopsy specimens of salivary lingual glands obtained from 299 patients of both sexes and various age ranging from newborn to longevity. The age-associated alterations of minor lingual and pharyngeal glands were revealed, and the topographical relations between the glands and lymphoid cells were described. The characteristic sparsity of the glands in infancy is caused by nutritional uniformity at this period, when diminished production of secretory IgA results in frequent inflammatory processes in oral and pharyngeal cavities. With age, the glandular orifices widen, and their number increases thereby augmenting local immunity in the oral cavity and in oral aspect of the pharynx. Starting from elderly and senile age, the involutive alterations were observed, which were accompanied by diminished production of secretory immunoglobulin A and related degradation of local and humoral immunity.

Sarcoidosis with cryptococcal infection apparently engaging only immune-privileged body compartments: a case report

BackgroundInfection with the Cryptococcus neoformans yeast fungus is largely restricted to patients with HIV, sarcoidosis or immunosuppressive therapies. In sarcoidosis, there is intense local immune response in granuloma lesions, coupled with a paradoxical systemic anergy. An analysis of cryptococcal infection in sarcoidosis may therefore shed light on whether opportunistic pathogens preferentially engage immune-privileged tissues.Case presentationA 54-year-old man was admitted to our hospital after 2 months with palpitations and activity-related presyncope. A chest X-ray was normal, electrocardiography showed type-II atrioventricular-block, and there was a tentative diagnosis of myocarditis. Computed tomography reported minor hilar lymph glands and multiple nodular lesions in the lungs. Magnetic resonance imaging showed oedema and nodular structures in the heart, and fibrosis and granulomas were found in endomyocardial biopsies. The diagnosis was revised to cardiac sarcoidosis, and prednisone was initiated. In parallel, positron-emission tomography had revealed a marked uptake in the right thyroid lobe, a thyroid lobectomy was then performed, and the pathology showed a BRAF-positive papillary thyroid carcinoma. Four days postoperatively the patient developed symptoms suggestive of meningoencephalitis. Cerebrospinal fluid and blood cultures yielded growth of C. neoformans. Fungal staining of the thyroid specimen revealed cryptococcal elements in the carcinoma and in granulomas close to the tumour. Notably, there was no evidence of cryptococci in the heart sarcoid sections or in the normal thyroid parenchyma.The patient was successfully treated with antifungal agents and at the 2-year follow-up there was no evidence of thyroid cancer relapse.ConclusionThis sarcoidosis patient had a remarkable clinic with evidence of cryptococcal infection only in body compartments commonly regarded to be immune-privileged. The findings suggest that an opportunistic and environmentally abundant pathogen, when infecting an immunocompromised host, primarily engages immunodeficient locations such as the brain, a tumour microenvironment and some forms of granuloma.

Interleukin 17E associates with haematologic involvement and autoantibody production in primary Sjögren's syndrome

Primary Sjögren's syndrome (pSS) is one of the most prevalent systemic autoimmune diseases characterised by inflammation and tissue damage of exocrine glands, especially salivary or lacrimal gland. IL-17 related immune response is pathogenic with proinflammatory feature in pSS. However, whether IL-17E, an IL-17 family member, is involved in pSS pathogenesis or not, has not been determined. Serum levels of IL-17E and IL-17A as comparison in 107 patients with pSS and 42 healthy controls were determined with multiplex cytokine assays. EULAR Sjögren's syndrome disease activity index (ESSDAI) score was calculated. Laboratory parameters were measured by standard laboratory techniques. The inflammatory infiltration of minor labial gland biopsies was graded based on numbers of lymphocyte and quantified by Focus Score (FS). Expression of IL-17E and IL-17A in the biopsy was evaluated with immunohistochemistry. Significantly elevated IL-17E in pSS patients associated with ESSDAI, haematologic disorders and autoantibody production, including anti-nuclear antibodies (ANA), rheumatoid factor (RF) and anti-SSA antibodies were found. Histopathological features showed that expression of IL-17E was found in labial salivary gland and correlated with lymphocytic infiltration. IL-17E expression in pSS patients was increased and associated with haematologic disorders, autoantibody production and lymphocytic infiltration in salivary gland. This finding indicated that IL-17E is involved in pSS pathogenesis.

Epidemiologic analysis of salivary gland tumors over a 10-years period diagnosed in a northeast Brazilian population

Background Salivary gland tumors (SGT) correspond to a heterogeneous group of lesions with variable biological behavior. The present study aimed to determine the distribution and demographic findings of salivary gland neoplasms in a northeast Brazilian population. Material and Methods A retrospective descriptive cross-sectional study was performed. A total of 588 cases of SGT were diagnosed between 2006 and 2016 of 4 pathology services in the state of Sergipe, Brazil. All cases were reviewed, and data such as sex, age, anatomical location, and histopathological diagnosis were collected. Results A total of 470 (79.9%) tumors were benign and 118 (20.1%) were malignant. The majority of the patients were females (n=328, 55.8%) with an overall female:male ratio of 1.2:1. The major salivary glands were affected more than the minor glands (69.5% vs. 30.5%). Pleomorphic adenoma (n=419, 71.3%) and mucoepidermoid carcinoma (n=29, 4.9%) were the most frequent benign and malignant tumors, respectively. In addition, both benign and malignant tumors occurred more frequently in the parotid gland (n=300, 51%, p<0.05). Conclusions The epidemiologic profile and clinical characteristics of SGT were similar to those described in other countries and other regions of Brazil. Epidemiological studies of SGT help to understand their clinical and pathological features and are essential to establish the proper management and prognosis. Key words:Salivary gland, tumors, epidemiology, head and neck pathology.

PLEOMORPHIC ADENOMA IN UNSUAL SITE: CASE REPORT

Pleomorphic adenoma is the benign tumor of salivary glands, which usually appears in the parotid gland, and when it affects minor glands it occurs mainly in the palate. This study presents a case report of male patient who presented to our service with slow-growing mass in the lip. Intraoral examination revealed nodule, which was sessile, well-circumscribed, covered by healthy mucosa, and located in the upper lip. Because of the well-circumscribed nature of the lesion and its clinical presentation, an excisional biopsy was performed with hypothesis of gland tumor. Microscopic examination revealed benign neoplasm of the salivary gland characterized by the proliferation of epithelial and myoepithelial cells arranged in sheets, cords, ductile structures, and small cellular clusters. Individually the cells exhibit oval or rounded vesicular nucleus with sparse and indistinct cytoplasm. There is abundant stromal or hyaline, sometimes myxoid or fibrous. The patient is under follow-up, and no sign of recurrence was observed for 1 year. Pleomorphic adenoma is the benign tumor of salivary glands, which usually appears in the parotid gland, and when it affects minor glands it occurs mainly in the palate. This study presents a case report of male patient who presented to our service with slow-growing mass in the lip. Intraoral examination revealed nodule, which was sessile, well-circumscribed, covered by healthy mucosa, and located in the upper lip. Because of the well-circumscribed nature of the lesion and its clinical presentation, an excisional biopsy was performed with hypothesis of gland tumor. Microscopic examination revealed benign neoplasm of the salivary gland characterized by the proliferation of epithelial and myoepithelial cells arranged in sheets, cords, ductile structures, and small cellular clusters. Individually the cells exhibit oval or rounded vesicular nucleus with sparse and indistinct cytoplasm. There is abundant stromal or hyaline, sometimes myxoid or fibrous. The patient is under follow-up, and no sign of recurrence was observed for 1 year.

Histomorphological study of salivary gland lesions: A study in tertiary care centre, Bangalore

Introduction: Salivary gland lesions are morphologically and clinically diverse group of lesions which is difficult task for histomorphological interpretation. Since salivary gland tumours are uncommon owing to limited experience with them. The salivary gland system comprises three pairs of major glands (parotid, submandibular and sublingual) and about 500-1000 lobules of minor glands dispersed in the submucosa of the oral cavity. Neoplastic and non-neoplastic lesions arises from major and minor salivary glands. Materials and Methods: Present study was done for 3 years from June 2015 to June 2018. The study was done on 50 specimens from patients with salivary gland lesions which are referred to the department of pathology, DR. B R Ambedkar medical college, Bangalore, Karnataka. The gross examination was done after fixing specimen in 10% formalin and sections were stained with haematoxylin and eosin. Results: Out of 50 cases, 35 cases are neoplastic, and 15 cases are non-neoplastic. Among 35 neoplastic lesions, 20 cases are benign, and 15 cases are malignant. Most common benign tumour of salivary gland is pleomorphic adenoma followed by Warthin’s tumour. Most common malignant tumour of salivary gland is mucoepidermoid carcinoma followed by adenoid cystic carcinoma. Most common non-neoplastic lesion is chronic sialadenitis. Conclusion: From the present study, it is evident that histomorphological examination is the mainstay for the diagnosis and categorization of neoplastic and non-neoplastic lesions of salivary gland. Keywords: Salivary gland, Pleomorphic adenoma and Mucoepidermoid carcinoma.

The salivary biomarkers: future clinical investigation technique

Human saliva is a clear, slightly acidic biological fluid containing a mixture of secretions from multiple salivary glands, including the parotid, sublingual gland other minor glands beneath the oral mucosa as well as gingival crevice fluid. Salivary diagnostics has evolved into a sophisticated science and serves as a subset of the larger field of molecular diagnostics, now recognized as a central player in a wide variety of biomedical basic and clinical areas. Saliva biomarkers are source of indicators for local, systemic, and infectious disorders. The saliva based microbial, immunologic, and molecular biomarkers offers unique opportunities to bypass the painful invasive procedures such as biopsies and repeated blood draws by utilizing oral fluids to evaluate the condition of diseased individuals. Accurate and reliable early stage disease detection is the benefit of salivary biomarkers. Salivary biomarkers represent a promising non-invasive approach for oral cancer detection also. This review explains about the salivary biomarkers and their diagnostic approaches

Transcavernous sinus pituitary gland transposition: how I do it.

Pituitary transposition preserving gland function is possible when approaching superior clival region tumors. Clinical experience along with detailed anatomical knowledge makes this technique safe and effective. We present a step by step description of our technique based on the most recent anatomical references to get a pituitary transposition through the different compartments of the cavernous sinus. By this technique, we achieve minor gland manipulation and a better surgical view of this area. We support this technique with an anatomical analysis on cadaveric specimens and clarifying dissection images. Transcavernous sinus pituitary gland transposition is an easily feasible technique and allows gland shifting preserving pituitary function.

Minimally invasive ultrasound-guided parotid gland biopsy in cadavers performed by rheumatologists.

IntroductionSurgical biopsy of minor salivary glands is routinely performed for the diagnosis of Sjögren syndrome. However, surgical biopsies of the minor labial glands may result in various complications in up to 6% of patients. On the other hand, adverse events following core needle biopsies of the parotid gland in non-rheumatological settings have been reported as very rare.AimThe objective of this study was to assess the feasibility and determine the presence of parotid gland tissue in ultrasound-guided parotid gland biopsies performed by rheumatologists in cadavers.Material and methodTwo senior rheumatologists obtained, under direct ultrasound visualization in in-plane technique, biopsies of 8 parotid glands from 4 different cadavers using a core biopsy needle. One biopsy per gland was taken.ResultsAll histological exams showed typical parotid gland tissue without any neuronal or vascular tissue.ConclusionIn conclusion, we demonstrated that minimally invasive, ultrasound-guided core needle biopsy of the parotid gland is a highly precise and easy method to obtain salivary gland tissue.

MUCOEPIDERMOID CARCINOMA: A RARE CASE REPORT

Minor salivary gland carcinomas are rarely reported. Mucoepidermoid carcinoma (MEC) is one of the most common salivary glandmalignancies. MEC accounts for 1% to 2% of major salivary gland neoplasms and 9% of minor gland tumors. It is most commonly seenin the parotid gland and usually appears as asymptomatic swelling. However, the palate is a frequent site when it occurs in the minorsalivary glands. Follow-up of the patient is very important as local recurrence rate with conservative treatment is high. Here we arereporting a low-grade mucoepidermoid carcinoma involving palatal region in a 25-years-old female patient. The patient presented witha fast-growing swelling, invading the underlying anatomical structures and was treated successfully through the antrostomy procedure.

Expression of alpha‐amylase during murine palatine gland development: A light microscopic immunocytochemical study

IntroductionSalivary alpha‐amylase is one of the major enzymes in the oral cavity. Beyond its primary function of initiation of digestion in the oral cavity, it is involved in defense against bacteria. Alpha‐amylase, a product of serous cells, is the most abundant protein of parotid saliva and it is also secreted by sublingual glands. However, its presence in the minor glands, including palatine glands, has been contradictory. Therefore, this study was conducted to observe the expression of alpha‐amylase at different developmental stages of rat palatine glands using light microscopic immunohistochemistry.Materials and MethodsAn avidin‐biotin technique was used to detect the binding of alpha‐amylase on sagittal frozen sections of palatine glands of pre‐ and post‐natal rats.ResultsPositive reaction of alpha‐amylase was observed at the basolateral and perinuclear membranes of the developing acinar cells at the embryonic day 20 (E20). At birth, in addition to the basolateral membranes, weak cytoplasmic reaction labelling a few mucous cells was observed. Amylase reactivity increased with maturation and reached peak reactivity at postnatal day (PN) 10 and 14, thereafter, decreased into adulthood. Serous cells expressed amylase starting from PN7. Whereas ducts showed variable reaction on the luminal membrane starting from PN3. In adult rats, heterogeneous distribution was revealed between the anterior and posterior portions of palatine glands, as amylase showed more reactivity in the posterior portion.ConclusionThe expression and distribution of alpha‐amylase showed significant modifications during cytodifferentiation and maturation of the palatine glands.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Labial Biopsy of Minor Salivary Glands: Indications in Clinical Diagnostics

The Labial Biopsy of the Salivary Minor Glands (LMSGB) is a complementary examination frequently performed in oral surgery since 1968 [1].

Salivary adenoid cystic carcinoma: A clinicohistologic study in a nigerian tertiary institution

Background: Adenoid cystic carcinoma (ADCC) is a slow-growing salivary gland tumor with high recurrence and mortality rates. Histologic variants present variable aggression. This has not been investigated in Nigeria. This study aimed to investigate association of histologic variants with clinical aggression in Nigerian cases. Patients and Methods: Fifty-nine ADCC from 363 salivary gland tumors were selected from the departmental oral biopsy archives. Clinical data were retrieved, and hematoxylin and eosin sections were reviewed for confirmation and categorization into solid, cribriform, and tubular (modified Perzin, Spiro and van Weert systems). Estimated mean tumor growth rates (EMTGRs) were computed and matched with histologic variants. Statistical analysis was Chi-square, Kruskal–Wallis, and Mann–Whitney's test. P value was ≤0.05. Statistical package was SPSS. Results: Age ranged between 7 and 83 years (mean 49.2 ± 16.8 years). About 75.1% occurred in the 4th–6th decade (P = 0.02). Most common histologic variant was predominantly cribriform no solid (PCNS) pattern (40.7%). In major salivary glands, there was association between histologic variant and EMTGR (P = 0.025). PCNS had the highest EMTGR (0.840) followed by predominantly solid (PS) (EMTGR, 0.744). These were significantly higher than predominantly tubular no solid (PTNS) (EMTGR, 0.442) and predominantly tubular 30% solid (EMTGR, 0.115). In minor glands, there was also association between histologic variants and EMTGR (P = 0.017). However, the highest EMTGR (0.509) occurred in PTNS followed by PCNS (0.428). These were significantly higher than PS (0.259) with the least EMTGR. Conclusion: Trend of clinical aggression of histological variants based on EMTGR of ADCC varies depending on the type of salivary gland (major vs. minor).

Antrochoanal Polyp: A Literature Update

The antrochoanal polyp (ACP) is a unilateral, solitary, pear shaped mass with a cystic stalk, differing from the inflammatory polyps in the formation of a constricted sac, half in the maxillary antrum and the other half in the nose, extruding in a variable extent to the nasopharynx. The ACP has a clinic diagnosis, with image studies as the CT scan and the MRI for the differential diagnosis. By microscopy ACP lacks minor mucoserous glands and a well-developed eosinophilic inflammatory infiltrate, the surface epithelium goblet cells are less frequent than in sinunasal polyps. Surgery is the only known treatment, complete removal by functional endoscopic sinus surgery with treatment of the obstructed ostium complex as the current standard.

The ontogeny of the spinning apparatus of Tengella perfuga (Araneae: Zoropsidae)

AbstractSilk is the most recognizable trait of spiders, and silk use has changed throughout spider evolutionary history. While morphology of the adult silk spigot has been a useful character for systematics, few studies have examined the ontogeny of the spinning apparatus, and none of these included cribellate spiders. Here, we report the first published full ontogeny of the spinning apparatus of a cribellate spider, Tengella perfuga. We found the presence of expected spigots: major ampullate gland and piriform gland spigots on the anterior lateral spinneret, minor ampullate gland and aciniform gland spigots on the posterior median spinneret, and aciniform gland spigots on the posterior lateral spinneret. Females, but not males, possessed cylindrical gland spigots on both the posterior median and lateral spinnerets. Spiderlings did not possess a functioning cribellum until the third instar. The cribellum grew with increasing numbers of spigots, but functionality was lost in adult males. Most intriguingly, second instars possessed a distinct triad of pre‐spigots on the posterior lateral spinneret. From the third instar onward, these structures formed the modified spigot along with two flanking spigots (in females) or formed nubbins (in males). We suggest that the modified spigot serves as the source of axial lines in the cribellate silk produced in T. perfuga. We also compare spigot ontogeny from previous studies of ecribellate spiders. These comparisons warrant further exploration using the recent spider tree of life in a phylogenetic comparative analysis of spigot ontogeny datasets, which could yield evidence for homologous spigots across the Araneomorphae, notably the Araneoidea and the Retrolateral Tibial Apophysis (RTA) clades.

Clinicopathologic analysis of 2736 salivary gland cases over a 11-year period in Southwest China

Objective: To investigate the epidemiological and clinicopathological characteristics of salivary gland tumors in southwest China in order to provide data for clinical diagnosis and other similar research.Methods: Between March 2007 and December 2017, 2736 patients with salivary gland tumors were recruited, the clinical and pathological data were retrospectively analyzed.Results: A total of 2736 patients had a ratio of males to females of about 1.02:1. The ratio of benign to malignant tumors was 3.46:1. Pleomorphic adenoma and adenoid cystic carcinoma had 50.8% and 7.2%, respectively. About 65.4% tumors occurred in the parotid gland. There was no significant difference between the tumor in the left or right parotid and the use of cell phones. There were significant differences between gender and both the characteristics and locations of salivary gland tumors (p < .05). There were also significant differences between the pathological characteristics and location of the salivary gland (p < .05).Conclusions: The salivary gland benign and malignant tumors were more common in pleomorphic adenoma and adenoid cystic carcinoma, most occurred in the parotid gland. The minor gland tumors are lower than other parts of China. The incidence of parotid gland tumors is not related to the use of cell phones.

Sialolipoma of the Parotid Gland: An Uncommon Lipoma Variant of Salivary Gland

Abstract Sialolipoma affecting the salivary glands is an uncommon lipoma variant composed of mature adipose tissue mixed with acinar, ductal, basal and myoepithelial cells of normal salivary gland. It has a wide age range at presentation. Generally, the major gland has male predilection while the minor gland has a female preponderance. A diagnostic workup requires CT or MRI to define the exact location and texture of the lesion. Surgical excision is recommended when the tumor progressively increases in size. Prognosis is good whereby no malignant transformation or recurrences has been reported.