Extraction, structural characteristics, bioactivities, structural-activity relationships, and application prospects of the polysaccharides from Ophiopogon japonicus: A review.

This study aimed to analyse structural and functional mitochondrial alterations, the release of mitochondrial DNA (mtDNA), and the activation of inflammatory signalling pathways that can be reversed by tofacitinib in the salivary glands (SG) of patients with Sjögren's disease (SjD). SG from patients with SjD and controls, as well as from mice with SjD treated with or without tofacitinib, were analysed. We determined the mitochondrial ultrastructure, the presence of mtDNA in the cytosol, and the levels and localisation of pattern recognition receptors (PRRs) that recognise mtDNA. The adenosine triphosphate (ATP) levels and oxygen consumption rate (OCR) were measured to evaluate mitochondrial respiration in frozen SG. We also evaluated the OCR in human submandibular gland cells incubated with interferon-gamma (IFN-γ), tofacitinib, or both. Increased mtDNA release into the cytosol was observed in SG epithelial cells of patients with SjD. This change was linked with increased PRR activation (cyclic GMP-AMP synthase, Z-DNA-binding protein 1, and nucleotide-binding oligomerisation domain-like receptor protein 3) and decreased mitochondrial transcription factor A (TFAM). Similar mitochondrial ultrastructural alterations and increased PRR activation were observed in the SG of the SjD mouse model. These changes were reversed by tofacitinib. Interestingly, increased activity of electron transport chain complexes was observed in SG of patients with SjD, which could be modulated by IFN-γ, as observed in vitro. We also found that tofacitinib stabilised mitochondrial function at basal conditions in vitro, counteracting the mitochondrial adaptations induced by IFN-γ. Taken together, these results suggest that mitochondrial alterations are linked with inflammation and support the potential use of tofacitinib in patients with SjD.

This study was designed to inspect the effects of vitamin D3 overdose on the submandibular salivary gland of Albino rats and to investigate the possible protective role of vitamin K1 after one month, as few studies have addressed its histopathological effects. This study was carried out on 60 adult male Albino rats, and they were divided into three groups. Group I (control): received physiological saline. Group II (vitamin D3 overdose): received 1ml/kg/day cholecalciferol (200IU) for 30days. Group III (vitamin D3 + vitamin K1): received the same vitamin D3 dose plus vitamin K1 (15mg/kg/day) for 30days. Blood samples were analyzed for baseline and terminal levels of total and ionized calcium. Specimens were examined using Hematoxylin and eosin, alizarin red stain, transmission electron microscopes, and histomorphometric analysis. Statistical analysis was performed using analysis of variance, followed by a post hoc test for pairwise comparisons, and paired t-test for intra-group comparison between baseline and terminal values. examination of group II revealed pronounced structural alterations, notably acinar atrophy, which was statistically validated by a significant reduction in acinar circumference (p-value = 0.024*), alongside ductal degeneration, vascular congestion, and tissue calcification as detected by alizarin red stain. These histopathological changes correlated with elevated serum calcium levels (p-value = 0.001**). In contrast, co-treatment with vitamin K1 in group III substantially mitigated these pathological effects, demonstrating preservation of acinar and ductal structures, attenuation of calcific deposits, and partial normalization of serum calcium levels (p-value = 0.004*). Chronic administration vitamin D₃ overdose triggered degenerative, inflammatory, and calcific changes in the SMG. Also, co-administration of vitamin K1 diminished vitamin D3-induced histopathological changes and hypercalcemia.

Submandibular gland prominence is increasingly recognized as a limiting factor in achieving optimal cervicomental contour. Although energy-based devices are widely used during glandular procedures, their tissue-level effects remain insufficiently defined. To compare the histological impact of a vessel-sealing system and conventional bipolar electrocautery on submandibular gland tissue in an experimental model. Twenty-four male Wistar rats were randomly assigned to three groups (LigaSure, bipolar electrocautery, and cold dissection control; n=8 per group). Partial glandular excision was performed under standardized conditions. Tissue specimens were processed for histological analysis using hematoxylin and eosin staining. Edema, hemorrhage, vascular injury, necrosis, inflammation, and ductal narrowing were assessed using a semi-quantitative scoring system. Non-parametric statistical methods were applied for intergroup comparisons. Both energy-based modalities produced significantly greater tissue alterations compared with controls (p<0.05). Bipolar electrocautery demonstrated higher levels of inflammation, edema, hemorrhage, and necrosis relative to LigaSure (p<0.05), while vascular injury showed no statistically significant difference. In contrast, ductal narrowing was significantly more pronounced in the LigaSure group (p<0.05). Overall, the most marked differences between modalities were observed in the inflammatory response and ductal changes. Distinct patterns of tissue injury are associated with different energy modalities. LigaSure appears to limit collateral tissue damage while exerting a greater effect on ductal structures, whereas bipolar electrocautery is associated with more extensive inflammatory and hemorrhagic changes. These findings provide experimental insight that may inform energy device selection in submandibular gland surgery, although further studies are needed to clarify their clinical implications.

The submandibular glands are salivary glands located under the mandible that secrete saliva into the oral cavity. The occurrence of heterotopic submandibular glands is an uncommon anatomical variation that is usually found unilaterally. There are few known reports of bilateral heterotopic submandibular glands; this paper describes a rare case of bilateral heterotopic submandibular glands that were discovered incidentally during routine dissection of a cadaver for medical education purposes and subsequent histological examination. The heterotopic glands were located in the carotid triangle at the level of the hyoid bone and appeared to receive blood supply from the facial artery and innervation from the facial nerve, similar to that of typical submandibular glands in normal anatomical location. Venous drainage was into the facial vein and communicating jugular vein. Dissection of each bilateral heterotopic submandibular gland revealed a duct oriented toward the oral cavity, suggesting that it was a functional salivary gland. Histological analysis of the glands and nearby deep cervical chain lymph nodes revealed normal salivary gland and lymph node structure, with no evidence of neoplasia. Encountering such anatomical variations during cadaveric dissection as part of medical education is an irreplaceable learning experience that increases the understanding of pathologies and clinical competency.

The aging of salivary glands (SGs) leads to xerostomia, impaired oral defenses, and a compromised quality of life, yet the biology of human submandibular gland (SMG) aging remains poorly understood due to limited availability of human tissues and differences in anatomy and physiology between rodent and human SGs. The common marmoset (Callithrix jacchus) is a short-lived non-human primate (NHP) with SMG histology that closely resembles humans and has the potential to provide a translational model for investigating SG aging. In this study, we examined the age-associated structural and molecular alterations that occur in marmoset SMGs and evaluated whether chronic oral rapamycin treatment, a gerotherapeutic mTOR inhibitor, mitigates these age-related changes. Histological and immunofluorescence analyses revealed that there was a substantial decline in mucous and serous acinar units, expansion of ductal and collagen-rich stromal compartments, increased extracellular matrix remodeling, elevated dysregulation of lipid metabolism, and increased numbers of apoptotic and senescent cells in the SMG with aging. Rapamycin treatment was associated with partial preservation of acinar structure and a reduction in fibrosis, lipid accumulation, and number of apoptotic and senescent cells that resulted in an overall tissue phenotype that more closely resembled that of younger animals. These findings suggest that the aging marmoset SMG recapitulates key features of human SG aging and that rapamycin treatment was associated with an attenuation in the hallmarks of SG degeneration. The results suggest that the marmoset represents a valuable NHP model for studying SG aging biology and testing therapeutic strategies aimed at attenuating age-related structural degeneration associated with SG dysfunction.

This paper discusses neck contouring prejuvenation techniques, focusing primarily on neck lift and submental liposuction to optimize neck definition. Traditional neck rejuvenation has relied on platysmaplasty, fat excision, and skin resuspension for addressing the aging neck. With growing demand for early neck rejuvenation, surgical approaches focused more on definitive sculpting such as submental liposuction and deep neck lifts have become increasingly popular. The neck consists of multiple layers and structures including skin, subcutaneous fat, platysma muscle, submandibular glands. Ideal candidates for prejuvenation surgical neck contouring procedures are patients aged 20-40 with early signs of submental fullness or a soft jawline with otherwise good skin elasticity. The senior author performs deep neck lift surgery using a small submental crease incision and sculpts prominent subplatysmal fat, anterior digastric muscle, and submandibular glands down to the level of the mandible. Following neck lift surgery, patients are instructed to follow a bland diet for 1 week and activity restriction for 2 weeks as well as appropriate wound care to the incisions. Neck lift and submental liposuction remain the cornerstones of effective surgical neck contouring procedures for younger adults. Neck Lift, Submental Liposuction.

Rationale:Royal jelly (RJ), a natural secretion produced by the hypopharyngeal and mandibular glands of worker honeybees, is a nutrient-rich substance that contains proteins, lipids, vitamins, and bioactive compounds. Among its key components, major royal jelly proteins (MRJPs) constitute the predominant fraction and have been linked to various physiological benefits. Our previous studies on female mice have shown that MRJPs can increase uterine and ovarian indices, estradiol levels, and endometrial thickening. Overexpression of MRJPs in female Drosophila can increase estrogen levels and activate cell proliferation signaling pathways, thereby promoting body growth. Therefore, we speculate that MRJPs may be helpful for women. Here, we describe a woman with diminished ovarian reserve (DOR) who conceived naturally at week 4 after receiving oral MRJPs, an observation that warrants further investigation.Patient’s concerns:A 35-year-old female who was diagnosed with DOR through hormone testing before MRJPs administration. The clinical manifestations included dysmenorrhea and poor sleep. After taking the MRJPs, she conceived naturally.Diagnoses:The patient underwent hormonal testing at a specialized hospital and was diagnosed with DOR.Interventions:The patient started taking 1g lyophilized powder of MRJPs (provided by Hangzhou Aili Biotechnology Co., Ltd. using ultrafiltration-mediated enrichment to retain MRJPs with a molecular weight of 4.9 × 104) orally in the morning and evening, respectively.Outcomes:The patient conceived naturally following 4 weeks of continuous MRJPs supplementation. During the administration of MRJPs, patients were monitored and asked about gastrointestinal and allergy-related adverse reactions. The results showed that no confirmed cases of gastrointestinal discomfort (including bloating, dull pain, cramps, nausea, or diarrhea) or allergic reactions (skin erythema, pruritus, or urticaria) occurred throughout the entire observation period.Lessons:Given the non-generalizable nature of this single-case report, a randomized double-blind clinical trial has been arranged. The mechanisms of MRJPs require further elucidation, and potential lifestyle confounders such as sleep quality and physical activity were not objectively monitored.

To investigate the etiology of chronic sialadenitis, and to analyze their clinical and imaging characteristics. This retrospective analysis reviewed the clinical and imaging data of patients with chronic sialadenitis who underwent sialendoscopy at the Peking University Hospital of Stomatology between January 2021 and August 2023. (1) with a history of recurrent swelling of major salivary glands; (2) complete medical records with detailed information about potential causes; (3) sialography images were available; and (4) patients had undergone interventional endoscopy. (1) salivary stones; (2) juvenile recurrent parotitis; (3) IgG4-related sialadenitis; (4) Sjögren syndrome; and (5) neoplastic diseases. Based on the latest research results and clinical data, chronic sialadenitis was classified into radioactive iodine-induced sialadenitis (RAIS), allergy-related sialodochitis (ARS), adult chronic recurrent parotitis (ACRP), sialadenosis with sialodochitis, and idiopathic sialadenitis. Idiopathic sialadenitis was defined as a type of chronic sialadenitis with duct stenosis of unknown etiology (allergic causes, autoimmune disorders, radioactive iodine exposure, history of "parotitis" in childhood, etc.). The proportions of five types of sialadenitis were calculated, and their relationships with age, gender, type of affected glands, number of affected glands, duration of symptoms, and imaging characteristics were statistically analyzed. A total of 544 consecutive patients diagnosed with chronic sialadenitis were enrolled in this study. They consisted of 192 males and 352 females, and their ages ranged from 14 to 83 years [mean age: (47.44±13.52) years]. Idiopathic sialadenitis accounted for the largest proportion (71.7%, 390 cases), followed by ARS (12.5%, 68 cases), RAIS (6.4%, 35 cases), ACRP (4.8%, 26 cases), and sialadenosis with sialodochitis (4.6%, 25 cases). Among the 2 176 available glands of the 544 patients, 1 120 (51.5%) glands were affected, including 880 (78.6%) parotid glands and 240 (21.4%) submandibular glands. These five types of sialadenitis exhibited significant differences in gender, age, type and number of affected glands, and duration of symptoms (P < 0.05). Among them, RAIS patients showed the lowest male to female ratio (male ∶ female=1 ∶ 4.83), ARCP patients were the youngest [(32.50±8.60) years], and RAIS and ARS patients had relatively higher number of affected glands. Sialography showed ductal atresia in 23.2% of affected glands with ARIS, "snowflake" pattern in 46.5% of affected glands with ARS, "punctate and globular" ectasia of terminal ducts in 80.4% of affected glands with ARCP, and clustered branch ducts in 71.4% of affected glands with sialadenosis with sialodochitis. Moreover, stenosis and/or dilatation of the main and branch ducts represented the most typical sialography appearance of idiopathic sialadenitis. Idiopathic sialadenitis, RAIS, ARS, ACRP, and sialadenosis with sialodochitis are the five common types of chronic sialadenitis. Among these, idiopathic sialadenitis is the most common type of chronic sialadenitis. Clarification of the etiology, clinical manifestations and imaging characteristics of chronic sialadenitis is important for clinicians to develop personalized treatment plans and improve treatment outcomes.

Senescence-associated tertiary lymphoid structures in Sjögren's disease model nishiura mice.

Antidepressants are widely prescribed group of medications frequently associated with xerostomia. Although alterations in salivary flow among antidepressant users have been extensively investigated, there is a paucity of data regarding the structural and vascular ultrasonographic characteristics of the major salivary glands. This study aimed to evaluate the echogenicity, parenchymal structure, margin characteristics, blood supply characteristics, and dimensions of the parotid and submandibular glands in antidepressant users compared with systemically healthy controls using ultrasonography (USG). In this study, both right and left parotid and submandibular salivary glands of 102 individuals (51 healthy and 51 antidepressant users) were examined by USG. Data normality was evaluated using the Kolmogorov-Smirnov test. Group comparisons were performed using independent samples t-tests or Mann-Whitney U tests, as appropriate, and categorical variables were analyzed using the chi-square test. A p-value < 0.05 was considered statistically significant. There is no significant differences between antidepressant users and healthy individuals in terms of echogenicity, parenchymal structure, margin and blood supply characteristics of the submandibular and parotid salivary glands. However, the mean supero-inferior dimension of the right submandibular gland was significantly higher in the patient group than in the control group. The median medio-lateral dimension of the left submandibular gland was significantly lower in patients compared with controls. Additionally, the mean medio-lateral dimensions of both the right and left parotid glands were significantly lower in the patient group than in the control group. The ultrasonographic appearance of the major salivary glands did not differ significantly between antidepressant users and healthy controls in terms of tissue characteristics and vascularity, despite limited dimensional differences. These findings suggest that antidepressant use does not markedly alter the ultrasonographic appearance of the salivary glands. Further studies with larger sample sizes, incorporating salivary flow measurements and elastography, are warranted to elucidate the functional and biomechanical effects of antidepressant use on the salivary glands.

IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder characterised by tissue infiltration of IgG4+ plasma cells, yet the precise roles of B cells remain unclear. This study aimed to characterise the longitudinal immune dynamics in IgG4-RD during B-cell depletion therapy to identify pathogenic cell subsets and specific biomarkers associated with relapse. We performed a longitudinal multiomics analysis on 119 peripheral blood samples from patients with IgG4-RD undergoing rituximab treatment, spanning active, remission, and relapse phases. Integrated single-cell transcriptomics, B-cell receptor (BCR) sequencing, and serum proteomics were performed on matched blood and tissue samples from submandibular gland and lymph nodes, with Sjögren's syndrome and healthy individuals as controls. We identified a previously unrecognised, disease-specific IgG4+ plasma cell subset characterised by aberrant expression of the neuropeptide NMU and highly skewed IGHV1-69 usage. Circulating follicular helper T cells (CD4+Tfh) displayed signatures consistent with chronic antigen stimulation and type 2 immunity. Furthermore, markedly expanded double-negative T cells (dnT) highly expressed IL10, suggesting their involvement in immune regulation and isotype class switching. Longitudinal analysis following B-cell depletion emphasised the reconstitution dynamics of pathogenic plasma cells, furthermore highlighting the concurrent shifts in CD4+Tfh and dnT that mirrored disease remission and relapse, and underscored the amelioration of proinflammatory immune profiles. NMU-expressing IGHV1-69+ plasma cells represent a pathogenic effector population driving IgG4-RD recurrence. These findings establish a mechanistic framework for B-cell depletion and identify specific cellular and molecular biomarkers to improve disease monitoring and relapse prediction in clinical practice.

Xerostomia is a shared clinical manifestation of both Sjögren disease (SjD) and type 2 diabetes mellitus (DM), but their underlying pathophysiology differs markedly. The differentiation between autoimmune glandular damage and metabolic dysfunction is of clinical significance. This study aimed to evaluate the diagnostic performance of shear wave elastography (2D-SWE) for discriminating SjD from DM patients with sicca symptoms. This cross-sectional study included three groups: 61 patients with SjD, 42 patients with type 2 DM presenting with sicca symptoms, and 43 age-matched healthy controls (HC). All participants underwent bilateral parotid and submandibular gland ultrasonography. Parenchymal inhomogeneity was graded using the Outcome Measures in Rheumatology (OMERACT) scoring system, and tissue stiffness (Young's modulus, kPa) was quantified via 2D-SWE. Pairwise comparison between groups were conducted, and the receiver operating characteristic (ROC) analysis was used to assess the performance of SWE in identifying SjD patients. The SjD group demonstrated higher stiffness values in the bilateral parotid and submandibular glands compared with both the DM and control groups. Additionally, the OMERACT total scores for all salivary glands were elevated in patients with SjD compared with the DM and HC groups (p < 0.001 for both groups). In contrast, the DM group exhibited tissue stiffness and gray-scale ultrasound profiles that were comparable to those of the HC group (p > 0.0167 for all comparisons). The ROC analysis indicated that SWE possessed moderate discriminatory power for distinguishing SjD from DM (Area Under the Curve (AUC) range for glands: 0.598-0.628). The combined use of SWE and gray-scale assessment may serve as a multiparametric approach that could contribute to differentiating autoimmune sialadenitis in SjD patients from metabolic sialosis in DM patients presenting with dry mouth.

ObjectivesThis study aimed to examine the diffusion properties, signal characteristics and size of the parotid and submandibular gland in neck magnetic resonance (MR) imaging.MethodsIn the study, neck MRI images of 80 patients, 40 men and 40 women, were examined. Area and "Apparent Diffusion Coefficient (ADC)" measurements of bilateral parotid and submandibular glands were measured in MRI images. The findings were compared between genders and between two age groups: 18-50 years and 51-80 years.ResultsLeft submandibular area measurements in men (394.4±107.1 mm2) were found to be statistically significantly larger than in women (330.1±89.8 mm2) (p<0.05). A significant difference was detected in right and left submandibular and parotid gland heterogeneity degrees according to the age groups of the patients (p<0.05). While grade 0 and grade 1 were more common in the 18-50 age groups, grade 1 and grade 2 were more common in the 51-80 age groups. In each area; and ADC measurements of the parotid glands; and submandibular glands bilaterally, there were positive correlations (p<0.05). However, there were negative correlations between ADC and area measurements in parotid glands (p<0.05).ConclusionAs a result, it was observed that the heterogeneity in the gland increased as the age of the patients increased. Neck MRI is frequently used today in the diagnosis of salivary gland diseases, and it is thought that heterogeneity in the salivary gland with age may be helpful in the diagnostic steps in MRI.

This article focuses on the series of viewpoints on the prevention and treatment of medication-related osteonecrosis of the jaw issued by the American Association of Oral and Maxillofacial Surgery (AAOMS), and puts forward several uncertain issues from a clinical perspective. The points of doubt in diagnosis include the definition of drug categories and the threshold of bone exposure duration, as well as the significance of imaging features of bone lesions for diagnostic and treatment decisions. The concerns in terms of prevention include drug risks and disease incidence, tooth extraction and drug holiday, intervention measures promoting bone wound healing and their effectiveness. In terms of treatment, with integration of the author's practical experience, the discussion points focused on the dominant principles of non-surgical treatment, the identification and confirmation of the surgical bone incision boundary, the application of buccal fat pads, chin flaps and submandibular gland transposition, as well as the applicable conditions for permanent repair of fibular transplantation, temporary repair of reconstruction plate bridging, compromise mandibular resection and maxillary sinus opening, etc. The article suggests seeking evidence-based research on the above issues.

Incidence of Frey's syndrome after submandibular gland excision: Minor's test-based evaluation.

Objective: Alongside evaluating the geometric and dosimetric performance of an AI auto-segmentation algorithm on conventional (primary) organs at risk (OARs), the aim of this work was to highlight its added advantages in terms of the dosimetric evaluation of secondary OARs, which are commonly under-reported despite their influence on overall toxicity. Methods: The study included 50 head and neck cancer patients, with volumetric modulated arc radiotherapy (VMAT) plans created based on both manual contouring and auto-contouring using a commercially available auto-segmentation tool. Quantitative assessment of auto-contouring was undertaken on 10 primary OARs using geometric performance metrics (the Dice Similarity Coefficient (DSC), Hausdorff distance (HD), sensitivity, and precision) as well as dosimetric differences between manual vs. auto-segmentation. Once the algorithm was validated on primary OARs, a dosimetric assessment of 29 secondary OARs delineated by the tool was conducted. Results: Manual contouring required 21.20 ± 2.25 min, while 9.25 ± 1.42 min were needed for auto-segmentation with adjustment. Dosimetric differences were found for the brainstem and the right submandibular gland. The mandible presented the maximum HD value of 24.09 ± 18.83 mm. Sensitivity, precision and DSC ranged from 0.77 to 0.93. For the 29 secondary OARs, 1500 dosimetric values were collected. Of these, 8.5% exceeded the dose constraints. The most impacted OAR was the constrictor muscle, exceeding the constraint in 56% of cases, while the glottis came in second. The dosimetric results also raised concerns regarding organs without defined dose constraints. Conclusions: When validated for primary OARs, auto-segmentation offers a more comprehensive dosimetric evaluation of secondary OARs to further reduce the dose to sensitive structures.

The aim of this retrospective study is to evaluate the volumetric and histogram-based characteristics of the parotid and submandibular salivary glands in patients with hypertension compared with healthy controls. Magnetic Resonance images of a total of 94 patients, including 42 hypertensive and 52 control subjects, were included in the study. The volumes of the right and left parotid and submandibular glands were manually measured on images obtained using a 1.5 Tesla Magnetic Resonance scanner. For volumetric assessment of the parotid and submandibular glands, T1-weighted MR images were analyzed using the Sectra IDS7 software program on a full HD display. In addition, histogram analysis was performed on manually defined regions of interest to calculate mean, skewness, and kurtosis values. A total of 94 participants were included. Submandibular gland volumes were significantly higher in hypertensive patients (right: 8.58 ± 2.0; left: 8.61 ± 2.1 ) compared to controls (right: 7.81 ± 2.1; left: 7.73 ± 1.9), while parotid gland volumes showed no significant difference (p < 0.05). Histogram analysis revealed significantly lower mean grayscale values in the parotid glands in the hypertension group (right: 113.73 ± 27.9; left: 113.81 ± 25.6) compared to healthy controls (right: 145.91 ± 31.1; left: 148.89 ± 32.6)(p < 0.001), whereas skewness and kurtosis values were not significantly different (p > 0.05). Hypertension may be associated with gland-specific volumetric changes and diffuse microstructural alterations in salivary glands. Histogram-based analysis provides complementary information beyond volumetric measurements and may improve the detection of subtle tissue changes. MRI is an effective method for quantitative evaluation of salivary glands.

Differential metabolic responses to hydrogen peroxide-induced oxidative stress in parotid and submandibular gland acinar cell lines.

Postnatal realignment of circadian PER2::LUC rhythms in the submandibular gland during oral feeding development.