Institute of Pharmaceutical Sciences, Pharmaceutical Technology and Biopharmacy, University of Graz, Universitätsplatz 1, 8010 Graz, Austria.
Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, 8010 Graz, Austria.
Int J Environ Res Public Health. 2021 Feb 9;18(4):1629. doi: 10.3390/ijerph18041629.
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.
唾液腺的完整功能对口腔健康至关重要。在头颈部肿瘤患者的放射治疗过程中，唾液腺可能会受到损伤，导致唾液成分发生变化。这会导致口干，这是口腔黏膜炎的主要原因之一。用于保护或姑息治疗的药物通常疗效不佳，因为人们对辐射引起的唾液理化性质变化了解甚少。为了改善治疗选择，本研究旨在仔细检查接受放射治疗的患者的未刺激全唾液，并将其与健康的未刺激全唾液进行比较。为此，研究了 pH 值、渗透压、电导率、缓冲能力、全蛋白和粘蛋白浓度以及粘弹性和粘性特性。此外，还研究了透明质酸作为唾液替代液的潜在候选物。结果表明，放射诱导的唾液的 pH 值从中性变为酸性，渗透压增加，粘弹性特性发生变化，这是由于粘蛋白网络的破坏以及唾液腺分泌的水分发生变化。通过采用 0.25%的透明质酸水溶液来弥补失去的特性，可以达到与健康、未刺激的唾液相似的粘附特性。
