Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions
Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions
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DOI:
10.3390/jcm9124095
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发表时间:
2020-12-18
影响因子:
3.9
通讯作者:
Limesand KH
中科院分区:
文献类型:
--
作者:
Jasmer KJ;Gilman KE;Muñoz Forti K;Weisman GA;Limesand KH
Salivary glands sustain collateral damage following radiotherapy (RT) to treat cancers of the head and neck, leading to complications, including mucositis, xerostomia and hyposalivation. Despite salivary gland-sparing techniques and modified dosing strategies, long-term hypofunction remains a significant problem. Current therapeutic interventions provide temporary symptom relief, but do not address irreversible glandular damage. In this review, we summarize the current understanding of mechanisms involved in RT-induced hyposalivation and provide a framework for future mechanistic studies. One glaring gap in published studies investigating RT-induced mechanisms of salivary gland dysfunction concerns the effect of irradiation on adjacent non-irradiated tissue via paracrine, autocrine and direct cell–cell interactions, coined the bystander effect in other models of RT-induced damage. We hypothesize that purinergic receptor signaling involving P2 nucleotide receptors may play a key role in mediating the bystander effect. We also discuss promising new therapeutic approaches to prevent salivary gland damage due to RT.
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