On the mechanism of salivary gland radiosensitivity
On the mechanism of salivary gland radiosensitivity
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DOI：
10.1016/j.ijrobp.2004.12.051
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发表时间：
2005-07-15
影响因子：
7
通讯作者：
Vissink, A
中科院分区：
文献类型：
--
作者：
Konings, AWT;Coppes, RP;Vissink, A
目的：通过分析相关文献，特别是早期放射损伤的作用机制，有助于理解唾液腺的神秘放射敏感性，并提供关于头颈部癌放射治疗后唾液腺放射损伤改善的可能性的信息。方法和材料：唾液腺的辐射敏感性和辐射防护的机制选择发表的数据进行了研究和analysed.Results：从经典的角度来看，唾液腺不应该迅速响应辐射，因为他们似乎这样做。除了大量细胞凋亡外，颗粒渗漏和随后的腺泡细胞溶解被认为是急性辐射诱导的唾液腺功能丧失的原因。这些假设的主要问题是，最近进行的测定显示，在照射后的第一天没有细胞损失，而唾液流量显着减少。在单剂量照射后的第一天，水的分泌被选择性地阻碍。文献进行了讨论，表明妥协的细胞遭受选择性辐射损伤的质膜，干扰信号转导主要影响水样分泌。虽然颌下腺和腮腺的细胞组成不同，但损伤反应非常相似。两个唾液腺的急性辐射诱导的功能丧失，可以改善预防性治疗与特定的受体agonists.Conclusions：最可能的作用机制，解释神秘的高辐射敏感性的早期效果，是选择性辐射损伤的分泌细胞的质膜，干扰毒蕈碱受体刺激的水样分泌。后期损伤主要是由于祖细胞的经典有丝分裂细胞死亡，导致腺体对分泌细胞的替代能力受阻，但也是由细胞外环境的损伤引起的，阻止了正常的细胞功能。(c)2005年爱思唯尔公司
Purpose: To contribute to the understanding of the enigmatic radiosensitivity of the salivary glands by analysis of appropriate literature, especially with respect to mechanisms of action of early radiation damage, and to supply information on the possibilities of amelioration of radiation damage to the salivary glands after radiotherapy of head-and-neck cancer.Methods and Materials: Selected published data on the mechanism of salivary gland radiosensitivity and radioprotection were studied and analyzed.Results: From a classical point of view, the salivary glands should not respond as rapidly to radiation as they appear to do. Next to the suggestion of massive apoptosis, the leakage of granules and subsequent lysis of acinar cells was suggested to be responsible for the acute radiation-induced function loss of the salivary glands. The main problem with these hypotheses is that recently performed assays show no cell loss during the first days after irradiation, while saliva flow is dramatically diminished. The water secretion is selectively hampered during the first days after single-dose irradiation. Literature is discussed that shows that the compromised cells suffer selective radiation damage to the plasma membrane, disturbing signal transduction primarily affecting watery secretion. Although the cellular composition of the submandibular gland and the parotid gland are different, the damage response is very alike. The acute radiation-induced function loss in both salivary glands can be ameliorated by prophylactic treatment with specific receptor agonists.Conclusions: The most probable mechanism of action, explaining the enigmatic high radiosensitivity for early effects, is selective radiation damage to the plasma membrane of the secretory cells, disturbing muscarinic receptor stimulated watery secretion. Later damage is mainly due to classical mitotic cell death of progenitor cells, leading to a hampered replacement capacity of the gland for secretory cells, but is also caused by damage to the extracellular environment, preventing proper cell functioning. (c) 2005 Elsevier Inc.