Psychophysics and Biological bases of taste alterations in radiotherapy patients:

临床味觉缺陷是普通人群中罕见的疾病，其发生率远低于嗅觉丧失（见核心）。味觉障碍患者的缺乏使得味觉障碍的研究困难，因此，他们的治疗存在问题。然而，这种概括有一个突出的例外;超过90%的接受放射治疗（放疗）的头颈癌患者经历了大量的味觉丧失和食物风味感知的改变。这些变化是导致食物摄入量减少、厌食和体重减轻的主要原因。它们还导致总体生活质量显著下降 增加痛苦。放疗对味觉的全面影响，以及与之相关的味觉异常的确切基础，都是未知的。放射治疗可以通过反复的炎症损伤、随后的纤维化和抗血管后遗症和/或通过上皮/味觉再生细胞过程的遗传改变来慢性改变味觉上皮。这个跨学科研究计划的长期目标是：（1）仔细记录放射治疗引起的味觉变化的幅度、质量和过程;（2）同时记录放射治疗后味觉系统的形态学、组织学和分子变化，并将这些变化与观察到的感知变化联系起来;（3）确定长期味觉缺陷和异常是否由以下原因引起： 反复的、累积的炎症损伤、辐射诱导的重建细胞和干细胞的遗传改变和/或这些事件的上皮后遗症，以便开始理解这些异常的原因。这种理解将有助于深入了解患者的潜在治疗干预措施。还预计这些结果将完善患者结局特征的开发，为患者及其医生提供重要的预后信息，并最终改善患者护理和生活质量。最后，关于辐射治疗如何损害味觉功能的信息可能会为正常口腔感觉生物学的基本过程提供新的见解。

Clinical taste deficits are rare disorders in the general population that occur at a rate well below that of olfactory loss (see Core). The dearth of taste patients renders the study of taste disorders difficult and, consequently, their treatment problematic. Yet, there is one prominent exception to this generalization; over 90% of all head and neck cancer patients who receive radiation therapy (radiotherapy) experience substantial taste loss and alterations of food flavor perception. These changes are major contributors to decreased food intake, anorexia, and weight loss. They also contribute to a significant decrement in general quality of life and an increase in suffering. Neither the full impact of radiotherapy on taste perception, nor the exact bases for gustatory abnormalities associated with it, is known. Radiotherapy may chronically alter the gustatory epithelia via repeated inflammatory insult, subsequent fibrotic and anti-vascular sequellae, and/or by genetic alteration of the epithelial/gustatory regenerative cellular processes. The long-term goals of this muttidisciplinary research program are: (1) to carefully document the magnitude, quality, and course of taste perception changes resulting from radiotherapy; (2) to simultaneously document morphological, histological, and molecular changes in the gustatory system that follow radiotherapy and relate these to observed perceptual changes; (3) to determine whether long-term gustatory deficits and abnormalities are caused by repeated, accumulated inflammatory insult, radiation-induced genetic alteration of reconstructive cells and stem cells, and/or the epithelial sequellae of these events, in order to begin to understand the causes of these abnormalities. This understanding will yield insight into potential therapeutic interventions for patients. It is also anticipated that the results will consummate in the development of patient outcome profiles providing important prognostic information to patients and their physicians and, ultimately, improve patient care and quality of life. Finally, information about how insult from radiation treatment compromises taste function may provide new insights into fundamental processes underlying normal orosensory biology.