muramidase and Pharyngeal-Neoplasms

We analyzed the radiation-induced changes in the flow rate and protein composition of stimulated whole saliva in eleven patients treated for malignant conditions of the head and neck. In all patients the radiation field covered all major salivary glands and a large area of the oral mucosa. Paraffin-stimulated whole saliva samples were collected once 2 to 21 days before therapy and then after 20, 40, and 60 gray (Gy) cumulative dose of irradiation. Five patients also provided samples 6 months after the therapy. Hyposalivation or xerostomia occurred in all patients, although the pretreatment secretion rates were already relatively low. Salivary amylase activities decreased with increasing dose of radiation, especially when expressed as the amount of enzyme secreted per minute. Unusually high salivary concentrations of albumin, lactoferrin, lysozyme, salivary peroxidase, myeloperoxidase, and total protein were observed during the therapy, but most values slowly returned to pretreatment levels after cessation of radiation. It is concluded that the observed qualitative changes in whole saliva components are net effects caused by the cancer itself, radiation therapy given, systemic diseases, or medications, as well as mucosal inflammations.

Topics: Adult; Aged; Amylases; Female; Humans; Isoenzymes; Lactoferrin; Male; Middle Aged; Mouth Neoplasms; Muramidase; Peroxidase; Peroxidases; Pharyngeal Neoplasms; Saliva; Salivary Proteins and Peptides; Secretory Rate

Function and morphology of the major salivary glands were investigated in patients suffering from carcinomas of the oral cavity, the oropharynx and the hypopharynx. In comparison to the results obtained from healthy control subjects, the tumour patients showed significantly decreased flow-rates of parotid and submandibular saliva. Furthermore the excretion of IgA, lysozyme and total protein and the pH-value in both, the parotid and the submandibular saliva of the patients was significantly lowered. The histological feature of the salivary glands of the patients was characterized by interstitial deposition of fat. In several cases a swelling and a degranulation of the acinar cells was observed additionally. Other patients showed an atrophy of the acinar cells. Sometimes an inflammatory reaction could also be noted in the submandibular and/or the parotid glands of patients suffering from head and neck cancer. The decreased salivary gland function reflects a reduction of the protective mechanisms of the oral cavity and the pharynx. Additionally it enables an increased penetration of environmental carcinogens through the mucous surface, and therefore has to be discussed as a factor for the etiology of carcinomas of the upper aerodigestive tract.

Topics: Humans; Hydrogen-Ion Concentration; Hypopharyngeal Neoplasms; Immunoglobulin A, Secretory; Male; Middle Aged; Mouth Neoplasms; Muramidase; Oropharyngeal Neoplasms; Parotid Gland; Pharyngeal Neoplasms; Saliva; Salivary Glands; Secretory Rate; Submandibular Gland

Topics: Enzyme Activation; Humans; Mouth Neoplasms; Muramidase; Pharyngeal Neoplasms; Precancerous Conditions; Saliva; Salivary Glands