tacrolimus and Xerostomia

To assess the prevalence of oral manifestations in a group of allogenic liver, kidney or haematopoietic stem cell transplantation recipients and patients, and analyze the possible oral manifestations associated with the use of 4 immunosuppressive drugs.. One hundred and eighteen patients submitted to liver, kidney and hematopoietic stem cell transplantation who used tacrolimus， sirolimus，cyclosporine or mycophenolate mofetil were enrolled. Through a questionnaire survey and oral examination, their oral manifestations were recorded, and the possible statistical associations with immunosuppressive drugs were analyzed using SPSS 21.0 software package.. The prevalence of oral lichenoid lesions and cheilitis for the group of patients using tacrolimus after transplantation was significantly lower than the group of patients who did not used the agent(P＜0.01). The prevalence of oral lichenoid lesions for the group of patients who used cyclosporine was significantly higher than the group of patients who did not used the drug(P＜0.05), and the prevalence of cheilitis for the group of patients who used cyclosporine was significantly higher than the group of patients who did not used the drug(P＜0.01). The prevalence of oral lichenoid lesions and cheilitis for the group of patients who used tacrolimus was significantly lower than the group of patients who used cyclosporine(P＜0.01). The group of patients who used mycophenolate mofetil after transplantation had a significantly lower prevalence of dry mouth than the group of patients who did not used the drug(P＜0.01). The prevalence of oral manifestations in patients with sirolimus after transplantation was not significantly reduced.. The use of tacrolimus improved the symptoms of oral lichenoid lesions and cheilitis and the effect was better than cyclosporine after transplantation. The use of mycophenolate mofetil improved dry mouth after organ transplantation.

Topics: Cheilitis; Cyclosporine; Humans; Immunosuppressive Agents; Mycophenolic Acid; Organ Transplantation; Sirolimus; Tacrolimus; Xerostomia

Presently, treatments for xerostomia only target symptoms, as an active therapy method has not been established. Herein, we discuss the possibility of using a submandibular gland allograft technique for the disease.. Using a vascularized submandibular gland transplantation method, we extracted portions of the submandibular gland, including the duct and chorda tympani branches, from beagle dogs and placed them into the submental region of age- and weight-matched dogs. We then measured the amount of saliva secretion and examined the grafted glands histologically.. Sufficient quantities of saliva were secreted from the grafted glands with pilocarpine treatment. Histologic findings showed that the acinar cells in the grafted and untreated contralateral glands had some atrophy, as compared with the normal glands; however, periodic acid Schiff staining showed that they produced saliva.. Transplantation of vascularized submandibular glands into dogs was successful and may become a novel treatment strategy for patients with xerostomia.

Topics: Animals; Cholinergic Agents; Chorda Tympani Nerve; Dogs; Female; Immunosuppressive Agents; Jugular Veins; Male; Maxillary Artery; Pilocarpine; Saliva; Salivary Ducts; Stimulation, Chemical; Submandibular Gland; Tacrolimus; Xerostomia

Topics: Adult; Drug Therapy, Combination; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Hyperbilirubinemia; Immunosuppressive Agents; Infection Control; Leukemia, Monocytic, Acute; Male; Mycophenolic Acid; Oral Ulcer; Prednisone; PUVA Therapy; Tacrolimus; Transplantation, Homologous; Xerostomia