Carcinoma ex pleomorphic adenoma of the sublingual gland:a case report

We report a case of carcinoma ex pleomorphic adenoma of a sublingual gland in a 70-year-old man.Under a clinical diagnosis of benign salivary gland tumor,excision of the mass with the sublingual salivary gland in an en bloc fashion via an intraoral approach was performed.Histopathologically,there was a rupture of the fibrous capsule and diffuse cell-rich sheets composed of myoepithelial cells with round nuclei were also seen.Immunohistochemically,the cells that composed of cell rich sheets were positive to smooth muscle actin.Final diagnosis of myoepithelial carcinoma ex pleomorphic adenoma was made.

Intravascular Papillary Endothelial Hyperplasia: A Rare Vascular Lesion Affecting Submandibular and Sublingual Region

Intravascular papillary endothelial hyperplasia is an unusual benign vascular lesion of the skin and subcutaneous tissue consisting of papillary formations lined with proliferative endothelial cells. The clinical characteristic is not specific and the diagnosis is based on histological examination. The lesion is often mistaken for angiosarcoma and a group of other benign and malignant vascular lesions. IPEH has been relatively rarely described in the head and neck region. An uncommon case located in the submandibular and sublingual region is presented which was misinterpreted as venous malformations and malignant tumors of vascular origin initially. A surgical excision was performed and no recurrences have been found after 5 years of follow-up.

Liver metastasis as the initial clinical manifestation of sublingual gland adenoid cystic carcinoma: A case report

BACKGROUND Adenoid cystic carcinoma(ACC)is a common malignant tumor of salivary gland.The lung and liver are frequent sites of distant metastasis.Liver metastasis as the initial clinical manifestation of sublingual gland ACC is very rare.CASE SUMMARY A 51-year-old Chinese woman presented with a painless mass in the right lobe of liver.The tumor was composed of ductal cells and myoepithelial cells with a morphology including tubiform and cribriform structures.Immunostaining results showed ductal cells positive for CK7,CK14,CK19,CD117,and 34βE12,and negative for MYB,vimentin,ER,PR,and CEA.The myoepithelial cells were positive for p63,calponin and CK5/6.Metastatic salivary ACC was considered,and a sublingual gland mass was revealed by computed tomography.Histological evaluation confirmed primary sublingual gland ACC.Fluorescence in situ hybridization(FISH)did not find an MYB-NFIB fusion gene in specimens from either the primary or metastatic ACC tumors.The sublingual gland ACC relapsed in 20 mo.The recurrent lesion disappeared following local radiation therapy and computed tomography-guided radioactive seed implantation.The patient remains in good condition until now.CONCLUSION Metastatic sublingual gland ACC with initial clinical manifestation as a liver mass is very rare,and was pathologically confirmed in this patient by its histological appearance.Primary hepatic tumors and metastatic carcinomas should be included in the differential diagnosis.Immunohistochemical detection of MYB protein and MYB-NFIB fusion gene detection by FISH can be helpful,but occasional negative results confuse the diagnosis.

Botulinum toxin A inhibits salivary secretion of rabbit submandibular gland

Botulinum toxin A （BTXA） has been used in several clinical trials to treat excessive glandular secretion; however, the precise mechanism of its action on the secretory function of salivary gland has not been fully elucidated. In this study, we aimed to investigate the effect of BTXA on secretion of submandibular gland in rabbits and to identify its mechanism of action on the secretory function of salivary gland. At 12 weeks after injection with 5 units of BTXA, we found a significant decrease in the saliva flow from submandibular glands, while the salivary amylase concentration increased. Morphological analysis revealed reduction in the size of acinar cells with intracellular accumulation of secretory granules that coalesced to form a large ovoid structure. Expression of M3-muscarinic acetylcholine receptor （M3 receptor） and aquaporin-5 （AQP5） mRNA decreased after BTXA treatment, and distribution of AQP5 in the apical membrane was reduced at 1, 2 and 4 weeks after BTXA injection. Furthermore, BTXA injection was found to induce apoptosis of acini. These results indicate that BTXA decreases the fluid secretion of submandibular glands and increases the concentration of amylase in saliva. Decreased expression of M3 receptor and AQP5, inhibition of AQP5 translocation, and cell apoptosis might involve in BTXA-reduced fluid secretion of submandibular lands.

Effects of Chinese herbs on salivary fluid secretion by isolated and perfused rat submandibular glands

AIM： TO determine whether Chinese herbs （CHs） relieve xerostomia （dry mouth） by increasing salivary secretion. METHODS： The submandibular glands of Wistar rats were surgically isolated and perfused arterially with buffered salt solution. After control perfusion, recording started 5 min prior to the start of stimulation. After fluid secretion was induced by 0.2 μmol/L carbamylcholine （CCh） in the perfusate for 10 min, Chinese herb （CH） was added in the perfusion for 5 min. CCh was then overloaded at 0.2 μmol/L in the perfusion for 20 min. The volume of salivary fluid secretion was recorded by a computer-controlled balance system. RESULTS： Saliva secretion formed an initial ephemeral peak at 30 s followed by a gradual increase to a sustained level. CH alone induced no or little saliva in all types of CH selected. During perfusion with CH,overloading of CCh promoted fluid secretion in 1S of 20 CHs. This promotion was classified into four patterns, which were eventually related to the categories of CH： Overall sustained phase was continuously raised （Yin-nourishing, fluid production-promoting and heatclearing agents）; The sustained secretion rose to reach a maximum then decreased （Qi-enhancing agent）; Sustained secretion rose to reach the highest maximum and was then sustained with a slight decline （swelling-reducing, phlegm-resolving and pus-expelling agents）; Stimulation of salivary secretion without any added stimulants. Addition of CCh raised the fluid secretion to reach the highest maximum then sharply decreased to a lower sustained level （blood activating agent）. CONCLUSION： The present findings lead to the conclusion that various CHs have different promotional effects directly on the salivary gland.

Clinical significance of hypoechoic submandibular gland lesions in type 1 autoimmune pancreatitis

To assess the role of ultrasonography of submandibular glands (SGs) in the diagnosis of type 1 autoimmune pancreatitis (AIP).METHODSThirty-seven patients who were definitively diagnosed with type 1 AIP according to the international consensus diagnostic criteria (ICDC) for AIP at our institution between December 1990 and April 2016 were retrospectively reviewed. Findings by physical examination, ultrasonography, and scintigraphy of SGs were analyzed to reach a diagnosis based on the ICDC for AIP. The efficacy of corticosteroid treatment in the resolution of hypoechoic lesions in SGs was also evaluated by assessment with ultrasonography before and after treatment in 18 cases.RESULTSThe sensitivity of multiple hypoechoic lesions in SGs by ultrasonography for the diagnosis of sialadenitis in type 1 AIP (84%) was higher than that of physical examination (46%), scintigraphy (28%), and SGs thickness (49%). Ultrasonographic evidence of hypoechoic lesions in SGs improved the definitive diagnosis of sialadenitis and type 1 AIP by the ICDC criteria in 11 (30%) and 2 (5.4%) cases, respectively. Multiple hypoechoic lesions in SGs were resolved or disappear by corticosteroid administration in 14 of 16 cases with hypoechoic lesions in SGs, whereas the ultrasonographic findings in the remaining 2 cases with hypoechoic lesions in SGs and the 2 cases with homogenous SG parenchyma remained unchanged after corticosteroid administration.CONCLUSIONSG ultrasonography to detect multiple hypoechoic lesions might be useful for type 1 AIP diagnosis by improving diagnostic accuracy together with the ICDC sialadenitis criteria.

Thermal influence of saliva secretion <i>ex vivo</i>in the mouse submandibular gland

The physiological and pharmacological responses of an ex vivo mouse submandibular gland were used to study fluid secretion and cell signaling in response to muscarinic stimulation at increasing temperatures. Saliva production at 37°C was 5.5-fold that at 25°C with pilocarpine stimulation and 9.8-fold that at 25°C with cevimeline stimulation. Both of these muscarinic agonists are used clinically. With the experimental agonist carbachol (CCh), saliva secretion was increased with an increase in temperature, but the CCh concentration producing the peak flow was the same in both dose-response curves, suggesting that the muscarinic receptor itself is not responsible for the temperature dependence. Purinergic agonists also induced temperature-dependent saliva production ex vivo. The calcium ionophore A23187 failed to have a significant effect on saliva production. The CCh-induced increase in intracellular Ca2+ also upregulated the initial increase and sustained the plateau phase of saliva flow. Thus, muscarinic receptor stimulation of saliva production is temperature sensitive due to an increase in intracellular Ca2+.

Sclerosing polycystic adenosis of the submandibular gland: Two case reports

BACKGROUND Sclerosing polycystic adenosis(SPA)is a rare disease of salivary glands,similar to fibrocystic disease of the breast.It occurs over a wide age range and exhibits a slight female preference.Most SPA cases have occurred in the parotid gland.The exact nature of SPA is unclear,but its tumor nature has recently been proposed.Although SPA has a good prognosis after adequate surgery,atypical lesions might occur,ranging from mild dysplasia to carcinoma in situ in some cases.To the best of our knowledge,only five cases of SPA in the submandibular gland have been reported to date.Here,we present two new cases of SPA involving the submandibular gland.CASE SUMMARY A 50-year-old woman and a 52-year-old woman were referred to Tongji Hospital in Wuhan,China,with complaints of moderate pain,recurrent swelling,and a mass in the submandibular area.After admission,the two cases of the submandibular mass were examined physically.The boundary of the submandibular tumor was clear,and the range of motion was good.After preoperative examinations,surgery was performed on a selective basis.Postoperative histopathological examination revealed a well-defined mass with acinar structures,ducts,or cystic dilated glands of various sizes scattered in a large number of proliferative sclerosing stroma.There were flat and cuboidal cells,and eosinophils in the duct epithelium.There was also a eosinophilic substance in the lumen of dilated cysts.No atypical epithelial hyperplasia,invasive growth,or carcinoma in situ was found.Based on the above findings,the mass was diagnosed as SPA.Both patients have remained asymptomatic and no recurrence or distant metastasis had occurred by the 7-mo and 5-year follow-up,respectively.CONCLUSIONSPA is a rare disease of the salivary gland. Even though it has a good prognosisafter adequate surgery, atypical lesions may occur from mild dysplasia tocarcinoma in situ. However, no recurrence, distant metastasis, or mortality hasbeen reported for submandibular gland SPA. Clinicians and pathologists shouldbe familiar with the characteristics of SPA in the submandibular gland to avoidmisdiagnosis and overtreatment.

Salivary duct carcinoma of the submandibular gland presenting a diagnostic challenge: A case report

BACKGROUND Salivary duct carcinoma(SDC)is a rare,extremely aggressive malignancy that arises in the submandibular gland.It can metastasize locally early and therefore is an important differential diagnosis of metastatic disease in cervical lymph nodes or specific lymphadenitis such as tuberculous cervical lymphadenitis.CASE SUMMARY We report a case of SDC in the submandibular gland that presented diagnostic difficulty.The lesion was coincidentally discovered through examination of the radiolucent area of the maxilla.Imaging failed to confirm the possibility of specific inflammation,leading us to execute an open biopsy to verify the diagnosis.The surgical specimen showed that the submandibular gland was primarily replaced with a calcified body.Following histological analysis and confirmation,we performed surgical resection,radiotherapy,and various chemotherapies.CONCLUSION Radiographic imaging characteristics of lymph node metastases of salivary gland cancer,especially of SDC,may resemble other cervical lymphadenitis;calcification at the submandibular gland is the landmark of SDC occurring at the submandibular gland.

Possible Role of the Submandibular Gland in the Development of Obesity in Mice

The possible role of submandiblular glands (SMG) in the development of obesity was studied in two types of genetically obese mice, ob/ob and yellow Ay: Obesity is caused by hyperplasia followed by hypertrophy in ob/ob mice and mainly by hypertrophy in Ay mice.The histological features of SMGs exhibited clear sexual dimorphism in both mice similarto lean controls. The SMGs of ob/ob mice was smaller in size and had smaller granular convoluted tubular portions than lean controls, while the SMGs of Ay mice did not differ from lean controls. Sialoadenectomy before and after development of obesity gCnerally reduced the gain of body weights in both sexes of Ay mice but not in ob/ob mice. The content of epidermal growth factor (EGF) in the SMGs was higher in Ay mice and lower in ob/ob mice than their controls. The possible role of EGF in the SMGs in the development of obesity is discussed

Changes of norepinephrine and tumor necrosis factor in submandibular gland of rats with sympathetic nerve injury and the protective effect of 17 beta-estradiol

BACKGROUND： Recent researches have indicated that estrogen has extensive neuroprotective effects. So some studies designed ovariectomized animal models and administrated with estrogen, so as to verify its neuroprotective effects. OBJECTIVE： To observe the effect of 17 beta-estradiol on the content of norepinephrine （NE） and level of tumor necrosis factor （TNF） in submandibular glands of rats with sympathetic nerve injury, and analyze the dose-dependence and pathway of action. DESIGN： A randomized control animal study SETTINGS： Department of Hand Surgery, the 252 Hospital of Chinese PLA; Department of Hand Surgery Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology. MATERIALS： Fifty healthy female Wistar rats were randomly divided into 5 groups with 10 rats in each group： sham-operated group, ovariectomy＋6-OHDA＋saline group, ovariectomy＋6-OHDA＋17β-estradiol 50, 200 and 500 μg/kg groups. METHODS： The experiments were carried out in Tongji Medical College, Huazhong University of Science and Technology between October 2005 and March 2006. Bilateral ovaries were only exposed but not resected for the rats in the sham-operated group, but bilateral ovaries were resected in all the other groups. In the ovariectomy＋6-OHDA＋176-estradiol 50, 200 and 500 μg/kg groups, the rats were administrated with intraperitoneal injection of 6-OHDA （8 mg/kg）, and then immediately given 176-estradiol of corresponding dosages respectively, once a day for 10 days continuously. Rats in the sham-operated group and ovariectomy＋6-OHDA＋saline group were administrated with saline of the same volume. After administration, 5 rats in each group were killed to determine the NE contents in bilateral submandibular glands with high performance liquid chromatography-electrochemical detector （HPLC-ECD）, and the other 5 rats were used to determine the TNF levels in submandibular glands with enzyme-linked immunosorbant assay. MAIN OUTCOME MEASURES： The NE contents and TNF levels in submandibular glands of rats in each group were observed. RESULTS： All the 50 rats were involved in the analysis of results. （1） The NE content was obviously lower in the ovariectomy＋6-OHDA＋saline group than in the sham-operated group [（1 035±196）, （1 823±314） ng/g, P 〈 0.05], there were no significant differences between the ovariectomy＋6-OHDA＋17β-estradiol 50 μg/kg group and ovariectomy＋6-OHDA＋saline group [（1 004±253）, （1 035±196） ng/g, P 〉 0.05], but obviously higher in the ovariectomy＋6-OHDA＋17β-estradiol 200 and 500 μg/kg groups than in the ovariectomy＋6-OHDA＋saline group [（1 487±268）, （1 939±274）, （1 035±196） ng/g, P 〈 0.05]. （2） The TNF level was obviously higher in the ovariectomy＋6-OHDA＋saline group than in the sham-operated group [（3.498±0.792）, （1.893±0.533） ng/g, P 〈 0.05], there were no significant differences between the ovariectomy＋ 6-OHDA＋17β-estradiol 50 μg/kg group and ovariectomy＋6-OHDA＋saline group [（3.328 ±0.712）, （3.498±0,792） ng/g, P 〉 0.05], but obviously lower in the ovariectomy＋6-OHDA＋17β-estradiol 200 and 500 μg/kg groups than in the ovariectomy＋6-OHDA＋saline group [（2.639±0.438）, （2.016±0.619）, （3.498＋0.792） ng/g, P 〈 0.05]. CONCLUSION： Estrogen has obvious protective effect dose-dependently on 6-OHDA induced chemical sympathetic nerve terminal injury in rats, and it may play its protective role by reducing TNF level and ameliorating inflammatory reaction.

Two Cases of Epidermoid Cyst of the Buccal Floor Simulating: A Tumour of the Submandibular Gland

Dermoid cyst of the oral floor is rare benign tumour, who having three histological aspects: dermoid, teratoid and epidermoid. This one is characterized by the presence of a squamous stratified epithelium with cutaneous remnants. It may occur in any part of the body, however their frequency in the ENT sphere is relatively scarce. Seven per cent (7%) only of epidermoid cysts occur in the cervico-facial area, 1.6% of which locate at the floor level. When they are located submandibular, they can pose diagnostic difficulties and look like a tumour of the submaxillary gland. We report two cases of epidermoid cyst of the floor. Both patients suffered from swelling of the submandibular gland. Magnetic Resonance Imaging was not requested due to lack of resources. However, surgery allowed in both cases the excision of a cyst next to a normal submandibular gland. Patients did well post operatively.

Bone marrow-derived mesenchymal stem cells migrate to healthy and damaged salivary glands following stem cell infusion

Xerostomia is a severe side effect of radiation therapy in head and neck cancer patients. To date, no satisfactory treatment option has been established. Because mesenchymal stem cells（MSCs） have been identified as a potential treatment modality, we aimed to evaluate stem cell distribution following intravenous and intraglandular injections using a surgical model of salivary gland damage and to analyse the effects of MSC injections on the recruitment of immune cells. The submandibular gland ducts of rats were surgically ligated. Syngeneic adult MSCs were isolated, immortalised by simian virus 40（SV40） large T antigen and characterized by flow cytometry. MSCs were injected intravenously and intraglandularly. After 1, 3 and 7 days, the organs of interest were analysed for stem cell recruitment. Inflammation was analysed by immunohistochemical staining. We were able to demonstrate that, after intravenous injection, MSCs were recruited to normal and damaged submandibular glands on days 1, 3 and 7. Unexpectedly, stem cells were recruited to ligated and non-ligated glands in a comparable manner. After intraglandular injection of MSCs into ligated glands, the presence of MSCs, leucocytes and macrophages was enhanced, compared to intravenous injection of stem cells. Our data suggest that injected MSCs were retained within the inflamed glands, could become activated and subsequently recruited leucocytes to the sites of tissue damage.

口外型舌下腺囊肿2例

口外型舌下腺囊肿是最少见舌下腺囊肿类型,常与头颈部其他囊肿性病变混淆。因判断头颈部囊肿性病变是否为口外型舌下腺囊肿决定了临床手术治疗方案的不同,本文通过2例经不同路径形成的口外型舌下腺囊肿CT、MRI图像,从解剖构成、图像特征、手术治疗方法等方面总结口外型舌下腺囊肿特征并与头颈部其他囊肿性病变相鉴别。

锥形束CT在下颌下腺结石精确诊断中的应用价值

目的比较X线片、超声、CT、锥形束CT(CBCT)对不同位置下颌下腺结石的检出率,探讨三维可视化技术在下颌下腺结石诊疗中的辅助价值。方法回顾性分析2014年11月至2021年3月宁夏医科大学总医院113例下颌下腺结石患者的X线片、超声、CT、CBCT检查资料,比较4种成像方法对不同位置结石的检出率及总检出率。利用Mimics 19.0软件和CBCT数据对结石进行3D重建,从可视化角度观察结石的位置、大小、形态及数目。结果CBCT和CT对下颌下腺结石的总检出率差异无统计学意义[98.2%(111/113)vs 95.6%(108/113),P>0.05],但均高于X线片(65.5%,74/113)和超声(73.5%,83/113)的总检出率。超声对导管前、中段结石的检出率最低[分别为63.6%(21/33)、72.2%(26/36)],与CBCT[分别为97.0%(32/33)、100.0%(36/36)]、CT[分别为93.9%(31/33)、97.2%(35/36)]相比差异均有统计学意义(均P<0.05)。X线片对导管后段结石的检出率低于超声、CBCT、CT[40.9%(18/44)vs 81.8%(36/44)、97.7%(43/44)、95.5%(42/44),均P<0.01]。将CBCT数据导入Mimics 19.0软件后,成功地对不同大小、形态及数目的下颌下腺结石进行了可视化重建,重建图像清晰,结石与下颌骨的解剖位置关系显示直观。结论CBCT对下颌下腺结石的诊断具有良好的应用价值,可替代传统CT进行涎石病诊断。对于双手双合诊未查及但超声提示的导管后段结石,可直接行CBCT检查进行精确诊断;对于导管前、中段结石,可考虑X线片和CBCT检查。可视化技术有助于临床患者宣教及制定个体化治疗方案。

生腺布液汤对干燥综合征NOD小鼠B细胞活化因子及B细胞活化因子受体表达的影响

目的:观察生腺布液汤对干燥综合征(SS)NOD模型小鼠颌下腺及血清中B细胞活化因子(BAFF)及B细胞活化因子受体(BAFFR)的影响,探索生腺布液汤治疗SS的作用机制。方法:将24只8周龄雌性NOD小鼠随机分为模型组、硫酸羟氯喹组及生腺布液汤组,每组8只,另取8只同周龄雌性BALB/c小鼠设为正常对照组。给药组分别予生腺布液汤1.75 g/ml灌胃及硫酸羟氯喹溶液0.0026 g/ml灌胃,模型组及正常组予等量蒸馏水,连续8周。实验期间记录小鼠的一般情况及每日饮水量;HE染色观察各组小鼠颌下腺组织病理变化;免疫组化法检测颌下腺组织BAFF、BAFFR表达;ELISA法检测血清BAFF含量。结果:与模型组相比,生腺布液汤组和硫酸羟氯喹组小鼠饮水量下降(均P<0.05),血清BAFF及颌下腺组织BAFF、BAFFR表达降低(均P<0.05),颌下腺组织中淋巴细胞浸润减少,未见明显浸润灶等组织结构破坏。结论:生腺布液汤能够改善干燥综合征NOD小鼠口干症状,减轻颌下腺淋巴细胞浸润程度,其作用机制可能与降低颌下腺及血清BAFF、BAFFR表达相关。

舌下腺瓣修复临床Ⅱ期慢性黄磷性颌骨骨髓炎和药物相关性颌骨坏死术后缺损

目的:探讨利用舌下腺瓣修复临床Ⅱ期慢性黄磷性颌骨骨髓炎(PNJ)和药物相关性颌骨坏死(MRONJ)术后颌骨缺损的临床效果。方法:利用舌下腺瓣修复慢性下颌骨坏死术后颌骨缺损的5例患者。其中慢性黄磷性颌骨骨髓炎3例,药物相关性颌骨坏死患者2例。结果:5例患者临床检查评价治疗效果,术后2周内创口愈合良好,无感染,舌下腺功能正常。结论:利用舌下腺瓣修复慢性黄磷性颌骨骨髓炎和药物相关性颌骨坏死术后下颌骨缺损有效可行。

细针吸取活检在下颌下腺肿物诊断中的价值及误诊原因分析

目的探讨细针吸取活检(FNA)对下颌下腺肿物的诊断价值。方法回顾2013-2022年就诊于首都医科大学附属北京友谊医院口腔科,行FNA并获得最终病理的下颌下腺肿物患者,以最终病理为金标准,计算FNA诊断各型下颌下腺肿物的准确性、灵敏度、特异性、安全性,分析误诊原因。结果共纳入114例患者。非肿瘤性疾病多为IgG4-RD,FNA诊断准确度为91.2%,灵敏度97.4%,特异性88.2%。FNA诊断下颌下腺良性肿瘤准确度:86.8%,灵敏度:81.7%,特异度:92.6%。FNA诊断下颌下腺恶性肿瘤准确度为93.0%,灵敏度62.5%,特异性98.0%。误诊原因包括10例取样误差及8例病理类型误判。结论FNA在诊断IgG4相关性下颌下腺炎中极具价值,在诊断下颌下腺恶性肿瘤灵敏度较低,有误诊可能,需结合患者资料进行综合考虑。

放射后氧化应激对大鼠颌下腺腺泡细胞凋亡的影响

目的:观察大鼠颌下腺放射后导致的氧化应激对细胞凋亡的影响。方法:24只大鼠随机分为对照组及放射24 h、72 h及1周组。对照组未照射,放射组右侧颌下腺进行一次性20 Gy照射,检测各组大鼠唾液分泌流率。苏木精-伊红(hematoxylin-eosin, HE)染色观察颌下腺组织形态改变;酶联免疫吸附试验法(enzyme linked immunosorbent assay, ELISA)检测丙二醛(malondialdehyde, MDA)、还原型谷胱甘肽(glutathione, GSH)及超氧化物歧化酶(superoxide dismutase, SOD)水平。免疫组织化学染色(immunol histochemistry, IHC)观察8-羟基脱氧鸟苷(8-hydroxy-2 deoxyguanosine, 8-OHdG)阳性表达;末端脱氧核苷酸转移酶dUTP缺口末端标记法(TdT-mediated dUTP nick-end labeling, TUNEL)检测颌下腺腺泡细胞凋亡情况;Western blot和实时定量聚合酶链反应(real-time fluorescence quantitative PCR,RT-qPCR)检测凋亡相关蛋白含半胱氨酸的天冬氨酸蛋白水解酶3(cysteinyl aspartate specific proteinase-3,Caspase-3)、Bcl-2关联X的蛋白质(BCL2-associated X protein, BAX)及B淋巴细胞瘤-2基因(B-cell lymphoma-2,Bcl-2)的蛋白及mRNA表达情况。结果:放射后大鼠唾液分泌减少;细胞内空泡化、组织水肿及间隙增宽等病理变化逐渐加重;细胞出现明显的氧化应激反应,并伴随出现细胞的凋亡;凋亡相关蛋白BAX、Bcl-2及Caspase-3蛋白及mRNA表达量异常。结论:放射后氧化应激反应可能是颌下腺细胞凋亡及功能障碍的重要影响因素。

三种方法建立干燥综合征小鼠模型对比研究

目的探讨3种干燥综合征(Sjögren's syndrome,SS)小鼠造模方式在临床症状、病理改变、炎症指标等方面的差异。对比研究临床症状、病变相关组织的病理改变、炎症因子表达情况。方法将30只C57BL/6J雌性小鼠根据随机数字表法分为3组,即正常组、N49组和颌下腺组,每组各10只。另外10只非肥胖型糖尿病重症联合免疫缺陷(NOD-scid)雌性小鼠则为NOD组。分别采用非肥胖型糖尿病(non-obese diabetic,NOD)小鼠自发、毒蕈碱受体3(muscarinic receptor 3,M3R)抗原表位多肽N49免疫诱导与颌下腺蛋白诱导构建小鼠干燥综合征模型,定期监测饮水量、唾液流量,造模结束时取病理组织做HE染色观察淋巴细胞浸润程度,眼球取血检测炎症因子表达水平。结果(1)造模5周后,与正常组相比,各造模组小鼠饮水量显著增长(P<0.01);3个选模组组间比较,差异有统计学意义(P<0.01)。(2)造模5周后,与正常组相比,各造模组唾液流量显著减少(P<0.01);N49组、颌下腺组两组唾液流量均低于NOD组,差异具有统计学意义(P<0.05)。(3)造模5周后,与正常组相比,N49组、颌下腺组小鼠颌下腺指数、胸腺指数、脾指数上升较明显(P<0.01);颌下腺组与NOD组颌下腺指数相比差异有统计学意义(P<0.05)。N49组、颌下腺组与NOD组相比,胸腺指数上升较明显,差异有统计学意义(P<0.01)。(4)造模5周后,颌下腺病理切片观察显示,仅见颌下腺组有淋巴细胞浸润;各造模组胸腺和脾均有损害,但差异不大。(5)造模5周后,与正常组相比,NOD组、N49组、颌下腺组IL-10和IL-17水平升高(P<0.05或P<0.01),颌下腺组与NOD组相比,IL-10和IL-17水平升高(P<0.01),颌下腺组与N49组相比,IL-10水平升高(P<0.05),IL-17表达水平更高(P<0.01),差异有统计学意义。结论相较于NOD模型和N49模型,颌下腺模型造模成本低,免疫反应起效快,症状更类似于人类SS,优点较为突出,可用于人类SS发病机制的研究和治疗药物的筛选。