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Epidermal and hepatocyte growth factors After mechanical and enzymatic digestion, aggregates of cells – salispheres Acinar by alpha amylase Ductal cells ( cytokeratins 7 and 14) Ductal like in vivo functionality is seen after transplantation
MSC like characteristics – adipogenic, osteogenic and chondrogenic in induction media Positive for MSC markers and –ve for HSC markers Both glands – in vivo also Intra glandular transplantation- 3rd day- Ductal structures
Differentiating into chondrocytes, adipocytes, osteoblasts and acinar cells.
In relation with sjogrens syndrome Can be given with CFA ( Complete Freund’s adjuvant), regen potential inc Allogenic MSCs both prevented and reduced inf response and with less adverse effects
Derivation by trypsinization. Can differntiate into the cells of three germ layers such as osteocytes, adipocytes, neurons, hepatocytes, cardiomyocytes and pancreatic cells
Mention recent bioengineering aproaches – muscarinic receptors agonists like pilocarpine and cevimeline but they have side effec
Gep: green fluorescence protein GEP +ve and -ve
By membrane water channel protein Nerve stimulation : pilocarpine (parasympathetic drug: inc, inhibited by Achs) SalivaBio Oral Swab (SOS) Saliva Collection Method Citrate: afferent and efferent stimulation Comparable to normal salivary gland
After extracting the glands, mice die after 5 days even with sufficient food, because of swallowing dysfunction. BW is initially decreased within 2 days of transplantation.
Stem cell therapy for xerostomia
It helps to speak , swallow , masticate , taste food and maintain healthy oral cavity.
In a healthy individual, production of saliva is 0.75-1.5 liters/ day (approx.)
• There are 800-1000 minor salivary
• In oral cavity,
70% of saliva – Submandibular
5% - Sublingual
• From ectoderm – Parotid
• From Endoderm – Submandibular and
CONTRIBUTION OF SALIVA
Submandibular gland Parotid gland Sublingual gland Minor
• Serous producing
morphology and are
joined to form
• Mucous producing
Cuboidal in shape
and are grouped
together to form
• Myoepithelial cells:
Located near the
ductal openings and
contracts the ducts
•Xerostomia is the subjective feeling of oral dryness,
which is often associated with hypofunction of the
•It may be associated with a change in the composition
of saliva, or reduced salivary flow (hyposalivation).
•Also known as:
- Cotton mouth
- Des (desert like)
- Drough mouth
1. IATROGENIC ORIGIN ( Radiation
therapy for head and neck cancers )
2. Developmental origin ( Salivary
gland aplasia )
3. Water / metabolite loss ( impaired
intake, haemorrhage, diarrhoea,
4. Local factors ( smoking, mouth
5. Systemic diseases
• DM and DI
6. Side effects of medications (
Diazepam, Atropine )
1. Chew sugar free gum
2. Limit you caffeine intake
3. Don’t use mouth washes that
4. Stop all tobacco use
5. Sip water regularly
6. Saliva substitutes
7. Avoid mouth breathing
8. Avoid excess use of anti-histamines
9. Stem cell therapy
1. Self renewal
STEM CELL THERAPY
Use of stem cells to treat or prevent a disease
STEM CELL THERAPY
There are different sources of stem cells
Rodent SSPCSs :
o Isolated cells were cultured
o 7th day – growth factors
o expression of ductal, acinar and myoepitheilial cells.
o salispheres with proliferating cells are seen.
o 70% recovery
Salivary gland- derived
Isolated from parotid
or submandibular or a
combination of both.
They display MSC like
After 60 days - twice
when compared to the
Acinar cell surface
They are multipotent stem
cells capable of differentiating
into many types of cells.
They have a high potential to
repair damaged tissues and
Both for in vivo and in vitro
as well as clinical treatment of
Mesenchymal stem cells
Mesenchymal stem cell
•The intravenous injection of MSCs reduced
lymphocytic infiltrate and inflammation of salivary
•It also preserved the saliva flow rate – 2 fold higher
•Reduced cell apoptosis and increased microvessel
•Additional tissue repair and regeneration was
observed when given with CFA.
Readily available, contributes to angiogenesis secretes
cytokines and growth factors.
After precutaneous administration, saliva flow rate
increased by 75%
The ADSC treatment displayed group had more acinar
cells and blood endothelial cells.
Human amniotic epithelial cells:
Derived from the top most layer of the amniotic membrane
Intra-glandularly injected hAECs were capable of
differentiating into acinar cells and restoring saliva.
The salivary flow rate at 30 days was restored to 48%
Bioengineered organ germ
developed to an
After 3 days:
of saliva in the
They are developed in vivo with the correct
connection to the recipient parotid glandular duct.
It is detected by fluorescence.
Histological analysis is done by H&E and PAS
ASSESSMENT OF SALIVA
The acinar cell differentiation and acinar cell formation is analysed.
In response to the nerve stimulations.
In response to citrate stimulation by citrate.
By analyzing the protein components, such as amylase.
FUNCTIONAL RECOVERY OF
SWALLOWING AND SURVIVAL
reducing the risk
It is investigated
by the analyzing
caused by the
The recovery is
done after 4
days which is
the amount of
time required by
When the damage is beyond repair, there is a need for
methods to salvage the RT damage that has occurred.
Stem cell therapy does not provide a symptomatic
treatment but rather treats the underlying cause: a lack of
functional acinar cells.
More research should be done regarding the stem cell
therapy for the complete and a better treatment for these