The Translational Role of MUC8 in Salivary Glands: A Potential Biomarker for Salivary Stone Disease?

Mucin (MUC) 8 has been shown to play an important role in respiratory disease and inflammatory responses. In the present study, we investigated the question of whether MUC8 is also produced and secreted by salivary glands and whether it may also play a role in the oral cavity in the context of inflammatory processes or in the context of salivary stone formation. Tissue samples from parotid and submandibular glands of body donors (n = 6, age range 63–88 years), as well as surgically removed salivary stones from patients (n = 38, age range 48–72 years) with parotid and submandibular stone disease were immunohistochemically analyzed targeting MUC8 and TNFα. The presence of MUC8 in salivary stones was additionally analyzed by dot blot analyses. Moreover, saliva samples from patients (n = 10, age range 51–72 years), who had a salivary stone of the submandibular gland on one side were compared with saliva samples from the other “healthy” side, which did not have a salivary stone, by ELISA. Positive MUC8 was detectable in the inter- and intralobular excretory ducts of both glands (parotid and submandibular). The glandular acini showed no reactivity. TNFα revealed comparable reactivity to MUC8 in the glandular excretory ducts and also did not react in glandular acini. Salivary stones demonstrated a characteristic distribution pattern of MUC8 that differed between parotid and submandibular salivary stones. The mean MUC8 concentration was 71.06 ng/mL in female and 33.21 ng/mL in male subjects (p = 0.156). Saliva from the side with salivary calculi contained significantly (15-fold) higher MUC8 concentration levels than saliva from the healthy side (p = 0.0005). MUC8 concentration in salivary stones varied from 4.59 ng/mL to 202.83 ng/mL. In females, the MUC8 concentration in salivary stones was significantly (2.3-fold) higher, with an average of 82.84 ng/mL compared to 25.27 ng/mL in male patients (p = 0.034). MUC8 is secreted in the excretory duct system of salivary glands and released into saliva. Importantly, MUC8 salivary concentrations vary greatly between individuals. In addition, the MUC8 concentration is gender-dependent (♀️ > ♂). In the context of salivary stone diseases, MUC8 is highly secreted in saliva. The findings support a role for MUC8 in the context of inflammatory events and salivary stone formation. The findings allow conclusions on a gender-dependent component of MUC8.

Sialotripsy as a treatment option for patients with salivary stone disease

Background. The pathologies of the salivary glands are very diverse. Salivary stone disease occupies a special place among diseases of the salivary glands of a non-neoplastic nature. The incidence of salivary stone disease is extremely extensive and accounts for up to 85% of all pathologies of the salivary glands.Objective. Improvement of minimally invasive methods of treatment of salivary stone disease, which does not lead to excision of the gland.Material and methods. On the basis of the Clinics of the Samara State Medical University of the Ministry of Health of Russia, in the period from 2010 to 2020, a clinical group was formed, consisting of 193 patients with salivary stone disease of various localization. The age of the patients ranged from 16 to 84 years. All patients were therapeutically examined at the preoperative stage, voluntary informed consent was signed. Shockwave sialotripsy was performed in 95 patients of the main group (in 64 patients the calculus was located in the submandibular salivary gland, in 31 patients – in the parotid salivary gland). For lithotripsy, we used a lithotripter apparatus "Edap" (France) and "Wolf" (Germany).Results. The analysis of the results obtained as a result of the study made it possible to draw a conclusion about reasonably better results of removal of calculi in the ducts of the salivary glands using the lithotripter "Swiss LithoClast® Master" (Switzerland). At the first visit and the therapeutic effect of the lithotripter, all patients suffering from bouts of salivary colic showed complete cessation.Conclusion. Thus our study, which was devoted to the study of the results of various methods of treating patients with salivary stone disease showed that sialolithotripsy using special narrowly targeted devices for crushing and subsequent excretion of salivary calculi allows to achieve the best results at present.

Clinical management of Sialadenitis

Within the area of salivary gland pathology, obstructive sialadenitis is the most common inflammatory condition of the salivary glands.1 It has been well established in the literature that salivary calculi occur most commonly in the submandibular gland, whereas fewer cases are found in the parotid gland, while the sublingual gland and the minor salivary glands form no more than 2% of cases.2 The early treatment of sialadenitis is usually conservative and involves hydration, anti inflammatory medication in conjunction to antibiotics when a bacterial infection is suspected. However, when initial treatment fails, further intervention is needed. The traditional external approach is sialadenectomy. However, with this exists the potential for injury to the lingual and facial nerves. Further complications including bleeding, infection and an unsightly scar are also found with this procedure.3,4 Sialendoscopy is a relatively new technique that only became available once optics had improved to the extent that fiber-optic endoscopes could be miniaturized to a diameter of 0.9 mm to 1.6 mm. This has ushered in a new era for the management of sialadenitis, particularly in cases where sialadenitis was caused by salivary duct obstruction. It must be noted that in South Africa, there are currently no generally accepted guidelines on the management of sialadenitis secondary to salivary ductal obstruction as well as in the role of sialendoscopy within the treatment algorithm.

In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi

Objectives The present study was developed to evaluate the accuracy of in vivo ultrasound sizing for parotid and submandibular salivary gland calculi, as compared with ex vivo pathology sizing with a standard plastic ruler after extraction. Study Design Retrospective chart review. Setting Ultrasound is frequently used to size salivary calculi and make treatment decisions, but the accuracy of measurements from this modality has not been validated. Subjects and Methods We evaluated and reviewed the charts and ultrasound examinations of 167 patients who underwent procedures for the treatment of sialolithiasis involving the parotid and submandibular glands. US examinations were performed between 2009 and 2016 in a tertiary-level hospital setting by the senior author. Measurements were collected from ultrasound evaluation before sialolithotomy, and pathology measurements were taken after removal. Ultrasound measurements in millimeters were compared with the measurements collected with a ruler. The differences were calculated and compared. Results A total of 167 calculi measurements were compared. Good concurrent validity between pathology and ultrasound measurements was suggested by a Pearson correlation of 0.92 (95% CI, 0.887-0.937). On Bland-Altman plot, correlation of the difference between US and pathology measurements showed a mean difference of 0.095 mm (95% CI, –0.19 to 0.38 mm) with a limit of agreement ranging from –3.59 mm (95% CI, –3.84 to –3.34 mm) to +3.78 mm (95% CI, +3.53 to +4.03 mm). Conclusions Ultrasound is an accurate, relatively precise, and minimally invasive imaging tool for salivary gland sialolithiasis. Preoperative size of calculi can be used to guide management and clinical decision making. Level of Evidence 2C.

Incidence of Salivary gland stone as a main cause of sialoadenitis a clinical study was done on a sample of 22 Iraqi patients

Background: sialolithiasis remains an entity carrying a significant morbidity. This study covers the current principles guiding the surgical management of sialolithiasis in Iraqi sample including diagnostic tools, interventional options, surgical techniques and their outcomes. Materials and Methods: A clinical study of 22 cases with salivary gland stones were collected from two major teaching and referral hospital in Baghdad “Medical city, hospital of surgical specialities” and “Al-Kinidy hospital, maxillofacial department” from 2010-2015 Results: The study population composed of 22 cases. The age range was from 10-70 year with average of 40 years. The females were 7 cases (31.81%) and males were15 (68.18%). The majority of cases were submandibular gland 16 cases (72.72%) followed by sublingual gland 5 cases (22.72%) and the parotid gland (4.54%). The presence of stone was similar on both sides. The surgical approach was applied by removal of stone in 11 cases and removal of gland in 11 cases. Conclusion: Salivary calculi are common cause of salivary gland disorder. Sialography is an important tool for assessment of salivary gland obstruction in patients presenting with It should be done after the acute symptoms are subsided. Success is measured by treatment that is efficient, clinically effective and glad sparing.

Effectiveness of Ultrasound in Verification of the Mucus Plugs and Sialoliths of the Wharton`s Duct

The pathological changes in 467 submandibular glands were identified both endoscopically and radiographically, and endoscopic findings showed three types: calculus (91 percent), mucus plug (3 percent), and stenosis (6 percent). —Yu Chuangqi et al, 2013 China Mucus plugs (synonyms: mucous plugs, mucin plugs, fibromucinous plugs and mucosal plugs) and sialoliths (synonyms: salivary stones, salivary calculi, and concrements) belong to the one of the common causes of the obstructive salivary gland disease (synonyms: obstructive sialadenitis and obstructive sialadenopathy). Among other etiologies of obstructive sialadenitis are: foreign bodies, inflammation, kinks, strictures, anatomic malformations, polyps or even tumors. Those causes are found in different percentages. The radiographic investigation e.g. X-ray and computed tomography (CT) are very useful in detection of the salivary stones. Nevertheless, as approximately 80-90 percent of the sialoliths are opaque on a standard review X-ray and CT, and in 10-20% radiolucent. But these methods are not useful in the detection of mucus plugs due to the non-contrast features of the last. There are a lot of studies which described ultrasound features of the sialoliths. Also, there are some studies that demonstrate endoscopic view of the mucosal plugs in a ductal system and in some cases the authors during sialendoscopy noted the floating mucous plugs. But we cannot find articles in PubMed which demonstrate ultrasound and clinical appearance of the obstructive salivary gland disease caused by sialoliths with mucus plugs simultaneously. The purpose of our article is to describe a first and precise description of ultrasound pattern of the mucus plugs comparing with sialolith and their clinical presentation after removal. We report the consecutive gray scale and color Doppler sonograms with a supplemental video.