Disease relevance of Xerostomia

• Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer [1].
• Frequencies of some side-effects (mouth dryness, decreased appetite, nausea, and constipation) were significantly higher in the venlafaxine 75 mg and 150 mg groups than in the placebo group [2].
• Oral pilocarpine hydrochloride for the treatment of refractory xerostomia associated with chronic graft-versus-host disease [3].
• OBJECTIVES: To analyze the role of oral pilocarpine in the treatment of xerostomia of Sjogren's syndrome (SS) [4].
• The purpose of this study was to evaluate whether or not amifostine also reduces the incidence of dental caries associated with the radiation-induced xerostomia [5].

High impact information on Xerostomia

• We evaluated pilocarpine hydrochloride for the treatment of radiation-induced xerostomia, a common complication of irradiation of the head and neck [1].
• Xerostomia associated with didanosine [6].
• CONCLUSION: Amifostine reduced acute and chronic xerostomia [7].
• The most common adverse events during tizanidine treatment were somnolence, xerostomia, and fatigue [8].
• MK-467 had no effect on clonidine-induced increased drowsiness, xerostomia, or increase in growth hormone secretion, which is consistent with it being a peripherally acting specific alpha 2-antagonist [9].

Chemical compound and disease context of Xerostomia

• A prospective, randomized, double-blind, placebo-controlled trial was undertaken to test the safety and efficacy of pilocarpine, particularly in reversing the decrease in the production of saliva and other manifestations of xerostomia [1].
• Saliva specimens provide an economical and practical method for melatonin assessment, however, in older adults, issues such as hyposalivation and low melatonin levels limit the feasibility and validity, respectively, of saliva melatonin [10].
• Plaque concentrations of cariogenic organisms increased during the first yr of radiation-induced xerostomia and fluoride gel use, before starting to decline [11].
• All patients with positive rose bengal staining results had associated xerostomia [12].
• The major side effects of racemic oxybutynin (OXY), which is used in the treatment of urinary incontinence are dry mouth (xerostomia) and blurred vision (mydriasis) [13].

Biological context of Xerostomia

• The concentrations of TGF alpha in unstimulated human saliva (age, 30-45 yr; n = 10; 1.5 +/- 3.1 nM) was reduced with age (age, 55-70 yr; n = 10; 0.4 +/- 0.1 nM), but increased in oral pathologies manifested in xerostomia (age, 57-70; n = 6; 0.8 +/- 0.2 nM) and Paget's disease (age, 58-76; n = 8; 2.0 +/- 0.6 nM) [14].
• Acupuncture for pilocarpine-resistant xerostomia following radiotherapy for head and neck malignancies [15].
• Cytoprotection with amifostine (Ethyol; Medimmune Inc, Gaithersburg, MD) has been shown to decrease rates of acute and late xerostomia in patients undergoing radiation therapy for head and neck squamous cell cancer [16].
• 3. It is concluded that guanfacine lowers blood pressure in hypertensive patients and is probably suitable for twice daily administration, but produces xerostomia and sedation [17].
• The effects of hyposalivation on the induction of dental caries and on the composition of the oral microflora were examined in specific pathogen-free Sprague-Dawley rats fed either a sucrose or a wheat flour diet with or without inoculation of Streptococcus mutans [18].

Anatomical context of Xerostomia

• We conclude that pilocarpine is an effective and safe treatment for salivary gland hypofunction and xerostomia in selected patients [19].
• Cytokine mRNA expression profiles and adoptive transfers of T lymphocytes from NOD.B10-H2b.Gfp mice into NOD.B10-H2b.IL4-/- mice at different ages suggest IL-4 is required during the pre-clinical disease stage (around 12 weeks of age) to initiate clinical xerostomia [20].
• OBJECTIVE: To determine the prevalence of keratoconjunctivitis sicca and xerostomia related to Sjögren's syndrome (SS) in asymptomatic patients with diagnosed autoimmune thyroid diseases (AITD); and to investigate whether the immunopathologies of sialadenitis observed in AITD associated SS and primary SS are similar [21].
• 5. The responsiveness of the parotid gland to subsequent stimulation with pilocarpine hydrochloride was apparently preserved in both xerostomia models by pretreatment with pilocarpine hydrochloride, which itself increased salivary secretion [22].
• The use of pilocarpine hydrochloride to prevent xerostomia in a child treated with high dose radiotherapy for nasopharynx carcinoma [23].

Gene context of Xerostomia

• All three hyposalivation groups tended to display a decrease in the concentrations of MUC5B and amylase [24].
• Significant reductions in both the resting and stimulated parotid and submandibular salivary flow rates were observed during IL-2/IFN-alpha immunotherapy compared with the pre- and post-therapy values (P < 0.01), while no hyposalivation was observed in the control patients who underwent ABSCT and did not received IL-2 [25].
• lnterleukin-2 (IL-2) is known to cause xerostomia and skin manifestations similar to graft-versus-host disease (GVHD) [25].
• Lactoferrin, amylase and mucin MUC5B and their relation to the oral microflora in hyposalivation of different origins [24].
• The aim of this study was to evaluate the efficacy and therapeutic value of mucin-containing lozenges in reducing patients' complaints of hyposalivation [26].

Analytical, diagnostic and therapeutic context of Xerostomia

• On the basis of these phase I results, an international multicenter phase III radiotherapy trial with or without amifostine was carried out by Brizel et al in a series of 315 patients with head and neck tumors showing a reduction in xerostomia with no suggestion of tumor protection [27].
• For each of the individual components of xerostomia scored on the visual analog scale, as well as the composite of all components, the group that had received oral pilocarpine during radiation had significantly less xerostomia (p < 0.01 for each) [28].
• Does salivary gland scintigraphy predict response to pilocarpine in patients with post-radiotherapy xerostomia [29]?
• CONCLUSIONS: Amifostine administration during head-and-neck RT reduces the severity and duration of xerostomia 2 years after treatment and does not seem to compromise locoregional control rates, progression-free survival, or overall survival [30].
• Immunosuppression levels measured by CD4 cell counts are significantly associated with xerostomia and salivary gland hypofunction in a population of HIV-positive women [31].

References