Pathology of salivary gland dysfunction and restoration of function

Pathol Int. 2021 May;71(5):304-315. doi: 10.1111/pin.13079. Epub 2021 Mar 22.

Abstract

In this review, the author shows that simultaneous multiple disorders caused by reactivation of Epstein-Barr virus can lead to salivary gland disorders as part of Sjogren's syndrome (SS). Therefore, clinicians must differentiate SS from other diseases when diagnosing and treating salivary gland disorders. In particular, the author explains how microbial infection in SS overcomes immunological tolerance, leading to pathological changes, and how cytokine overexpression and endocrine disrupters contribute to glandular tissue injury. Also, the author suggests that involvement of reactive oxygen species is a common pathogenesis of salivary gland disorders and SS, so regulation of oxidative stress is an effective treatment for both. The results of clinical studies on restoring salivary gland function and regenerating salivary glands with tissue stem cells may provide clues on elucidating the cause of SS.

Keywords: Epstein-Barr virus; IL-10; Sjogren syndrome; dioxin; immunological tolerance; regeneration; salivary glands; stem cells; ubiquinol.

Publication types

  • Review

MeSH terms

  • Antioxidants / pharmacology
  • Arthritis, Rheumatoid / complications
  • Autoantigens
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / immunology
  • Cytokines / metabolism
  • Diagnosis, Differential
  • Dioxins / metabolism
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / immunology
  • Epstein-Barr Virus Infections / pathology
  • Estrogens / metabolism
  • Female
  • Genetic Predisposition to Disease
  • Herpesvirus 4, Human / pathogenicity
  • Humans
  • Interleukin-10 / metabolism
  • Lymphocytes / immunology
  • Male
  • Mikulicz' Disease / diagnosis
  • Mikulicz' Disease / pathology
  • Oxidative Stress / immunology
  • Reactive Oxygen Species / immunology
  • Reactive Oxygen Species / metabolism
  • Salivary Glands* / metabolism
  • Salivary Glands* / pathology
  • Salivary Glands* / virology
  • Sjogren's Syndrome* / diagnosis
  • Sjogren's Syndrome* / genetics
  • Sjogren's Syndrome* / pathology
  • Sjogren's Syndrome* / therapy
  • Stem Cell Transplantation
  • Ubiquinone / analogs & derivatives
  • Ubiquinone / pharmacology
  • Virus Activation
  • Virus Diseases / complications
  • Virus Diseases / pathology

Substances

  • Antioxidants
  • Autoantigens
  • Cytokines
  • Dioxins
  • Estrogens
  • Reactive Oxygen Species
  • Interleukin-10
  • Ubiquinone
  • ubiquinol