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Does Salivary Function Decrease in Proportion to Radioiodine Dose?
Ji Won Kim1, Jeong Mi Kim1, Mi Eun Choi1
1Department of Otolaryngology, Inha University, School of Medicine, Incheon.
Objectives:
This study was conducted to investigate the dose-response characteristics of radioiodine on salivary glands and to investigate the mechanism responsible for radioiodine-induced salivary glands toxicity.
Methods:
Twenty-four mice were divided into six groups: 0, 0.05, 0.10, 0.20, 0.40, and 0.80 mCi/20 g mouse, administered orally. Mortalities were noted 12 months after radioiodine administration. Body weights, gland weights, salivary lag times, flow rates, and changes in 99m Tc pertechnetate were recorded. Histopathological changes and mRNA expressions were also evaluated, and immunohistochemical analysis and apoptotic assays were performed.
Results:
Survival rates, body weights, gland weights, and flow rates decreased, and lag times increased on increasing radioiodine dose. Animals administered radioiodine showed acinar atrophy, striated duct dilations, and lymphocytic infiltration in glands and irregular destruction of epithelial surfaces of tongue. The uptake and excretion of 99m Tc pertechnetate were impaired by radioiodine. Immunohistochemical analysis showed that numbers of salivary epithelial, myoepithelial, and endothelial cells decreased and that numbers of ductal cells increased with radioiodine dose. Oxidative stress biomarker levels increased; reactive oxygen species scavenger levels decreased; and numbers of apoptotic cells increased in animals exposed to higher radioiodine doses.
Conclusion:
These dose-related, long-term effects on salivary gland should be taken into account when determining radioiodine doses.
Level Of Evidence:
NA Laryngoscope, 130:2173-2178, 2020.
Insights
Radioiodine negatively impacts salivary glands in a dose-dependent manner, causing long-term damage and impaired function. These findings are crucial for managing radioiodine therapy doses.
Area of Science:
- Nuclear Medicine
- Toxicology
- Histopathology
Background:
- Radioiodine is widely used in treating thyroid conditions.
- Salivary gland toxicity is a known side effect of radioiodine therapy.
- Understanding the dose-response relationship is critical for patient safety.
Purpose of the Study:
- To investigate the dose-response characteristics of radioiodine on salivary glands.
- To elucidate the mechanisms underlying radioiodine-induced salivary gland toxicity.
Main Methods:
- Mice were administered varying oral doses of radioiodine.
- Evaluated outcomes included mortality, body and gland weights, salivary function tests, and histopathological changes.
- Assessed 99mTc pertechnetate uptake/excretion, cell populations, oxidative stress, and apoptosis.
Main Results:
- Increased radioiodine doses led to decreased survival, body weight, gland weight, and salivary flow rate, with increased lag times.
- Histopathology revealed acinar atrophy, ductal dilation, lymphocytic infiltration, and epithelial damage.
- Radioiodine impaired 99mTc pertechnetate uptake/excretion, altered cell populations, increased oxidative stress, and induced apoptosis.
Conclusions:
- Radioiodine causes dose-related, long-term adverse effects on salivary glands.
- These findings necessitate careful consideration of radioiodine dosage in clinical practice.
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