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Salivary Glands and Saliva01:23

Salivary Glands and Saliva

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The salivary glands, of which there are three pairs known as the parotid, submandibular, and sublingual glands, play a crucial role in maintaining oral health and initiating the digestive process. Positioned near the ears, beneath the masseter muscle, the parotid glands secrete saliva into the oral cavity through the parotid duct of Stensen. Meanwhile, the submandibular glands, located on the floor of the mouth, secrete saliva through channels named submandibular ducts. The sublingual glands,...
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Cancer Therapies02:49

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Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
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Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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Chemotherapy-Induced Nausea and Vomiting: Cannabinoids01:21

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
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Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

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Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

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Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates...
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Updated: Jun 14, 2025

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Cancer therapy-related salivary dysfunction.

Cristina Paz1, Annemarie Glassey1, Abigail Frick1

  • 1Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

The Journal of Clinical Investigation
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Cancer treatments like chemotherapy and radiation can cause dry mouth, impacting patients' quality of life. This review explores salivary gland function, treatment side effects, and new therapeutic strategies for xerostomia.

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Area of Science:

  • Oncology
  • Oral Medicine
  • Cancer Therapeutics

Background:

  • Salivary gland dysfunction is a frequent adverse effect of cancer treatments, significantly diminishing patients' quality of life.
  • Salivary function is crucial for daily activities such as eating, speaking, and swallowing.
  • Anticancer therapies can disrupt the complex anatomy and physiology of salivary glands.

Purpose of the Study:

  • To review the impact of cancer therapies on salivary gland function.
  • To discuss methods for quantifying xerostomia (dry mouth) in clinical settings.
  • To present current and emerging treatments for cancer therapy-induced salivary dysfunction.

Main Methods:

  • Review of salivary gland anatomy and physiology in relation to cancer therapies.
  • Analysis of methods for clinical quantification of xerostomia, including quality-of-life instruments and direct salivary function measurements.
  • Examination of therapeutic strategies for radiation-induced salivary dysfunction, including limitations of existing treatments and novel approaches.

Main Results:

  • Chemotherapy, bone marrow transplantation, immunotherapy, and radiation therapy impair salivary gland function through various mechanisms.
  • Validated quality-of-life instruments and direct measurements offer different perspectives on quantifying xerostomia.
  • Current treatments like sialagogues have limitations, highlighting the need for innovative therapies.

Conclusions:

  • Understanding salivary gland physiology is key to addressing treatment-induced dysfunction.
  • Accurate quantification of xerostomia is essential for patient management.
  • Emerging cellular, gene, and pharmacologic therapies hold promise for treating cancer therapy-induced dry mouth.