Enumeration of T cell subsets with monoclonal antibodies in minor salivary glands of patients with rheumatoid arthritis

Abstract – Labial salivary glands of 51 patients with rheumatoid arthritis and those of 25 control patients were examined by the ANAE (acid α-naphthyl acetate esterase) technique to determine the percentages of B- and T-lymphocytes and mononuclear phagocytes (MPS cells). Using monoclonal antibodies (OKT3 for all T cells, OKT4 for helper/inducer T cells, OKT6 for thymocytes, and OKT8 for suppressor/cytotoxic T cells) T cell subsets were enumerated. B- lymphocytes predominated in both series of salivary glands, and the percentages of B and T cells were equal in both series. The absolute cell counts in the salivary glands of rheumatics were significantly higher (P<0.001) than in those of healthy controls. The number of OKT4⁺ cells was increased in rheumatics, leading to an elevated OKT4⁺/OKT8⁺ ratio when compared with that in controls (P<0.01). The results suggest that the basic phenomenon behind the B cell hyperactivity noticed in rheumatics might be due to increased activity of T helper cells rather than reduced number of T suppressor cells, which were shown to remain almost unaffected in the salivary glands of patients with rheumatoid arthritis.     

Inflammatory cell infiltrate in labial salivary glands of patients with rheumatoid arthritis with special emphasis on tissue mast cells

The labial salivary glands of 81 patients with rheumatoid arthritis (RA) and those of 45 control (CO) patients were biopsied. Mast cell counts were compared with the number of other inflammatory cells (B- and T-lymphocytes and mononuclear phagocytes, stained with acid-alpha-naphthyl acetate esterase technique (ANAE) and to fatty change and fibrosis. Mast cells were directly related to the amount of fibrosis and fatty change in both series, supporting the recent theory that these changes are age-related phenomena and not caused by RA per se. Mast cell counts increased slightly with increasing inflammatory cell infiltration, but no correlation could be found between mast cell counts and B or T cells. Mononuclear phagocyte system (MPS) cells were fewer in the RA group than in CO patients, possibly suggesting an impaired phagocytizing capacity in their salivary glands. In many respects the results are consistent with the known functions of tissue mast cells. Their role in the labial salivary glands is discussed in the light of current immunopathologic concepts of RA and lesions associated with it, i.e. Sj?gren's syndrome.     

Inflammatory cell infiltrate in labial salivary glands of patients with rheumatoid arthritis with special emphasis on tissue mast cells

The labial salivary glands of 81 patients with rheumatoid arthritis (RA) and those of 45 control (CO) patients were biopsied. Mast cell counts were compared with the number of other inflammatory cells (B- and T-lymphocytes and mononuclear phagocytes, stained with acid-α-naphthyl acetate esterase technique (ANAE) and to fatty change and fibrosis. Mast cells were directly related to the amount of fibrosis and fatty change in both series, supporting the recent theory that these changes are age-related phenomena and not caused by RA per se. M ast cell counts increased slightly with increasing inflammatory cell infiltration, but no correlation could be Found between mast cell counts and B or T cells. Mononuclear phagocyte system (MPS) cells were fewer in the RA group than in CO patients, possibly suggesting an impaired phagocytizing capacity In their salivary glands. In many respects the results are consistem with the known function of tissue mast cells. There role in the labial salivary glands is dicussed in the light of current immunopathologic concepts of RA and lesions associated with it, i.e. Sjögren's syndrome     

Immunoglobulin-producing cells in labial salivary glands of patients with rheumatoid arthritis and systemic lupus erythematosus

The distribution of immunoglobulin-producing cells within labial salivary glands from normal individuals (n = 7) and patients with rheumatoid arthritis (n = 10) and systemic lupus erythematosus (n = 9) was studied using morphometric and indirect immunoperoxidase methods. Cell counts revealed a significant increase in the density of IgG cells within glands from both patient groups compared with glands from normal individuals. No significant differences in the density of IgA- or IgM-producing cells between the 3 groups were observed although large individual variations were apparent. Histomorphometric studies showed an increase in the lymphoid compartment and a decrease in glandular elements within glands from the 2 patient groups. When data for all specimens were pooled a significant positive correlation was obtained between the percent area of stromal lymphoid tissue and density of IgG and IgM cells.     

Immunoglobulin-producing cells in labial salivary glands of patients with rheumatoid arthritis and systemic lupus erythematosus

The distribution of immunoglobulin-producing cells within labial salivary glands from normal individuals (n = 7) and patients with rheumatoid arthritis (n = 10) and systemic lupus erythematosus (n = 9) was studied using morphometric and indirect immunoperoxidase methods. Cell counts revealed a significant increase in the density of IgG cells within glands from both patient groups compared with glands from normal individuals. No significant differences in the density of IgA- or IgM-producing cells between the 3 groups were observed although large individual variations were apparent. Histomorphometric studies showed an increase in the lymphoid compartment and a decrease in glandular elements within glands from the 2 patient groups. When data for all specimens were pooled a significant positive correlation was obtained between the percent area of stromal lymphoid tissue and density of IgG and IgM cells.     

Acinic cell tumor of the minor salivary glands

The histologic characteristics and clinical features of six new cases of ACT of the minor salivary glands are reported. These neoplasms accounted for 3.8% of all the minor salivary gland tumors examined by our service.Three cell types were identified: acinar, vacuolated, and intercalated duct-cell. Those cell types were organized in three growth patterns: solid, papillary, and microcystic. Tumor cells were PAS positive both before and after treatment with diastase. Occasionally, they were slightly positive to mucicarmine staining.According to our study, ACT occurs in adult life, apparently without sex preference. Asymptomatic swelling was the most frequent presenting symptom; however, on occasion pain and ill-fitting dentures were reported. Most of the tumors in were described as fixed soft tissue masses, less than 1.5 cm in diameter. No recurrences or metastases were seen in any of the patients for a mean period of four years. Simple surgical removal was the therapeutic measure used in all cases.     

Adenomatoid hyperplasia of minor salivary glands

Adenomatoid hyperplasia of minor salivary glands is an uncommon clinicopathologic entity. It comprises clinical swelling resembling a neoplasm with a histologic picture of aggregates of normal-appearing salivary gland tissue in excess of that anticipated for the anatomic site. The significance of this lesion is derived from its clinical resemblance to a neoplasm of salivary gland origin. This study adds 40 new cases to the literature and analyzes their clinical and histologic features. Most of the lesions were located on the hard and soft palates. The exact nature of the minor salivary gland hyperplasia is not clear. Some of the cases may represent a hamartoma or a reactive hyperplasia, but in most cases the nature of the hyperplasia is idiopathic.     

Sialolithiasis of minor salivary glands.

Sialolithiasis of minor salivary glands is generally considered to be extremely rare. Reports of seven cases are presented. A review of the literature suggests that the condition is not as uncommon as previously considered, and that definitive histopathological diagnosis of lip swellings should be obtained due to the incidence of labial pleomorphic adenoma and the possibility of the clinical misdiagnosis with sialolithiasis.     

Outcomes of patients with adenoid cystic carcinoma of the minor salivary glands

Adenoid cystic carcinoma is a tumour of glandular cells responsible for 10% of salivary gland neoplasms. It has a high rate of perineural spread but limited involvement of regional lymphatics even in late stage disease. Early survival is typically good (60-90%) although long term survival is poor with spread to distant sites in 40-60% of cases. The authors performed a retrospective review of clinical and pathological records for 24 patients managed by their institution over a 22-year period. The overall 5, 10 and 20-year survival rates in this study were 92%, 72% and 54%, respectively. Perineural invasion was seen in 63% and close or positive margins seen in 64% of all primary resection specimens although survival was not associated with any clinical factor other than the initial size of lesion. Most patients presented complaining of a lump, whilst a burning neuralgia-type pain was the second most common symptom. The study confirms the conclusion of previous studies that tumour size at diagnosis is the most important predictor of outcome.     

Secretion from minor salivary glands following ablation of the major salivary glands in rats

Since minor salivary glands are tiny and dispersed, ductal cannulation cannot be used when studying their function. The present study was devised to develop a method of measuring minor salivary gland function by excision of the major glands. Female rats (230–280 g) were anaesthetized with sodium pentobarbital. Ablation of the submandibular, sublingual and parotid glands was performed through a sagittal neck incision. Sham-operated rats served as controls. Groups of sialadenectomized animals were investigated immediately and after 1 week, 2 weeks and 3 months. To study secretory function, the mouth was rinsed with 250 μl water in every 5 min and protein and amylase concentrations were measured. After an initial 50 min of basal secretion pilocarpine (1 mg/kg, i.p.) was given. Bilateral ablation of both submandibular, sublingual and parotid glands led to a moderate loss of body weight and a considerable increase in water intake. No other obvious abnormality was observed for periods up to 90 days following surgery. We deduce that the minor glands secrete approximately 14% of protein and 1% of amylase in whole saliva. Secretion is maintained even after 90 days following removal of the major glands. Surgical removal of the major salivary glands allows the secretory function of the minor glands in rats to be studied in vivo.     

Inverted ductal papilloma of minor salivary glands

Inverted ductal papillomas are rare tumours of minor salivary glands. A case is reported on the lower lip of a 50–year-old man. The tumour showed a characteristic endophytic growth pattern and was composed of bulbous papillary projections of basaloid cells dilating and filling the superficial portion of the excretory duct. Histologically, inverted ductal papillomas resemble the inverted papilloma of the nose and paranasal sinuses, but are completely benign and are not associated with malignant change.     

Morphological features of the minor salivary glands

The minor salivary, glands are important components of the oral cavity, present in most parts of the mouth, and their secretions directly bathe the tissues. Individual glands are usually in the submucosa or between muscle fibres, and consist of groups of secretory endpieces made up of mucous acinar cells and serous or seromucous demilune cells. The ductal systems comprise intercalated ducts, intralobular ducts usually lacking basal striations, and excretory ducts opening directly through the mucosa. Minor glands secrete highly glycosylated mucins, containing blood group determinants, and probably active in tissue lubrication and bacterial aggregation. They also secrete several antimicrobial proteins and immunoglobulins, and the lingual serous (van Ebner's) glands secrete digestive enzymes and proteins with possible taste perception functions. Minor gland morphology and function can conveniently be studied in the rat. There are substantial differences between major and minor salivary glands, as well as among the minor glands, in the nature and composition of their mucous and serous secretory products. The role of minor salivary glands in the function and defence of the oral cavity may be better understood as a result of new physiological and molecular methods applicable to samples of limited size and availability.     

Flow rate of minor salivary glands in elderly patients wearing complete dentures

Minor salivary glands show diverse levels of secretion in different regions of the oral cavity. The smallest production can be measured at the palatal glands, the highest in the buccal and the lingual glands. The labial glands show an intermediate value between the palatal and the buccal flow rate. According to the literature, secretion of the minor salivary glands decreases with age, yet only few data are available regarding the influence of removable dentures on the flow rate. The aim of this study was to assess the influence of complete dentures on the palatal, the labial and the whole saliva flow rate on elderly patients. A further aim was to compare the results obtained by the two measuring methods (weighing method and the PERIOTRON method), used to determine the flow rates of the minor salivary glands. According to the results of this study neither whole resting saliva flow rate nor the flow rate of the minor salivary glands (palatal, buccal) was influenced by long term removable denture wearing (denture wearers and controls -- weighing method: palatal: right side 2.4 +/- 3.3 microl/min/cm2, left side 1 +/- 3.8 microl/min/cm2 and labial: 1.4 +/- 2.6 microl/min/cm2; controls: right side 3.7 +/- 5.2 microl/min/cm2, left side 1.4 +/- 2.5 microl/min/cm2 and labial 1.8 +/- 3.9 microl/min/cm whole resting saliva flow: 0.32 +/- 0.26 ml/min and 0.29 +/- 0.24 ml/min respectively) (The data of denture wearers and controls -- PERIOTRON method: palatal right side 4 +/- 4.6 microl/min/cm2, palatal left side 3.5 +/- 3.6 microl/min/cm2 and labial 0.9 +/- 0.6 microl/min/cm2; controls: palatal right side 2.2 +/- 3.1 microl/min/cm2, palatal left side 1.8 +/- 1.8 microl/min/cm2 and labial 1.9 +/- 3 microl/min/cm2). Authors could not show difference between the weighing method and the PERIOTRON method applied in the measurement of the saliva flow rate of the minor glands.