IADR Abstract Archives
Salivary Changes Before and After HSCT: A Systematic Review
Objectives: Severe oral problems including oral mucositis (OM) and xerostomia regularly occur after conditioning therapy for hematopoietic stem cell transplantation (HSCT). Saliva plays a major role in protecting the oral mucosae and teeth. Alterations in salivary flow rate or salivary composition, possibly resulting in decreased salivary defence, may affect oral/mucosal health and may influence the severity of OM. To assess current scientific knowledge on changes in salivary function and composition related to HSCT a systematic review was conducted.
Methods: All English or Dutch articles examining salivary flow rate or salivary components before and after HSCT were included after title/abstract selection by 2 independent reviewers (weighted kappa: 0.39). After quality assessment and exclusion of all studies involving children, 24 articles were included for data analysis.
Results: Overall, salivary flow rate was reduced several days and months after HSCT. Although several salivary components were studied, most components were only examined in one or two studies with different patient populations or different time points after HSCT, reducing possibilities for assessing the consistency/reproducibility of the findings. Seven days after HSCT, concentrations of albumin and pro-inflammatory cytokines were increased, whereas those of secretory IgA and components of the salivary antioxidant system were decreased. One month after HSCT, secretory IgA levels were still reduced, but returned to pre-HSCT values 6 months after HSCT. Six months after HSCT, lactoferrin, secretory leukocyte protease inhibitor and β2-microglobulin concentrations were increased.
Conclusions: Changes in saliva composition reflect an inflammatory response directly after HSCT followed by an increased salivary antimicrobial defence 6 months after HSCT.
Methods: All English or Dutch articles examining salivary flow rate or salivary components before and after HSCT were included after title/abstract selection by 2 independent reviewers (weighted kappa: 0.39). After quality assessment and exclusion of all studies involving children, 24 articles were included for data analysis.
Results: Overall, salivary flow rate was reduced several days and months after HSCT. Although several salivary components were studied, most components were only examined in one or two studies with different patient populations or different time points after HSCT, reducing possibilities for assessing the consistency/reproducibility of the findings. Seven days after HSCT, concentrations of albumin and pro-inflammatory cytokines were increased, whereas those of secretory IgA and components of the salivary antioxidant system were decreased. One month after HSCT, secretory IgA levels were still reduced, but returned to pre-HSCT values 6 months after HSCT. Six months after HSCT, lactoferrin, secretory leukocyte protease inhibitor and β2-microglobulin concentrations were increased.
Conclusions: Changes in saliva composition reflect an inflammatory response directly after HSCT followed by an increased salivary antimicrobial defence 6 months after HSCT.