title: Advances in salivary gland gene therapy - oral and systemic implications.
abstract: BACKGROUND
  Much research demonstrates the feasibility and efficacy of gene transfer to salivary glands. Recently, the first clinical trial targeting a salivary gland was completed, yielding positive safety and efficacy results.
  
  
  METHODS
  There are two major disorders affecting salivary glands: radiation damage following treatment for head and neck cancers and Sjögren's syndrome (SS). Salivary gland gene transfer has also been employed in preclinical studies using transgenic secretory proteins for exocrine (upper gastrointestinal tract) and endocrine (systemic) applications.
  
  
  CONCLUSIONS
  Salivary gland gene transfer is safe and can be beneficial in humans. Applications to treat and prevent radiation damage show considerable promise. A first-in-human clinical trial for the former was recently successfully completed. Studies on SS suffer from an inadequate understanding of its etiology. Proof of concept in animal models has been shown for exocrine and endocrine disorders. Currently, the most promising exocrine application is for the management of obesity. Endocrine applications are limited, as it is currently impossible to predict if systemically required transgenic proteins will be efficiently secreted into the bloodstream. This results from not understanding how secretory proteins are sorted. Future studies will likely employ ultrasound-assisted and pseudotyped adeno-associated viral vector-mediated gene transfer.
authors.affiliation: a National Institute of Dental and Craniofacial Research, National Institutes of Health, Molecular Physiology and Therapeutics Branch , Bethesda, MD 20892-1190, USA bbaum@mail.nih.gov.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Baum
authors.affiliation: a National Institute of Dental and Craniofacial Research, National Institutes of Health, Molecular Physiology and Therapeutics Branch , Bethesda, MD 20892-1190, USA bbaum@mail.nih.gov.
authors.forename: Ilias
authors.initials: I
authors.lastname: Alevizos
authors.affiliation: a National Institute of Dental and Craniofacial Research, National Institutes of Health, Molecular Physiology and Therapeutics Branch , Bethesda, MD 20892-1190, USA bbaum@mail.nih.gov.
authors.forename: John A
authors.initials: JA
authors.lastname: Chiorini
authors.affiliation: a National Institute of Dental and Craniofacial Research, National Institutes of Health, Molecular Physiology and Therapeutics Branch , Bethesda, MD 20892-1190, USA bbaum@mail.nih.gov.
authors.forename: Ana P
authors.initials: AP
authors.lastname: Cotrim
authors.affiliation: a National Institute of Dental and Craniofacial Research, National Institutes of Health, Molecular Physiology and Therapeutics Branch , Bethesda, MD 20892-1190, USA bbaum@mail.nih.gov.
authors.forename: Changyu
authors.initials: C
authors.lastname: Zheng
mesh_terms: D000818:Animals; D000229:Dependovirus / Q000235:genetics; D015316:Genetic Therapy; D005822:Genetic Vectors / Q000235:genetics / Q000378:metabolism; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D011506:Proteins / Q000378:metabolism; D012469:Salivary Glands / Q000378:metabolism*; D012859:Sjogren's Syndrome / Q000473:pathology / Q000628:therapy
chemical_list: D011506:Proteins
keywords: Sjögren’s syndrome; gene therapy; non-viral gene transfer; radiation damage; salivary glands; secretory proteins; viral vectors