Summary
Long-term treatment of hypertension with the adrenergic blocking agent Guanacline has the side effect of severe pain in the parotid gland which starts on chewing. To gain some insight into this clinical symptom five parotid-gland biopsies were taken from hypertensive patients after treatment with Guanacline and investigated by light and electron microscopy. Biopsies from patients without hypertension and not treated with Guanacline were studied as controls.
The morphological alterations consist in swelling of the acini cells, disturbances of secretion with development of “light” and “dark” cells and changes in the myoepithelial cells with pycnoses of the nuclei, incorporation of lipid droplets, destruction of myofilaments, and enlargement of the pericellular spaces. The “dark” cells are characterized by enrichment of secretory granules, vesicular transformation of the endoplasmatic reticulum, and enlargement of the Golgi area with membrane-bound myeline figures. The alterations in the “light” cells consist in a decrease of secretory granules and spiral transformation of the endoplasmatic reticulum. In both types of cells the secretory granules show a marked variation of configuration, size, optic density and ultrastructure. Changes of the duct system were not observed.
The findings are interpreted as neurovegetative sialadenosis after a deficit of sympathetic innervation. These drug-induced changes in the parotid gland demonstrate the importance of the sympathetic nervous system for the synchronization of amylase secretion in the acinic cells. The additional functional loss of the sympathetic innervated myoepithelial cells favors an inversion of the swelling pressure of the acinic cells into the interstitutium with the sensoric nerve fibers.
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Herrn Prof. Dr. H. Bartelheimer, Hamburg zum 65. Geburtstag gewidmet.
Mit Unterstützung durch die Deutsche Forschungsgemeinschaft.
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Donath, K., Seifert, G. & Pirsig, W. Sialadenosis of the parotid gland after long-term treatment with antihypertensive agents (Guanacline). Virchows Arch. Abt. A Path. Anat. 360, 33–44 (1973). https://doi.org/10.1007/BF00548656
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DOI: https://doi.org/10.1007/BF00548656