Artificial Saliva with Sugarcane Protein Aids Cancer Patients' Dental Health\n\nResearch has identified an artificial saliva, incorporating the laboratory-modified CANECPI-5 protein extracted from sugarcane, that may assist in treating dental issues for patients undergoing head and neck cancer treatment. Radiotherapy in proximity to the mouth can damage salivary glands, compromising saliva production. Saliva is essential for controlling oral bacteria and preventing disease.\n\n## Research Findings\n\nA study conducted at the Bauru School of Dentistry at the University of São Paulo (FOB-USP) in Brazil, in collaboration with researchers from the Federal University of São Carlos (UFSCar), the University of California in San Francisco, and Yonsei University College of Dentistry, explored the efficacy of this artificial saliva. The findings were published in the Journal of Dentistry.\n\nAccording to the research, CANECPI-5 creates a protective layer on teeth, safeguarding enamel from acids found in various beverages and stomach acids. Initial tests involved applying the CANECPI-5 solution to animal teeth once daily for one minute, demonstrating its protective capabilities.\n\nThis product is noted as the first to apply the concept of acquired pellicle—a protective layer that forms on tooth surfaces—to address xerostomia, or dry mouth caused by insufficient saliva. The mechanism involves substances that reformulate the composition of proteins binding to teeth, with CANECPI-5 directly binding to enamel to enhance resistance against acids produced by bacteria.\n\nThe data indicated that CANECPI-5 protein is most effective when combined with fluoride and xylitol. In these combinations, the artificial saliva spray significantly reduced bacterial activity and tooth demineralization, a process where teeth lose calcium and phosphate, increasing susceptibility to cavities.\n\n## Addressing an Unmet Need\n\nThis development is important as patients undergoing head and neck cancer treatment currently lack a specific commercial product to combat and treat severe cavities that often develop following radiation therapy. Artificial saliva improves dry mouth symptoms and aids in bacterial control, providing relief for temporary or permanent saliva production loss.\n\n## Development and Future Directions\n\nThe patent for the CANECPI-5 protein has been filed. The current objective is to scale up production through partnerships with interested companies to make the artificial saliva widely available.\n\nThe solution has been tested in multiple forms, including mouthwash, gel, and orodispersible film, demonstrating consistent effectiveness across these applications.\n\n## Discovery of CANECPI-5\n\nThe CANECPI-5 protein was developed through research linked to the Sugarcane Genome Project (SUCEST, FAPESP). Initially, researchers identified and produced the first cystatin from sugarcane, CANECPI-1, before identifying CANECPI-5 and other cane cystatins. CANECPI-5 showed potent inhibitory activities against cysteine peptidases. Its strong binding to smooth surfaces led to tests on tooth enamel.\n\nBeyond dental applications, CANECPI-5 has been investigated for periodontitis and wound healing, showing potential to reduce inflammation and promote angiogenesis and fibrinogenesis, processes crucial for tissue repair.\n\nFuture research within the Thematic Project aims to understand CANECPI-5's interactions with other substances. Possible avenues include studying CANECPI-5 fused with a peptide from statherin (a salivary protein) to enhance acid resistance, and exploring its role in combating periodontal disease. Additionally, researchers are investigating combining CANECPI-5 with vitamin E, which could act as a carrier to facilitate direct patient application at home.\n\nThe São Paulo Research Foundation (FAPESP) is a public institution in Brazil that supports scientific research across various fields through grants and scholarships.