Sugarcane-Derived Artificial Saliva Offers Hope for Cancer Patients Facing Severe Dry Mouth
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A novel artificial saliva, formulated with a protein extracted from sugarcane, shows significant promise in alleviating the debilitating effects of dry mouth and protecting teeth in patients undergoing head and neck cancer treatment. Radiotherapy in this region frequently damages salivary glands, leading to a severe lack of saliva – a condition known as xerostomia – which dramatically increases the risk of bacterial infections and tooth decay.
A Protective “Shield” for Teeth
Researchers at the Bauru School of Dentistry at the University of São Paulo (FOB-USP) in Brazil have been investigating CANECPI-5, a modified protein derived from sugarcane, as a potential solution. According to findings published in the Journal of Dentistry in early 2025, CANECPI-5 forms a protective “shield” around teeth, guarding enamel against damaging acids found in common beverages like juice and alcohol, and even stomach acid.
The research, spearheaded during the doctoral studies of Natara Dias Gomes da Silva at FOB-USP, was a collaborative effort involving scientists from the Federal University of São Carlos (UFSCar) in Brazil, the University of California in San Francisco, and Yonsei University College of Dentistry in South Korea. The project falls under the broader “Modulation of acquired pellicle to control dental mineral loss” thematic project, coordinated by Professor Marília Afonso Rabelo Buzalaf from FOB-USP.
How CANECPI-5 Works
Initial testing involved applying the CANECPI-5 mouthwash to small pieces of animal teeth once daily for one minute. “Based on these results, we’ll conduct further research so that we can think about applications of this product,” explained Gomes da Silva.
The innovation lies in CANECPI-5’s ability to interact with the acquired pellicle – a naturally forming, thin protective layer on tooth surfaces. “This is the first product that uses the concept of acquired pellicle to treat xerostomia,” Buzalaf stated. “We use substances that will reformulate the composition of the proteins that bind to the teeth.”
Further investigation revealed that CANECPI-5 directly binds to tooth enamel, bolstering its resistance to acid attacks from bacteria. The protein is particularly effective when combined with fluoride and xylitol, significantly reducing bacterial activity and demineralization – the process where teeth lose essential minerals, increasing cavity risk.
Addressing an Unmet Need for Cancer Patients
This discovery is particularly significant because currently, there are no products specifically designed to combat the aggressive cavities that often develop in patients following radiation therapy for head and neck cancer. “Artificial saliva improves the sensation of dry mouth and sores. This helps with discomfort and also combats bacteria,” Buzalaf added. “In some cases, the use of this type of product is only for a short time. In others, it’s permanent, because many individuals lose the ability to produce saliva.”
The researchers have already secured a patent for the CANECPI-5 protein and are now focused on scaling up production through partnerships with interested companies. Testing has extended beyond a traditional mouthwash to include gel and orodispersible film formulations – a plastic film that dissolves on the tongue, releasing the protein. “We’ve tested it in several vehicles and found that CANECPI-5 works very well in all of them,” Buzalaf confirmed.
From Sugarcane Genome Project to Dental Innovation
The origins of CANECPI-5 trace back to the Sugarcane Genome Project (SUCEST), a research initiative led by FAPESP. According to Flávio Henrique Silva, a professor at the Federal University of São Carlos (UFSCar) involved in the protein’s development, his team initially identified and produced a cystatin protein from sugarcane, named CANECPI-1. Subsequent research led to the identification and production of five additional cystatins, including CANECPI-5, which demonstrated potent inhibitory activity against key enzymes.
“Throughout our work, we noticed that this protein bound strongly to smooth surfaces,” Silva explained, which prompted collaboration with Professor Buzalaf to explore its potential binding affinity to tooth enamel. Researchers have also found promising applications for CANECPI-5 beyond dental health, including potential benefits in periodontitis treatment, inflammation reduction, and wound healing.
Future Research and Potential Applications
The research team plans to continue investigating how CANECPI-5 interacts with other substances. One avenue involves fusing CANECPI-5 with a peptide derived from statherin, a naturally occurring salivary protein, to enhance its effectiveness against stomach acid. Another focus is exploring its potential in combating periodontal disease.
“Another aspect of the Thematic Project is to associate CANECPI-5 with vitamin E because this vitamin acts as a carrier, bringing the protein into contact with the tooth. We imagine that this could facilitate the application of the product directly by the patient at home,” Buzalaf noted. This innovative approach, born from sugarcane research, offers a beacon of hope for improving the quality of life for cancer patients struggling with the debilitating effects of radiation-induced dry mouth.
Source: São Paulo Research Foundation (FAPESP)
Journal reference: Gomes Da Silva, N. D., et al. (2025). A novel artificial saliva enriched with CaneCPI-5 for irradiated head and neck cancer (HNC) patients: in vitro antimicrobial and anticaries effect. Journal of Dentistry. DOI: 10.1016/j.jdent.2025.106176. https://www.sciencedirect.com/science/article/abs/pii/S0300571225006220?via%3Dihub
