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We evaluate the submandibular gland (SMGs) pathogenesis in SARS-CoV-2-infected K18-hACE2 mice, focusing on the impact of infection on the mucin production and structural integrity of acini, ductal system, myoepithelial cells (MECs) and telocytes. The spike protein, the nucleocapsid protein, hACE2, actin, EGF, TNF-\u03b1 and IL-1\u03b2 were detected by immunofluorescence, and the Egfr and Muc5b expression was evaluated. In the infected animals, significant acinar hypertrophy was observed in contrast to ductal atrophy. Nucleocapsid proteins and\/or viral particles were detected in the SMG cells, mainly in the nuclear membrane-derived vesicles, confirming the nuclear role in the viral formation. The acinar cells showed intense TNF-\u03b1 and IL-1\u03b2 immunoexpression, and the EGF-EGFR signaling increased, together with Muc5b upregulation. This finding explains mucin hypersecretion and acinar hypertrophy, which compress the ducts. Dying MECs and actin reduction were also observed, indicating failure of contraction and acinar support, favoring acinar hypertrophy. Viral assembly was found in the dying telocytes, pointing to these intercommunicating cells as viral transmitters in SMGs. Therefore, EGF-EGFR-induced mucin hypersecretion was triggered by SARS-CoV-2 in acinar cells, likely mediated by cytokines. The damage to telocytes and MECs may have favored the acinar hypertrophy, leading to ductal obstruction, explaining xerostomia in COVID-19 patients. Thus, acinar cells, telocytes and MECs may be viral targets, which favor replication and cell-to-cell viral transmission in the SMG, corroborating the high viral load in saliva of infected individuals.<\/jats:p>","DOI":"10.3390\/ijms25136820","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T05:33:28Z","timestamp":1718948008000},"page":"6820","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Submandibular Gland Pathogenesis Following SARS-CoV-2 Infection and Implications for Xerostomia"],"prefix":"10.3390","volume":"25","author":[{"given":"Estela","family":"Sasso-Cerri","sequence":"first","affiliation":[{"name":"Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School\u2013S\u00e3o Paulo State University (UNESP), Araraquara 14801-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitor Dallacqua","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School\u2013S\u00e3o Paulo State University (UNESP), Araraquara 14801-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0439-1331","authenticated-orcid":false,"given":"Salmo Azambuja","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Morphology and Genetics, Federal University of S\u00e3o Paulo, S\u00e3o Paulo 04023-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 Ac\u00e1cio Souza","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Morphology and Genetics, Federal University of S\u00e3o Paulo, S\u00e3o Paulo 04023-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8814-644X","authenticated-orcid":false,"given":"Juliana Cerini Grassi","family":"de Moraes","sequence":"additional","affiliation":[{"name":"Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School\u2013S\u00e3o Paulo State University (UNESP), Araraquara 14801-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5756-5828","authenticated-orcid":false,"given":"Paulo S\u00e9rgio","family":"Cerri","sequence":"additional","affiliation":[{"name":"Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School\u2013S\u00e3o Paulo State University (UNESP), Araraquara 14801-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"25942","DOI":"10.1073\/pnas.2018637117","article-title":"Identifying airborne transmission as the dominant route for the spread of COVID-19","volume":"117","author":"Zhang","year":"2020","journal-title":"Proc. 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