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Choudhury M, Brunton P, Schwass D, Pletzer D, Ratnayake J, Dias G, Tompkins G. Effectiveness of gold nanoparticles in prevention and treatment of oral mucositis in animal models: a systematic review. Syst Rev 2024; 13:39. [PMID: 38273391 PMCID: PMC10809540 DOI: 10.1186/s13643-023-02425-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/08/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Oral mucositis remains a significant complication during cancer therapy with no effective treatment. Gold nanoparticles offer anti-inflammatory, antioxidant properties with low toxicity. This study systematically reviews the literature assessing gold nanoparticles in the management of oral mucositis in animal models. METHODS A literature search was undertaken using MEDLINE, Embase, PubMed, and Web of Science databases, using the format for Systematic Review Centre for Laboratory Animal Experimentation. Prior to the review, the protocol was registered in the systematic review register, PROSPERO (registration no. CRD42021272169). Outcome measures included ulceration, histopathological scores, inflammatory mediators, microbial growth, and pain. Study quality was analysed by SYRCLE risk-of-bias tool. RESULTS Only one study met the inclusion criteria, documenting reduction in ulceration, inflammatory, and oxidative biomarkers. Exposure to AuNPs prevented inflammatory response induced by 5-fluorouracil in oral mucosa of hamsters. However, a high risk of bias necessitates further research. CONCLUSION This review identifies a potential therapeutic strategy for prevention and management of oral mucositis. It also provides future direction for gold nanoparticle research in oral mucositis; however, there is lack of sufficient evidence to derive any conclusion. Research with standardized parameters including nanoparticle size, capping agent, surface charge, and appropriate oral mucositis animal models will establish risk-benefit balance and margin of safety for therapeutic use of gold nanoparticles for oral mucositis.
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Affiliation(s)
- Minati Choudhury
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
- Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Paul Brunton
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- DVCA, Curtin University, Perth, Australia
| | - Donald Schwass
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Daniel Pletzer
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand.
| | - Jithendra Ratnayake
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - George Dias
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Geoffrey Tompkins
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Yaroslavsky AN, Iorizzo TW, Juliano AF, Adnan A, Carroll JD, Sonis ST, Duncan CN, London WB, Treister NS. Monte Carlo based dosimetry of extraoral photobiomodulation for prevention of oral mucositis. Sci Rep 2023; 13:20425. [PMID: 37993500 PMCID: PMC10665335 DOI: 10.1038/s41598-023-47529-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
Photobiomodulation therapy (PBMT) is recommended for prevention and treatment of oral mucositis, a painful condition that occurs in cancer patients. Intraoral PBMT is limited to treating distal oral mucosa and oropharynx. Extraoral PBMT may provide a more efficient intervention. The goal of this study was to develop a clinically viable protocol for extraoral PBMT. Monte Carlo modeling was used to predict the distribution of 850 nm light for four treatment sites, using anatomical data obtained from MRI and optical properties from the literature. Simulated incident light power density was limited to 399 mW/cm2 to ensure treatment safety and to prevent tissue temperature increase. The results reveal that total tissue thickness determines fluence rate at the oral mucosa, whereas the thickness of individual tissue layers and melanin content are of minor importance. Due to anatomical differences, the fluence rate varied greatly among patients. Despite these variations, a universal protocol was established using a median treatment time methodology. The determined median treatment times required to deliver efficacious dose between 1 and 6 J/cm2 were within 15 min. The developed PBMT protocol can be further refined using the combination of pretreatment imaging and the Monte Carlo simulation approach implemented in this study.
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Affiliation(s)
- Anna N Yaroslavsky
- Advanced Biophotonics Laboratory, Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, 01854, USA.
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - Tyler W Iorizzo
- Advanced Biophotonics Laboratory, Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, 01854, USA
- IPG Medical, Marlborough, MA, 01752, USA
| | - Amy F Juliano
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Ather Adnan
- College of Medicine, Texas A&M Health Science Center, Houston, TX, 77030, USA
| | | | - Stephen T Sonis
- Department of Surgery, Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, 02114, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, 02114, USA
- Biomodels LLC., Waltham, MA, 02451, USA
| | - Christine N Duncan
- Department of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, 02114, USA
| | - Wendy B London
- Department of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, 02114, USA
| | - Nathaniel S Treister
- Department of Surgery, Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, 02114, USA.
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, 02114, USA.
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Agbele AT, Dehpour AR, Jafari RM, Mahdavi SRM, Elyassi A, Seydi M, Bagheri M, Ala M, Roudsari BA, Hejazi M. Development and Application of Prototype System Based on Light-Emitting Diode Arrays (660 nm) with a Top Hat Beam Profile in Order to Optimize Photobiomodulation Protocols for Treatment of Radiation-Induced Oral Mucositis in Rats. Photobiomodul Photomed Laser Surg 2023; 41:622-631. [PMID: 37890115 DOI: 10.1089/photob.2023.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Abstract
Background: Oral mucositis (OM) is a common adverse effect of radiation to the head and neck. Recent research has shown that extra oral photobiomodulation (EO-PBM) reduces the severity of OM. However, appropriate EO-PBM therapy parameters for OM severity reduction have not been documented. Objective: This work aims to optimize EO-PBM radiation parameters for lowering the severity of radiation-induced OM in rats by establishing a photobiomodulation (PBM) treatment system based on light-emitting diode arrays with top-hat beam profile. Methods: The 36 rats are separated into 2 control groups and 4 groups receiving PBM treatment. The PBM groups are exposed to irradiance between 4 and 24 J/cm2 at 660 nm. The cheek pouch mucosa is removed after scarification for biochemical and histological examination. Student's t-test, and one-way analysis of variance (ANOVA) followed by Tukey's Multiple were applied to compare the statistical significance of differences between control groups and PBM treatment groups. Results: Statistical analysis reveals that PBM irradiation at 12 J/cm2 (200 sec) with a flatness of 0.8 and a diameter of 3 cm substantially decreased the level of inflammatory cytokines compared with the positive control group. Conclusions: Our results indicate that the designed treatment PBM system is capable of delivering the optical parameters necessary for therapeutic treatment.
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Affiliation(s)
- Alaba Tolulope Agbele
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Mohammad Jafari
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Rabi Mehdi Mahdavi
- Department of Cell Biology and Anatomy, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Elyassi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Seydi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmood Bagheri
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Ala
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Arji Roudsari
- Department of Cell Biology and Anatomy, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Marjaneh Hejazi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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4
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Madani F, Kazemi S, Shirafkan F, Lotfi M, Hosseini SM, Moghadamnia AA. Thymoquinone protects against 5-Fluorouracil-induced mucositis by NF-κβ and HIF-1 mechanisms in mice. J Biochem Mol Toxicol 2023; 37:e23405. [PMID: 37338137 DOI: 10.1002/jbt.23405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/07/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
Mucositis is among the most common side effects of 5-Fluorouracil (5-FU) and other cancer therapeutic drugs. Thymoquinone (TQ), a bioactive constituent extracted from Nigella sativa, has antioxidant and anti-inflammatory properties and can modify acute gastrointestinal injury. To investigate the effects of TQ on mucositis induced by 5-FU, studied animals were divided into four groups: control, 5-FU unit dose (300 mg/kg) to cause oral and intestinal mucositis (OM and IM), TQ (2.5 mg/kg) and TQ (2.5 mg/kg) plus 5-FU. Due to The molecular mechanisms, it was confirmed that the expression of NF-κβ and HIF-1 increases in OM. The serum levels of malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD), as well as pathological parameters, were assessed. Based on our results, the nuclear factor-kappa β gene expression in the tongue was downregulated significantly in the 5-FU + TQ compared to the 5-FU. TQ treatment can diminish MDA, and a reduction in oxidative stress was shown. TQ could also reduce the severity of tissue destruction and damaging effects induced by 5-FU on the tongue and intestine. We also observed lower villus length and width in the intestine of the 5-FU group compared to the control group. According to our research's pathological, biochemical, and molecular results, treatment with TQ as an anti-inflammatory and antioxidant compound may be the potential to improve and treat 5-FU-induced OM and IM, and TQ could be used against cancer treatment drugs and exhibit fewer adverse effects.
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Affiliation(s)
- Fatemeh Madani
- Student Research Committee, Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Sohrab Kazemi
- Cellular and Molecular Biology Research Center, Health Research Center, Babol University of Medical, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Shirafkan
- Department of Pharmacology and Toxicology, Babol University of Medical Sciences, Babol, Iran
| | - Mandana Lotfi
- Department of Pharmacology and Toxicology, Babol University of Medical Sciences, Babol, Iran
| | - Seyed M Hosseini
- Department of Veterinary Parasitology, Babol-Branch, Islamic Azad University, Babol, Iran
| | - Ali A Moghadamnia
- Department of Pharmacology and Toxicology, Babol University of Medical Sciences, Babol, Iran
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5
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da Silva TG, Ribeiro RS, Mencalha AL, de Souza Fonseca A. Photobiomodulation at molecular, cellular, and systemic levels. Lasers Med Sci 2023; 38:136. [PMID: 37310556 DOI: 10.1007/s10103-023-03801-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
Since the reporting of Endre Mester's results, researchers have investigated the biological effects induced by non-ionizing radiation emitted from low-power lasers. Recently, owing to the use of light-emitting diodes (LEDs), the term photobiomodulation (PBM) has been used. However, the molecular, cellular, and systemic effects involved in PBM are still under investigation, and a better understanding of these effects could improve clinical safety and efficacy. Our aim was to review the molecular, cellular, and systemic effects involved in PBM to elucidate the levels of biological complexity. PBM occurs as a consequence of photon-photoacceptor interactions, which lead to the production of trigger molecules capable of inducing signaling, effector molecules, and transcription factors, which feature it at the molecular level. These molecules and factors are responsible for cellular effects, such as cell proliferation, migration, differentiation, and apoptosis, which feature PBM at the cellular level. Finally, molecular and cellular effects are responsible for systemic effects, such as modulation of the inflammatory process, promotion of tissue repair and wound healing, reduction of edema and pain, and improvement of muscle performance, which features PBM at the systemic level.
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Affiliation(s)
- Thayssa Gomes da Silva
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil.
| | - Rickson Souza Ribeiro
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil
| | - Andre Luiz Mencalha
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil
| | - Adenilson de Souza Fonseca
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil
- Departamento de Ciências Fisiológicas, Instituto Biomédico, Universidade Federal do Estado do Rio de Janeiro, Rua Frei Caneca, 94, Rio de Janeiro, 20211040, Brazil
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6
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Moravej FG, Amini A, Masteri Farahani R, Mohammadi-Yeganeh S, Mostafavinia A, Ahmadi H, Omidi H, Rezaei F, Gachkar L, Hamblin MR, Chien S, Bayat M. Photobiomodulation, alone or combined with adipose-derived stem cells, reduces inflammation by modulation of microRNA-146a and interleukin-1ß in a delayed-healing infected wound in diabetic rats. Lasers Med Sci 2023; 38:129. [PMID: 37243832 DOI: 10.1007/s10103-023-03786-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Abstract
Diabetic wounds are categorized by chronic inflammation, leading to the development of diabetic foot ulcers, which cause amputation and death. Herewith, we examined the effect of photobiomodulation (PBM) plus allogeneic diabetic adipose tissue-derived stem cells (ad-ADS) on stereological parameters and expression levels of interleukin (IL)-1ß and microRNA (miRNA)-146a in the inflammatory (day 4) and proliferation (day 8) stages of wound healing in an ischemic infected (with 2×107 colony-forming units of methicillin-resistant Staphylococcus aureus) delayed healing wound model (IIDHWM) in type I diabetic (TIDM) rats. There were five groups of rats: group 1 control (C); group 2 (CELL) in which rat wounds received 1×106 ad-ADS; group 3 (CL) in which rat wounds received the ad-ADS and were subsequently exposed to PBM(890 nm, 80 Hz, 3.5 J/cm2, in vivo); group 4 (CP) in which the ad-ADS preconditioned by the PBM(630 nm + 810 nm, 0.05 W, 1.2 J/cm2, 3 times) were implanted into rat wounds; group 5 (CLP) in which the PBM preconditioned ad-ADS were implanted into rat wounds, which were then exposed to PBM. On both days, significantly better histological results were seen in all experimental groups except control. Significantly better histological results were observed in the ad-ADS plus PBM treatment correlated to the ad-ADS alone group (p<0.05). Overall, PBM preconditioned ad-ADS followed by PBM of the wound showed the most significant improvement in histological measures correlated to the other experimental groups (p<0.05). On days 4 and 8, IL-1 β levels of all experimental groups were lower than the control group; however, on day 8, only the CLP group was different (p<0.01). On day 4, miR-146a expression levels were substantially greater in the CLP and CELL groups correlated to the other groups, on day 8 miR-146a in all treatment groups was upper than C (p<0.01). ad-ADS plus PBM, ad-ADS, and PBM all improved the inflammatory phase of wound healing in an IIDHWM in TIDM1 rats by reducing inflammatory cells (neutrophils, macrophages) and IL-1ß, and increasing miRNA-146a. The ad-ADS+PBM combination was better than either ad-ADS or PBM alone, because of the higher proliferative and anti-inflammatory effects of the PBM+ad-ADS regimen.
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Affiliation(s)
- Fahimeh Ghasemi Moravej
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdollah Amini
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza Masteri Farahani
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Mohammadi-Yeganeh
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atarodalsadat Mostafavinia
- Department of Anatomical Sciences & Cognitive Neuroscience, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Houssein Ahmadi
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Omidi
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemehalsadat Rezaei
- College of Pharmacy, University of Kentucky, 789 South Limestone, Lexington, KY, 40536, USA
| | - Latif Gachkar
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa, and Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sufan Chien
- Price Institute of Surgical Research, University of Louisville, and Noveratech LLC, Louisville, KY, USA
| | - Mohammad Bayat
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Price Institute of Surgical Research, University of Louisville, and Noveratech LLC, Louisville, KY, USA.
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7
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Salman S, Guermonprez C, Peno-Mazzarino L, Lati E, Rousseaud A, Declercq L, Kerdine-Römer S. Photobiomodulation Controls Keratinocytes Inflammatory Response through Nrf2 and Reduces Langerhans Cells Activation. Antioxidants (Basel) 2023; 12:antiox12030766. [PMID: 36979014 PMCID: PMC10045240 DOI: 10.3390/antiox12030766] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Photobiomodulation (PBM) is rapidly gaining traction as a valuable tool in dermatology for treating many inflammatory skin conditions using low levels of visible light or near-infrared radiation. However, the physiological regulatory pathways responsible for the anti-inflammatory effect of PBM have not been well defined. Since previous studies showed that nuclear factor-erythroid 2 like 2 (Nrf2) is a master regulator of the skin inflammatory response, we have addressed its role in controlling inflammation by PBM. Primary human keratinocytes (KCs) stimulated with 2,4-dinitrochlorobenzene (DNCB) to mimic pro-inflammatory stress were illuminated with two wavelengths: 660 nm or 520 nm. Both lights significantly reduced the mRNA expression of the DNCB-triggered TNF-α, IL-6, and IL-8 cytokines in KCs, while they enhanced Nrf2 pathway activation. PBM-induced Nrf2 is a key regulator of the inflammatory response in KCs since its absence abolished the regulatory effect of light on cytokines production. Further investigations of the mechanisms contributing to the immunoregulatory effect of PBM in inflamed human skin explants showed that 660 nm light prevented Langerhans cells migration into the dermis, preserving their dendricity, and decreased pro-inflammatory cytokine production compared to the DNCB-treated group. This study is the first to report that the PBM-mediated anti-inflammatory response in KCs is Nrf2-dependent and further support the role of PBM in skin immunomodulation. Therefore, PBM should be considered a promising alternative or complementary therapeutic approach for treating skin-related inflammatory diseases.
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Affiliation(s)
- Sara Salman
- Inserm, Inflammation Microbiome Immunosurveillance, Université Paris-Saclay, 91400 Orsay, France
- Lightinderm, Pépinière Paris Santé Cochin, Hôpital Cochin, 75014 Paris, France
| | - Cyprien Guermonprez
- Lightinderm, Pépinière Paris Santé Cochin, Hôpital Cochin, 75014 Paris, France
| | | | - Elian Lati
- Laboratoire BIO-EC, 91160 Longjumeau, France
| | - Audrey Rousseaud
- Lightinderm, Pépinière Paris Santé Cochin, Hôpital Cochin, 75014 Paris, France
| | - Lieve Declercq
- Lightinderm, Pépinière Paris Santé Cochin, Hôpital Cochin, 75014 Paris, France
| | - Saadia Kerdine-Römer
- Inserm, Inflammation Microbiome Immunosurveillance, Université Paris-Saclay, 91400 Orsay, France
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8
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Ala M, Mohammad Jafari R, Ala M, Hejazi SM, Tavangar SM, Mahdavi SR, Dehpour AR. Sildenafil improves radiation-induced oral mucositis by attenuating oxidative stress, NF-κB, ERK and JNK signalling pathways. J Cell Mol Med 2022; 26:4556-4565. [PMID: 35810384 PMCID: PMC9357636 DOI: 10.1111/jcmm.17480] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/18/2022] [Accepted: 06/26/2022] [Indexed: 11/29/2022] Open
Abstract
Radiation-induced oral mucositis is a common and dose-limiting complication of head and neck radiotherapy with no effective treatment. Previous studies revealed that sildenafil, a phosphodiesterase 5 inhibitor, has anti-inflammatory and anti-cancer effects. In this study, we investigated the effect of sildenafil on radiation-induced mucositis in rats. Two doses of radiation (8 and 26 Gy X-ray) were used to induce low-grade and high-grade oral mucositis, separately. A control group and three groups of sildenafil citrate-treated rats (5, 10, and 40 mg/kg/day) were used for each dose of radiation. Radiation increased MDA and activated NF-κB, ERK and JNK signalling pathways. Sildenafil significantly decreased MDA level, nitric oxide (NO) level, IL1β, IL6 and TNF-α. The most effective dose of sildenafil was 40 mg/kg/day in this study. Sildenafil also significantly inhibited NF-κB, ERK and JNK signalling pathways and increased bcl2/bax ratio. In addition, high-dose radiation severely destructed the mucosal layer in histopathology and led to mucosal cell apoptosis in the TUNEL assay. Sildenafil significantly improved mucosal structure and decreased inflammatory cell infiltration after exposure to high-dose radiation and reduced apoptosis in the TUNEL assay. These findings show that sildenafil can improve radiation-induced oral mucositis and decrease the apoptosis of mucosal cells via attenuation of inflammation and oxidative stress.
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Affiliation(s)
- Moein Ala
- Experimental Medicine Research Center, School of medicine, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Mohammad Jafari
- Experimental Medicine Research Center, School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahan Ala
- Faculty of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sedigheh Marjaneh Hejazi
- Medical Physics and Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Advanced Medical Technologies and Equipment Institute Research Center for Molecular and Cellular in Imaging, Bio-optical Imaging Group, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Tavangar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Science Institute, Tehran University of Medical Sciences, Iran
| | - Seied Rabi Mahdavi
- Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Medical Physics, School of medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Experimental Medicine Research Center, School of medicine, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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9
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Sun H, Zhou Y, Ma R, Zhang J, Shan J, Chen Y, Li X, Shan E. Metformin protects 5-Fu-induced chemotherapy oral mucositis by reducing endoplasmic reticulum stress in mice. Eur J Pharm Sci 2022; 173:106182. [PMID: 35405270 DOI: 10.1016/j.ejps.2022.106182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/05/2022] [Accepted: 04/03/2022] [Indexed: 11/03/2022]
Abstract
Metformin (Met) is a first-line and essential treatment for type 2 diabetes, with anti-inflammatory effects. It has been reported Met could inhibit NF-κB activity and down-regulate the release of inflammatory factors. However, whether Met has a protective effect on chemotherapy-induced oral mucositis(CIOM) is unknown. The purpose of this study was to evaluate the protective effect of Metformin(Met) on chemotherapy-induced oral mucositis(CIOM) and further explore its possible mechanism. 5-Fu was used in the C57BL/6 mice to establish the model of CIOM. Our results showed Met could significantly improve 5-Fu-induced mucosal damage, apoptosis, ROS and releasing of inflammatory factors in the tongue tissue. In addition, Met could inhibit 5-Fu-induced high expression of endoplasmic reticulum stress(ERS)-related proteins GRP78 and CHOP. Further studies showed that the protective effect of ERS inhibitor 4-PBA on CIOM was similar to Met. Moreover, Met inhibited the phosphorylation of NF-κB in tongue tissue, independent of AMPK phosphorylation. The protective effect of PDTC, an inhibitor of NF-κB, on tongue tissue was similar to that of Met. This study confirmed the protective effect of Met on 5-Fu-induced CIOM, which was achieved by inhibiting ERS and reducing the activity of NF-κB.
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Affiliation(s)
- Hang Sun
- School of Nursing, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China
| | - Yufeng Zhou
- School of Nursing, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China
| | - Rui Ma
- School of Health Policy & Management, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China
| | - Jia Zhang
- School of Nursing, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China
| | - Jinhua Shan
- School of Nursing, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China
| | - Yue Chen
- School of Nursing, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China
| | - Xianwen Li
- School of Nursing, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China
| | - Enfang Shan
- School of Nursing, Nanjing Medical University, No.140 Hanzhong Road, Nanjing, Jiangsu 210000, China.
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10
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Comparative study of royal jelly, propolis, and photobiomodulation therapies in 5-fluorouracil-related oral mucositis in rats. Support Care Cancer 2021; 30:2723-2734. [PMID: 34822003 DOI: 10.1007/s00520-021-06660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This study aimed to evaluate the effects and mechanisms of action of royal jelly (RJ) and propolis compared to photobiomodulation therapy (PBMT) in an animal model of 5-fluorouracil-related oral mucositis (OM). METHODS Seventy-two male Wistar rats were randomly allocated to four groups (n = 18 each): control (no treatment), PBMT (intraoral laser, 6 J/cm2), RJ, and propolis. On days 0 and 2, the animals received an injection of 5-fluorouracil (5-FU). The buccal mucosa was scratched (days 3 and 4) and the treatments were initiated on day 5. Six animals of each group were euthanized on days 8, 10, and 14. Phytochemical analysis (thin-layer chromatography, TLC) and clinical, histopathological, and immunohistochemical analysis of pS6, pAKT, and NF-κB were performed, and oxidative stress markers were also investigated. RESULTS TLC revealed the presence of large amounts of sucrose (Rf 0.34) in RJ and of flavonoids in propolis. Lower clinical OM scores were observed on day 8, and improved morphological data were observed on day 10 in the PBMT, RJ, and propolis groups (p < 0.05). On day 8, immunoexpression of pS6, pAKT, and NF-κB was increased compared to control. On day 14, reduced glutathione (GSH) antioxidant levels were increased in the propolis group compared to control (p < 0.05). CONCLUSIONS Our results showed that RJ and propolis, as well as PBMT, are effective in the treatment of OM. Considering that some patients who develop OM do not have access to PBMT, the present study demonstrated that topical application of RJ and propolis may be an important alternative for the treatment of OM.
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Shetty SS, Maruthi M, Dhara V, de Arruda JAA, Abreu LG, Mesquita RA, Teixeira AL, Silva TA, Merchant Y. Oral mucositis: Current knowledge and future directions. Dis Mon 2021; 68:101300. [PMID: 34758917 DOI: 10.1016/j.disamonth.2021.101300] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Oral mucositis secondary to head and neck chemoradiation displays a complex molecular pathogenesis involving epithelial and microvascular injury, release of pro-inflammatory cytokines, and host-microbiome communications. These processes lead to oxidative stress and the release of reactive oxygen species that stifle the structural integrity of the oral mucosa, with emergence of erosions and ulcers. The consequences are malnutrition, psychological/psychiatric symptoms, poor quality of life, and occurrence of opportunistic infections. The latter pose a major challenge due to the risk of interruption of anti-neoplastic therapy, tumour recurrence and, ultimately, death. This article aims to present the clinical characteristics, molecular pathogenesis, and an overview of the predisposing factors and current management of oral mucositis. It is anticipated that the future direction of the management of oral mucositis will focus on evidence-based prehabilitation and pre- and per-chemoradiation therapy monitoring.
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Affiliation(s)
- Sameep S Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, A Constituent of MAHE, Manipal 576104, India.
| | - Meghana Maruthi
- Department of Dental Rehabilitative Oncology, HealthCare Global Enterprises Ltd., Bangalore, India.
| | - Vasantha Dhara
- Consultant Maxillofacial Surgeon, Hyderabad, Telangana, India.
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, room 3202 D, CEP: 31.270-910, Belo Horizonte, Minas Gerais, Brazil.
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Antonio Lucio Teixeira
- Faculdade Santa Casa BH, Belo Horizonte, Brazil. Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, room 3204, CEP: 31.270-910, Belo Horizonte, Minas Gerais, Brazil.
| | - Yash Merchant
- Consultant Maxilofacial Surgeon, Pune, Maharashtra, India.
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12
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Agbele AT, Hejazi SM, Dehpour AR, Mohammad Jafari R, Elyassi A, Bagheri M, Seydi M. Treatment Parameters of Photobiomodulation in the Prevention of Non-surgical Cancer Treatment-Induced Oral Mucositis: A Review of Preclinical Studies. J Lasers Med Sci 2021; 12:e54. [DOI: 10.34172/jlms.2021.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 03/06/2021] [Indexed: 01/03/2023]
Abstract
Introduction: The most important side effect after non-surgery cancer treatment (NSCT) is oral mucositis (OM) which degrades the quality of life. Using photobiomodulation (PBM), formerly known as low-level laser therapy (LLLT), in the prevention of NSCT-induced OM was widely studied. Hence, this review evaluates the efficacy of optical treatment parameters behind the working process of PBM in preventing NSCT-induced OM in preclinical studies. Methods: Using the PubMed, Scopus and Embase databases, the present study systematically reviewed existing preclinical studies for optical treatment parameters of PBM in preventing NSCT-induced OM in experimental models without restriction on the year of publication. Results: In total, 51 articles were recognized during the search of the literature, and only 16 research papers were included in this review, taking into consideration the inclusion as well as exclusion benchmarks. The reviewed studies showed that a consensus has yet to be reached on the optimal PBM treatment parameters in preventing NSCT-induced OM. However, a wavelength of 660 nm, a power density of 40 mW as well as fluence which ranged between 2 and 6 J/cm2 were mostly utilized in the included studies. Furthermore, the severity of NSCT-induced OM was reduced following PBM application with no reported severe side effects. Conclusion: The efficacy of PBM with the associated optical parameters is a promising strategy in preventing NSCT-induced OM. However, the optimal parameters of PBM need to be investigated.
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Affiliation(s)
- Alaba Tolulope Agbele
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Department of Basic Medical Sciences, College of Health Sciences and Technology, Ijero-Ekiti, Nigeria
- Department of Physics, School of Sciences, Federal University of Technology Akure, Nigeria
| | - Sedigheh Marjaneh Hejazi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Experimental Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Mohammad Jafari
- Experimental Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Elyassi
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Bagheri
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Seydi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
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13
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Cotomacio CC, Calarga CC, Yshikawa BK, Arana-Chavez VE, Simões A. Wound healing process with different photobiomodulation therapy protocols to treat 5-FU-induced oral mucositis in hamsters. Arch Oral Biol 2021; 131:105250. [PMID: 34482219 DOI: 10.1016/j.archoralbio.2021.105250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the effects of three different Photobiomodulation Therapy (PBMT) protocols in the treatment of 5-fluorouracil-induced oral mucositis in hamsters. DESIGN 60 hamsters were divided into five groups: group "C", which did not receive oral mucosa scratching, 5-fluorouracil (5-FU) or PBMT; group "Ch", which received anesthesia, superficial oral mucosa scratching and 5-FU (oral mucositis induction); and three groups that received oral mucositis induction and a PBMT protocol: groups ChLI, ChLII and ChLIII that received 0.24 J (one point), 1 J (one point) and 1.2 J (five points of 0.24 J) of energy, respectively. The laser equipment used had λ = 660 nm and 0.04 cm2 of spot area (0.226 cm diameter). The animals were euthanized on days 7 and 10 of the experiment, and their oral mucosas were removed for histological (light microscopy and collagen staining), immunohistochemical (NF-kB and TNF-α), and biochemical (TNF-α, NF-kB and hydroxyproline) analysis. RESULTS Group ChLI (less energy), showed the most accelerated repair rates and a lower concentration of inflammatory biomarkers than group Ch. Comparing the three PBMT protocols for treatment of 5-FU-induced oral mucositis in hamsters, the one with low energy (0.24 J) showed better results, regarding reduction of inflammatory biomarkers and tissue repair, than the ones with higher energy (1 and 1.2 J).
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Affiliation(s)
- Claudia C Cotomacio
- School of Dentistry, Paulista University (UNIP), Sao Paulo, SP, Brazil; Pediatric Oncology Institute/GRAACC (Support Group for Children and Adolescents with Cancer), Department of Dentistry, Sao Paulo, Brazil
| | - Caio C Calarga
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Bianca K Yshikawa
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Victor E Arana-Chavez
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Alyne Simões
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil.
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14
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Chauhan A, Gretz N. Role of Visible Light on Skin Melanocytes: A Systematic Review. Photochem Photobiol 2021; 97:911-915. [PMID: 33987856 DOI: 10.1111/php.13454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/10/2021] [Indexed: 01/09/2023]
Abstract
In the last few years, the focus of phototherapy has shifted toward the visible (400-700 nm) part of the electromagnetic spectrum of light. Lately, it has been demonstrated that visible light (VL) can have both beneficial and detrimental effects, especially on the skin. Previously and until now, the most harmful effects on the skin are associated with ultraviolet radiation (UVR). After exposure to natural light, the most evident and immediate change is observed on skin pigmentation. Various wavelengths within the visible spectrum have been reported to alter skin pigmentation. However, the underlying mechanisms are incompletely understood so far. The article aims to shed light on the progress made in the photobiology field (photobiomodulation, PBM) to study the role of visible light on skin melanocytes.
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Affiliation(s)
- Aparna Chauhan
- Medical faculty of Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Norbert Gretz
- Medical faculty of Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
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15
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Martins AFL, Morais MO, Sousa-Neto SS, Oton-Leite AF, Pereira CH, Valadares MC, Freitas NMA, Batista AC, Leles CR, Mendonça EF. The Effect of Photobiomodulation on Nitrite and Inflammatory Activity in Radiotherapy-Induced Oral Mucositis: A Randomized Clinical Trial. Lasers Surg Med 2020; 53:671-683. [PMID: 32997817 DOI: 10.1002/lsm.23328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/29/2020] [Accepted: 09/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES To investigate pro- and anti-inflammatory cytokines and nitrite salivary levels in patients with head and neck cancer receiving photobiomodulation therapy (PBMT) associated with a Preventive Oral Care Program (POCP), for prevention and control of oral mucositis (OM) during radiotherapy (RT) associated or not with chemotherapy protocol. STUDY DESIGN/MATERIALS AND METHODS In this randomized double-blinded clinical trial, 48 patients were randomly assigned to two groups: PBMT (n = 25) and Control (n = 23). In the PBMT group, patients were submitted to PBMT associated with the POCP. In the Control group, patients were submitted only to the POCP. Saliva samples were collected in the 1st (baseline), 7th, 14th, 21st, and 30th sessions of RT, and the levels of interleukin-6 (IL-6), IL-8, IL-10, IL-12p70, IL-1β, and tumoral necrosis factor-α (TNF-α) were measured using the cytometric bead array. Nitrite levels were measured by colorimetric method. OM was assessed using the World Health Organization and the National Cancer Institute scales. RESULTS Patients in the PBMT group presented less severe OM. PBMT tended to stabilize nitrite concentration levels during the RT regimen. The IL-1β concentration was associated with higher OM scores. PBMT promoted an increase in IL-12p70, TNF-α, and IL-10 concentration. CONCLUSION PBMT was effective in the prevention and control of severe OM, and its mechanism of action may be related to a better balance of inflammatory response that may favor injury control. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Allisson F L Martins
- Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Marília O Morais
- Setor de Odontologia do Hospital de Câncer Araújo Jorge. R. 239, 206-Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Sebastião S Sousa-Neto
- Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Angélica F Oton-Leite
- Setor de Odontologia do Hospital de Câncer Araújo Jorge. R. 239, 206-Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Carlos H Pereira
- Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Marize C Valadares
- Laboratório de Farmacologia e Toxicologia Celular da, Faculdade de Farmácia da, Universidade Federal de Goiás, 5ª Avenida Esquina com Rua 240, s/n. Setor Universitário, Goiânia, Goiás, 74605-170, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Nilceana M A Freitas
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
| | - Aline C Batista
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Departamento de Prevenção e Reabilitação Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
| | - Cláudio R Leles
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
| | - Elismauro F Mendonça
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
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16
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Sumatriptan alleviates radiation-induced oral mucositis in rats by inhibition of NF-kB and ERK activation, prevention of TNF-α and ROS release. Arch Oral Biol 2020; 119:104919. [PMID: 32977152 DOI: 10.1016/j.archoralbio.2020.104919] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Oral mucositis caused by radiation therapy is a common problem in cancer patients, especially those with head and neck cancer. Numerous experimental and clinical studies have attempted to find a drug to alleviate oral mucositis. Sumatriptan, is conventionally used to treat migraine attack and cluster headache. Recently, low doses have been shown to have anti-inflammatory properties. In this study we aimed to measure the effect of sumatriptan on experimental radiotherapy-induced oral mucositis. MATERIAL AND METHODS This study evaluates the use of sumatriptan 0.3 and 1 mg/kg in radiation-induced oral mucositis. In order to induce oral mucositis, six rats from each group received 8-Gy of X-ray in a single session. Likewise, three rats from each group received 26-Gy of X-ray. The latter dose of X-ray was used for inducing severe mucositis and apoptosis evaluation by TUNEL assay, while the first dose was used for histopathological and molecular assessments. On 8th day after irradiation, specimens were collected from their tongues for histology, TUNEL and molecular assessments. RESULTS Radiation caused mucosal atrophy, derangement of the tissue and vasodilation. Sumatriptan significantly decreased histopathological score and alleviated mucosal atrophy. As well, there was no evidence of vasodilation in the sumatriptan group. Likewise, sumatriptan decreased the increased level of NF-kB and prevented its activation as well as ERK phosphorylation. In addition, Sumatriptan-treated rats had lower tissue level of TNF-α, reactive oxygen species and fewer apoptotic cells in TUNEL assay. CONCLUSION Based on study results, sumatriptan mitigate radiation-induced oral mucositis by inhibiting NF-kB, ERK and limiting the release of TNF-α, oxidative stress factor and apoptosis.
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Picciolo G, Pallio G, Altavilla D, Vaccaro M, Oteri G, Irrera N, Squadrito F. β-Caryophyllene Reduces the Inflammatory Phenotype of Periodontal Cells by Targeting CB2 Receptors. Biomedicines 2020; 8:biomedicines8060164. [PMID: 32560286 PMCID: PMC7344807 DOI: 10.3390/biomedicines8060164] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 12/20/2022] Open
Abstract
Human gingival fibroblasts (GF) and human oral mucosa epithelial cells (EC) with an inflammatory phenotype represent a valuable experimental paradigm to explore the curative activity of agents to be used in oral mucositis. The role of cannabinoid receptor 2 (CB2) has not yet been investigated in oral mucositis. The aim of this study was to evaluate the therapeutic potential of β-Caryophyllene (BCP), a CB2 agonist, in an in vitro model of oral mucositis. GF and EC were stimulated with LPS (2 µg/mL) alone or in combination with BCP; a group of LPS challenged GF and EC were treated with BCP and AM630, a CB2 antagonist. LPS increased the inflammatory cytokines TNF-α, IL-1β, IL-6 and IL-17A whereas it decreased the anti-inflammatory cytokine IL-13. The upstream signals were identified in an augmented expression of NF-κB and STAT-3 and in reduced mRNA levels of PPARγ and PGC-1α. BCP blunted the LPS-induced inflammatory phenotype and this effect was reverted by the CB2 antagonist AM630. These results suggest that CB2 receptors are an interesting target to develop innovative strategies for oral mucositis and point out that BCP exerts a marked curative effect in a preclinical model of oral mucositis which deserves to be confirmed in a clinical setting.
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Affiliation(s)
- Giacomo Picciolo
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (D.A.); (G.O.)
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.V.); (N.I.)
| | - Domenica Altavilla
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (D.A.); (G.O.)
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.V.); (N.I.)
| | - Giacomo Oteri
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (D.A.); (G.O.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.V.); (N.I.)
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.V.); (N.I.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy
- Correspondence: ; Tel.: +39-0902213648
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18
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Prophylactic photobiomodulation therapy using 660 nm diode laser for oral mucositis in paediatric patients under chemotherapy: 5-year experience from a Brazilian referral service. Lasers Med Sci 2020; 35:1857-1866. [PMID: 32535807 DOI: 10.1007/s10103-020-03060-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/01/2020] [Indexed: 12/22/2022]
Abstract
The use of photobiomodulation therapy (PBMT) in the prevention of oral mucositis (OM) in paediatric care has increased. In this article, we report data of paediatric oncology/haematopoietic stem cell transplantation (HSCT) patients treated with PBMT to prevent chemotherapy-induced OM. A retrospective study was conducted at a Brazilian referral service. Prophylactic PBMT was used in children and adolescents (≤ 17 years) following the protocol: InGaAIP, 660 nm, 100 mW, 2 J, 3.33 W/cm2, and 20 s per point. Demographic data and OM severity scores were assessed. A regression model tested the association between OM with prophylactic PBMT and antineoplastic therapy. A total of 148 individuals who had undergone 358 chemotherapy cycles were analysed. A higher occurrence of OM was observed in HSCT and osteosarcoma (OS) patients. Except for HSCT, OM was associated with methotrexate (MTX) use in all disease groups. PBMT significantly reduced OM severity in acute lymphoblastic leukaemia (ALL) and OS patients. OM grade was 3.16 and 5.45 times higher among individuals with ALL and OS, who had not undergone prophylactic PBMT compared with those who had undergone prophylactic PBMT (p < 0.001). PBMT prevented chemotherapy-induced OM. Individuals who used MTX and did not undergo prophylactic PBMT were at increased risk of OM.
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19
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Martins MD, Silveira FM, Webber LP, Wagner VP, Martins MAT, Squarize CH, Castilho RM. The impact of photobiomodulation therapy on the biology and behavior of head and neck squamous cell carcinomas cell lines. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 209:111924. [PMID: 32570058 DOI: 10.1016/j.jphotobiol.2020.111924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/30/2019] [Accepted: 06/01/2020] [Indexed: 01/01/2023]
Abstract
Photobiomodulation therapy (PBMT) is an emerging therapeutic modality designed to prevent and treat chemotherapy-driven oral mucositis (OM). However, the response of tumor cells to the effects of PBMT remains poorly understood. Our study explores the effects of PBMT in head and neck squamous cell carcinoma (HNSCC) based on cellular proliferation, migration, and survival of tumor cells and its population of cancer stem cells (CSC). We explored the behavior of two HNSCC cell lines (HN6 and HN13) under two distinct conditions, a physiological growing condition (10% FBS), and under stress growing condition (2% FBS) prior to irradiation using diode laser (InGaAlP; MM Optics, São Carlos, SP, Brazil). Diode laser (660 nm) was applied with a power of 100 mW delivering a total energy per point of 0.24 J. MTT and wound healing test (scratch assay) were performed to evaluate, respectively, proliferation and migration of tumor cells. Clonogenic and spheres formation assays were also performed to evaluate the survival and percentage of CSC upon irradiation. Overall, we observed that PBMT does not exacerbate the behavior of HNSCC. We could only observe a decrease in cellular proliferation of one cell line (HN6) when cultured under nutritional stress conditions (p < .05). There were no significant differences between the control and the PBMT groups regarding cell migration, survival and the percentage of CSC. Collectively, our results suggest that in vitro administration of PBMT to HNSCC does not modify the behavior of tumor cells.
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Affiliation(s)
- Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Felipe Martins Silveira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Liana Preto Webber
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Vivian Petersen Wagner
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Cristiane Helena Squarize
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Rogerio Moraes Castilho
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA.
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Serrage H, Heiskanen V, Palin WM, Cooper PR, Milward MR, Hadis M, Hamblin MR. Under the spotlight: mechanisms of photobiomodulation concentrating on blue and green light. Photochem Photobiol Sci 2019; 18:1877-1909. [PMID: 31183484 DOI: 10.1039/c9pp00089e] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Photobiomodulation (PBM) describes the application of light at wavelengths ranging from 400-1100 nm to promote tissue healing, reduce inflammation and promote analgesia. Traditionally, red and near-infra red (NIR) light have been used therapeutically, however recent studies indicate that other wavelengths within the visible spectrum could prove beneficial including blue and green light. This review aims to evaluate the literature surrounding the potential therapeutic effects of PBM with particular emphasis on the effects of blue and green light. In particular focus is on the possible primary and secondary molecular mechanisms of PBM and also evaluation of the potential effective parameters for application both in vitro and in vivo. Studies have reported that PBM affects an array of molecular targets, including chromophores such as signalling molecules containing flavins and porphyrins as well as components of the electron transport chain. However, secondary mechanisms tend to converge on pathways induced by increases in reactive oxygen species (ROS) production. Systematic evaluation of the literature indicated 72% of publications reported beneficial effects of blue light and 75% reported therapeutic effects of green light. However, of the publications evaluating the effects of green light, reporting of treatment parameters was uneven with 41% failing to report irradiance (mW cm-2) and 44% failing to report radiant exposure (J cm-2). This review highlights the potential of PBM to exert broad effects on a range of different chromophores within the body, dependent upon the wavelength of light applied. Emphasis still remains on the need to report exposure and treatment parameters, as this will enable direct comparison between different studies and hence enable the determination of the full potential of PBM.
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Affiliation(s)
- Hannah Serrage
- College of Medical and Dental Sciences, University of Birmingham, UK.
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Comparison of photobiomodulation using either an intraoral or an extraoral laser on oral mucositis induced by chemotherapy in rats. Support Care Cancer 2019; 28:867-876. [PMID: 31165336 DOI: 10.1007/s00520-019-04889-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of the present study was to compare the effect of intraoral (IO) and extraoral (EO) diode laser irradiation on oral mucositis (OM) induced by 5-fluorouracil (5-FU) in rats. METHODS Animals (n = 78) were divided into the following groups: negative control (NC), positive control (PC), IO 6 J/cm2, EO with 6 J/cm2 (EO 6 J/cm2), and 12 J/cm2 (EO 12 J/cm2). OM was induced with an intraperitoneal injection of 5-FU and scarification of the buccal mucosa. Over the following 14 days, animals received photobiomodulation (PBM) daily. Clinical and histological evaluation was done by scores at days 8, 10, and 14. The redox state was evaluated by reactive species levels, antioxidant network, and immunohistochemistry analysis. RESULTS Clinically, on day 8, PBM groups showed lower scores of OM with EO 6 J/cm2 presenting a significantly lower degree compared to PC (p < 0.05). On days 10 and 14, all PBM groups exhibited improvement of OM compared to PC (p < 0.01). On day 8, all PBM groups exhibited an accelerated healing process compared to PC (p < 0.01) and reduction of reactive species (p < 0.001). Also, all PBM groups demonstrated higher levels of antioxidant GPx compared to PC (p < 0.001). Analysis of nitrotyrosine revealed that on day 14, this protein damage marker was significantly reduced in the EO 6 J/cm2 group (p > 0.05). CONCLUSIONS An EO diode laser protocol promoted positive effects in the clinical, histopathological, and redox state in OM induced by 5-FU in rats. Among the EO protocols, EO 6 J/cm2 showed the most encouraging results.
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Photobiomodulation therapy modulates epigenetic events and NF-κB expression in oral epithelial wound healing. Lasers Med Sci 2019; 34:1465-1472. [DOI: 10.1007/s10103-019-02745-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/06/2019] [Indexed: 01/13/2023]
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Silveira FM, Paglioni MDP, Marques MM, Santos-Silva AR, Migliorati CA, Arany P, Martins MD. Examining tumor modulating effects of photobiomodulation therapy on head and neck squamous cell carcinomas. Photochem Photobiol Sci 2019; 18:1621-1637. [DOI: 10.1039/c9pp00120d] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of the present systematic review was to analyze studies that investigated the effects of photobiomodulation therapy on head and neck squamous cell carcinoma cells.
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Affiliation(s)
| | | | - Márcia Martins Marques
- Department of Restorative Dentistry
- School of Dentistry
- University of Sao Paulo
- Sao Paulo-SP
- Brazil
| | | | | | - Praveen Arany
- Departments of Oral Biology and Biomedical Engineering
- Schools of Dental Medicine
- Engineering and Applied Sciences
- State University of New York at Buffalo
- Buffalo
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New photobiomodulation protocol prevents oral mucositis in hematopoietic stem cell transplantation recipients—a retrospective study. Lasers Med Sci 2017; 32:2013-2021. [DOI: 10.1007/s10103-017-2314-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/16/2017] [Indexed: 11/24/2022]
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