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Kullenberg F, Peters K, Sjöblom M, Heindryckx F, Dahlgren D, Lennernäs H. Anakinra and dexamethasone treatment of idarubicin-induced mucositis and diarrhoea in rats. Basic Clin Pharmacol Toxicol 2023; 132:511-520. [PMID: 36878867 DOI: 10.1111/bcpt.13851] [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: 10/20/2022] [Revised: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Chemotherapy-induced mucositis, characterized by diarrhoea and villous atrophy, is a severe side effect contributing to reduced quality of life and premature death in cancer patients treated with cytostatics. Despite its high incidence, there is no effective supportive therapy available. The main objective of this study was to determine if the anti-inflammatory drugs anakinra and/or dexamethasone-which have different mechanisms-of-action-might be used to effectively treat idarubicin-induced mucositis in rats. Mucositis was induced through a single injection with 2 mg/kg idarubicin (with saline as control), followed by daily treatments of anakinra (100 mg/kg/day), dexamethasone (10 mg/kg/day) or both for 3 days. After 72 h, jejunal tissue was collected for morphological, apoptotic and proliferative analyses, and colonic faecal water content and body weight change were determined. The diarrhoea that was induced by idarubicin (from 63.5% to 78.6% water content in faeces) was completely reversed by anakinra alone, and the jejunal villus height reduction by 36% was prevented by a combination of anakinra and dexamethasone. Dexamethasone reduced apoptosis in the jejunal crypts, both alone and in combination with anakinra. These positive effects encouraged further investigations into the use of anakinra and dexamethasone as supportive therapies for chemotherapy-induced intestinal mucositis and diarrhoea.
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Affiliation(s)
- Fredrik Kullenberg
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Karsten Peters
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.,Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Markus Sjöblom
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Femke Heindryckx
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - David Dahlgren
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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2
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Zhou W, Liu F, Fang J, Han L. Dexamethasone in preventive analgesia alleviates pain and complications after jaw cyst enucleation: a randomized controlled trial. BMC Anesthesiol 2022; 22:344. [DOI: 10.1186/s12871-022-01895-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/31/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Dexamethasone is widely used in the prevention of postoperative complications in oral surgery and strengthening the analgesic effect after anesthesia, but the efficacy is controversial, and the relationship between postoperative complications and pain is still unclear. The purpose of this study was to evaluate the analgesic effect of dexamethasone in the treatment of jaw cyst and to explore the relationship between postoperative complications and pain.
Methods
We conducted a prospective, randomized, double-blind clinical trial. 120 patients were divided into two groups, dexamethasone group ( group D) and control group (Group C). All patients were given 0.02 mg·kg−1 of hydromorphone to relieve pain in advance at 10 min before the beginning of operation. Meanwhile, dexamethasone was injected 0.2 mg·kg−1 intravenously in group D and normal saline was injected in group C. The primary endpoint was pain intensity at 2 h, 6 h, 12 h, 24 h and 48 h after surgery. The secondary endpoints were the incidence and extent of complications after surgery, including facial swelling and trismus.
Results
Compared with group C, the visual analogue scale (VAS) scores and occurrence of painful event postoperatively in group D were significantly lower both at rest (P < 0.0001 and P = 0.0014) and during mobilization (P < 0.0001 both). The degree of facial swelling and trismus in group D were significantly lower than that in group C at 24 h (P < 0.0001 and P = 0.00022) and 48 h (P < 0.0001 and P = 0.00015) after surgery, but there was no difference at 6 h and 12 h (P = 0.137 and P = 0.083) after surgery. The C-reactive protein (CRP) level at 24 h after operation in group D was lower than group C (P = 0.012), but there was no significant difference in blood glucose concentration between the two groups (P = 0.608).
Conclusion
Dexamethasone can reduce the degree of facial swelling and trismus after jaw cyst surgery by inhibiting the production of inflammation, which alleviated the postoperative pain of patients significantly. In addition, it did not increase the risk of hyperglycemia.
Trial registration
This study was registered with the Chinese Clinical Trial Registry on May 07, 2020 (URL: http://www.chictr.org.cn/showproj.aspx?proj=53344. Registry number: ChiCTR2000032693). Registered on 07/05/2020.
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In Vitro and In Vivo Cell-Interactions with Electrospun Poly (Lactic-Co-Glycolic Acid) (PLGA): Morphological and Immune Response Analysis. Polymers (Basel) 2022; 14:polym14204460. [PMID: 36298036 PMCID: PMC9611119 DOI: 10.3390/polym14204460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Random electrospun three-dimensional fiber membranes mimic the extracellular matrix and the interfibrillar spaces promotes the flow of nutrients for cells. Electrospun PLGA membranes were analyzed in vitro and in vivo after being sterilized with gamma radiation and bioactivated with fibronectin or collagen. Madin-Darby Canine Kidney (MDCK) epithelial cells and primary fibroblast-like cells from hamster’s cheek paunch proliferated over time on these membranes, evidencing their good biocompatibility. Cell-free irradiated PLGA membranes implanted on the back of hamsters resulted in a chronic granulomatous inflammatory response, observed after 7, 15, 30 and 90 days. Morphological analysis of implanted PLGA using light microscopy revealed epithelioid cells, Langhans type of multinucleate giant cells (LCs) and multinucleated giant cells (MNGCs) with internalized biomaterial. Lymphocytes increased along time due to undegraded polymer fragments, inducing the accumulation of cells of the phagocytic lineage, and decreased after 90 days post implantation. Myeloperoxidase+ cells increased after 15 days and decreased after 90 days. LCs, MNGCs and capillaries decreased after 90 days. Analysis of implanted PLGA after 7, 15, 30 and 90 days using transmission electron microscope (TEM) showed cells exhibiting internalized PLGA fragments and filopodia surrounding PLGA fragments. Over time, TEM analysis showed less PLGA fragments surrounded by cells without fibrous tissue formation. Accordingly, MNGC constituted a granulomatous reaction around the polymer, which resolves with time, probably preventing a fibrous capsule formation. Finally, this study confirms the biocompatibility of electrospun PLGA membranes and their potential to accelerate the healing process of oral ulcerations in hamsters’ model in association with autologous cells.
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Liao YF, Luo FL, Tang SS, Huang JW, Yang Y, Wang S, Jiang TY, Man Q, Liu S, Wu YY. Network analysis and experimental pharmacology study explore the protective effects of Isoliquiritigenin on 5-fluorouracil-Induced intestinal mucositis. Front Pharmacol 2022; 13:1014160. [PMID: 36278232 PMCID: PMC9582754 DOI: 10.3389/fphar.2022.1014160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
5-fluorouracil (5-FU) is one of the most widely used chemotherapy drugs for malignant tumors. However, intestinal mucositis caused by 5-FU is a severe dose-limiting toxic effect and even leads to treatment interruption. Isoliquiritigenin (ISL) is one of the main active compounds of licorice, which is a traditional Chinese herbal medicine commonly used in inflammation and gastrointestinal diseases. It is speculated that ISL have protective effects on intestinal mucositis. However, no such studies have been reported. Therefore, to investigate the impact of ISL on 5-Fu-induced intestinal mucositis, a strategy based on network prediction and pharmacological experimental validation was proposed in this study. Firstly, the targets and mechanism of ISL in alleviating 5-Fu-induced gastrointestinal toxicity were predicted by network analysis. And the results were further confirmed by molecular docking. Then, a mouse model of intestinal mucositis was established by intraperitoneal injection of 5-FU (384 μmol/kg) to verify the prediction of network analysis. The network analysis results suggested that PTGS2 (Prostaglandin G/H synthase 2) and NOS2 (Nitric oxide synthase, inducible) might be the critical targets of ISL for reducing the intestinal toxicity of 5-FU. In addition, KEGG and GO enrichment analysis revealed that the HIF-1, TNF, MAPK, IL-17, PI3K-Akt, Ras, NF-kappa B signaling pathway, and biological processes of the inflammatory response, apoptosis regulation, NO production and NF-kappa B transcription factor activity might be involved in the mechanism of ISL against intestinal mucositis. Subsequent animal experiments showed that ISL could reduce the weight loss, leukopenia and mucosal damage caused by 5-FU. Compared with the intestinal mucositis model, the protein expressions of PTGS2, NOS2, TNFα (Tumor necrosis factor-alpha) and NF-κB p65 (nuclear factor kappa-B P65) were decreased after ISL treatment. In conclusion, this study is the fist time to find that ISL can attenuate 5-FU-induced intestinal mucositis in mice. Its anti-mucositis effect may be through regulating TNF/NF-κB pathway and inhibiting inflammatory mediators PTGS2 and NOS2. It will provide a potential candidate for the prevention and treatment of chemotherapy-induced intestinal mucositis.
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Affiliation(s)
- Yi-fan Liao
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
| | - Feng-lin Luo
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
| | - Shan-shan Tang
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
| | - Jing-wei Huang
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industralization, Chengdu University, Chengdu, Sichuan, China
| | - Ying Yang
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
| | - Shuang Wang
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
| | - Tang-yu Jiang
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
| | - Qiong Man
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
- *Correspondence: Yi-ying Wu, ; Qiong Man, ; Sha Liu,
| | - Sha Liu
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
- *Correspondence: Yi-ying Wu, ; Qiong Man, ; Sha Liu,
| | - Yi-ying Wu
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pharmacy, Study on the Structure-Specific Small Molecule Drug in Sichuan Province College Key Laboratory, Chengdu Medical College, Chengdu, Sichuan, China
- *Correspondence: Yi-ying Wu, ; Qiong Man, ; Sha Liu,
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Mozaffari MS, Abdelsayed R. Expression Profiles of GILZ and Annexin A1 in Human Oral Candidiasis and Lichen Planus. Cells 2022; 11:cells11091470. [PMID: 35563776 PMCID: PMC9100531 DOI: 10.3390/cells11091470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 12/10/2022] Open
Abstract
Adrenal glands are the major source of glucocorticoids, but recent studies indicate tissue-specific production of cortisol, including that in the oral mucosa. Both endogenous and exogenous glucocorticoids regulate the production of several proteins, including the glucocorticoid-induced leucine zipper (GILZ) and Annexin A1, which play important roles in the regulation of immune and inflammatory responses. Common inflammation-associated oral conditions include lichen planus and candidiasis, but the status of GILZ and Annexin A1 in these human conditions remains to be established. Accordingly, archived paraffin-embedded biopsy samples were subjected to immunohistochemistry to establish tissue localization and profile of GILZ and Annexin A1 coupled with the use of hematoxylin–eosin stain for histopathological assessment; for comparison, fibroma specimens served as controls. Histopathological examination confirmed the presence of spores and pseudohyphae for oral candidiasis (OC) specimens and marked inflammatory cell infiltrates for both OC and oral lichen planus (OLP) specimens compared to control specimens. All specimens displayed consistent and prominent nuclear staining for GILZ throughout the full thickness of the epithelium and, to varying extent, for inflammatory infiltrates and stromal cells. On the other hand, a heterogeneous pattern of nuclear, cytoplasmic, and cell membrane staining was observed for Annexin A1 for all specimens in the suprabasal layers of epithelium and, to varying extent, for inflammatory and stromal cells. Semi-quantitative analyses indicated generally similar fractional areas of staining for both GILZ and Annexin A1 among the groups, but normalized staining for GILZ, but not Annexin A1, was reduced for OC and OLP compared to the control specimens. Thus, while the cellular expression pattern of GILZ and Annexin A1 does not differentiate among these conditions, differential cellular profiles for GILZ vs. Annexin A1 are suggestive of their distinct physiological functions in the oral mucosa.
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Fu YN, Li Y, Deng B, Yu Y, Liu F, Wang L, Chen G, Tao L, Wei Y, Wang X. Spatiotemporally dynamic therapy with shape-adaptive drug-gel for the improvement of tissue regeneration with ordered structure. Bioact Mater 2022; 8:165-176. [PMID: 34541394 PMCID: PMC8424390 DOI: 10.1016/j.bioactmat.2021.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 12/30/2022] Open
Abstract
A spatiotemporally dynamic therapy (SDT) is proposed as a powerful therapeutic modality that provides spatially dynamic responses of drug-carriers for adapting to the wound microenvironment. Herein, dynamic chitosan-poly (ethylene glycol) (CP) Schiff-base linkages are employed to perform SDT by directly converting a liquid drug Kangfuxin (KFX) into a gel formation. The obtained KFX-CP drug-gel with shape-adaptive property is used to treat a representative oral mucositis (OM) model in a spatiotemporally dynamic manner. The KFX-CP drug-gel creates an instructive microenvironment to regulate signaling biomolecules and endogenous cells behavior, thereby promoting OM healing by the rule of dynamically adjusting shape to fit the irregular OM regions first, and then provides space for tissue regeneration, over KFX potion control and the general hydrogel group of CP hydrogel and KFX-F127. Most interestingly, the regenerated tissue has ordered structure like healthy tissue. Therefore, the SDT provides a new approach for the design of next generation of wound dressing and tissue engineering materials.
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Affiliation(s)
- Ya-nan Fu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Yongsan Li
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, 100029, China
- The Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Bo Deng
- Department of Oncology of Integrative Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Yingjie Yu
- Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen, 518035, China
| | - Fang Liu
- Department of Oncology of Integrative Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Lei Wang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Guang Chen
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Lei Tao
- The Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Yen Wei
- The Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Xing Wang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, 100029, China
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7
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Geng QS, Liu RJ, Shen ZB, Wei Q, Zheng YY, Jia LQ, Wang LH, Li LF, Li J, Xue WH. Transcriptome sequencing and metabolome analysis reveal the mechanism of Shuanghua Baihe Tablet in the treatment of oral mucositis. Chin J Nat Med 2021; 19:930-943. [PMID: 34961591 DOI: 10.1016/s1875-5364(22)60150-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Indexed: 12/22/2022]
Abstract
Oral mucositis (OM) caused by cancer therapy is the most common adverse reaction in the radiotherapy of head and neck tumors. In severe cases, it can lead to the interruption of treatment, which affects the control of the disease and the quality of life. Shuanghua Baihe Tablet (SBT) is a traditional Chinese medicine (TCM) formula, which is administerd to treat OM in China. It has been clinically effective for more than 30 years, but the underlying mechanism is not completely understood. With the development of multiple omics, it is possible to explore the mechanism of Chinese herbal compound prescriptions. Based on transcriptomics and metabolomics, we explored the underlying mechanism of SBT in the treatment of OM. An OM model of rats was established by 5-FU induction, and SBT was orally administered at dosages of 0.75 and 3 g·kg-1·d-1. In order to search for SBT targets and related metabolites, the dysregulated genes and metabolites were detected by transcriptomics and metabolomics. Immune related indicators such as interleukin-17 (IL-17) and tumor necrosis factor-α (TNF-α) were detected by ELISA. Treg cell disorders was analyzed by flow cytometry. Our results showed that SBT significantly alleviated the symptoms of OM rats and the inflammatory infiltration of ulcer tissues. After SBT administration, inflammatory related metabolic pathways including linoleic acid metabolism, valine, leucine and isoleucine biosynthesis were significantly altered. Furthermore, the production of proinflammatory factors like IL-17 and TNF-α, were also dramatically reduced after SBT administration. Besides, the infiltration degree of Treg cells in the spleen of OM modeling rats was significantly improved by SBT administration, thus maintaining the immune balance of the body. The current study demonstrates that SBT regulates inoleic acid metabolism, glycerophospholipid metabolism and amino acid metabolism, and inhibits IL-17/TNF signal transduction to restore Treg and Th17 cell homeostasis in OM rats, thereby alleviating chemotherapy-induced OM.
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Affiliation(s)
- Qi-Shun Geng
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Rui-Juan Liu
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Zhi-Bo Shen
- Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Qian Wei
- Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yuan-Yuan Zheng
- Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Lan-Qi Jia
- Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Long-Hao Wang
- Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Li-Feng Li
- Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Jun Li
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| | - Wen-Hua Xue
- Engineering Laboratory for Digital Telemedicine Service, The first Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
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Analgesic Mechanisms of Steroid Ointment against Oral Ulcerative Mucositis in a Rat Model. Int J Mol Sci 2021; 22:ijms222212600. [PMID: 34830488 PMCID: PMC8621744 DOI: 10.3390/ijms222212600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022] Open
Abstract
Despite the long history of use of steroid ointments for oral mucositis, the analgesic mechanism has not been fully elucidated. In this study, we examined the effects of triamcinolone acetonide (Tmc) on oral ulcerative mucositis-induced pain in conscious rats by our proprietary assay system. Based on evaluations of the physical properties and retention periods in the oral mucosa of human volunteers and rats, we selected TRAFUL® ointment as a long-lasting base. In oral ulcerative mucositis model rats, TRAFUL® with Tmc suppressed cyclooxygenase-dependent inflammatory responses with upregulations of glucocorticoid receptor-induced anti-inflammatory genes and inhibited spontaneous nociceptive behavior. When an ointment with a shorter residual period was used, the effects of Tmc were not elicited or were induced to a lesser extent. Importantly, TRAFUL® with Tmc also improved oral ulcerative mucositis-induced mechanical allodynia, which has been reported to be independent of cyclooxygenase. Ca2+ imaging in dissociated trigeminal ganglion neurons showed that long-term preincubation with Tmc inhibited the hypertonic stimulation-induced Ca2+ response. These results suggest that the representative steroid Tmc suppresses oral ulcerative mucositis-induced pain by general anti-inflammatory actions and inhibits mechanical sensitivity in peripheral nerves. For drug delivery, long-lasting ointments such as TRAFUL® are needed to sufficiently induce the therapeutic effects.
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9
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Anti-inflammatory effect of L-cysteine (a semi-essential amino acid) on 5-FU-induced oral mucositis in hamsters. Amino Acids 2021; 53:1415-1430. [PMID: 34410507 DOI: 10.1007/s00726-021-03062-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/05/2021] [Indexed: 01/01/2023]
Abstract
Oral mucositis is an inflammation of the oral mucosa mainly resulting from the cytotoxic effect of 5-fluorouracil (5-FU). The literature shows anti-inflammatory action of L-cysteine (L-cys) involving hydrogen sulfide (H2S). In view of these properties, we investigate the effect of L-cys in oral mucositis induced by 5-FU in hamsters. The animals were divided into the following groups: saline 0.9%, mechanical trauma, 5-FU 60-40 mg/kg, L-cys 10/40 mg and NaHS 27 µg/kg. 5-FU was administered on days 1st to 2nd; 4th day excoriations were made on the mucosa; 5th-6th received L-cys and NaHS. For data analysis, histological analyses, mast cell count, inflammatory and antioxidants markers, and immunohistochemistry (cyclooxygenase-2(COX-2)/inducible nitric oxide synthase (iNOs)/H2S) were performed. Results showed that L-cys decreased levels of inflammatory markers, mast cells, levels of COX-2, iNOS and increased levels of antioxidants markers and H2S when compared to the group 5-FU (p < 0.005). It is suggested that L-cys increases the H2S production with anti-inflammatory action in the 5-FU lesion.
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Agha-Hosseini F, Pourpasha M, Amanlou M, Moosavi MS. Mouthwash Containing Vitamin E, Triamcinolon, and Hyaluronic Acid Compared to Triamcinolone Mouthwash Alone in Patients With Radiotherapy-Induced Oral Mucositis: Randomized Clinical Trial. Front Oncol 2021; 11:614877. [PMID: 33777752 PMCID: PMC7991076 DOI: 10.3389/fonc.2021.614877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022] Open
Abstract
One of the most common side effects of radiotherapy in head and neck cancers is mucositis. Despite all the studies conducted on new therapies proposed for oral mucositis caused by radiation therapy, a single standard treatment strategy has not been developed yet. In the present study, for the first time, the effectiveness of the treatment with a combined mouthwash containing vitamin E (as an antioxidant), triamcinolone (as an anti-inflammatory agent) and hyaluronic acid (HA) (as a local reducer used for reducing the effects of ROS on the mucosa, with ameliorative effects (improving the healing process) compared to triamcinolone mouthwash alone was investigated in patients with radiotherapy-induced oral mucositis. This study was a randomized triple-blind clinical trial performed on 60 patients underwent radiotherapy on an outpatient basis. The combined mouthwash containing vitamin E, triamcinolone, and hyaluronic acid compared to triamcinolone mouthwash alone was prescribed for 4 weeks. The severity of oral mucositis was assessed based on the WHO classification and the intensity of pain was assessed using the numerical pain intensity scale. According to the analysis performed in the first, second, third and fourth weeks, the reduction of oral mucositis grade in the intervention group was significantly higher than in the comparison group. In the first, second, third, and fourth weeks, the reduction in pain intensity in the intervention group was significantly higher than in the comparison group (P < 0.001). The combined mouthwash containing vitamin E, hyaluronic acid and triamcinolone acetonide can be used as an effective treatment for oral mucositis caused by radiation therapy, which is probably the result of antioxidant, anti-inflammatory and improved healing process mechanisms due to the biological nature of the components of this mouthwash.
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Affiliation(s)
- Farzaneh Agha-Hosseini
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,The Academy of Medical Sciences Tehran, Tehran, Iran
| | - Mona Pourpasha
- Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Massoud Amanlou
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh-Sadat Moosavi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Ribeiro SB, de Araújo AA, Oliveira MMB, dos Santos Silva AM, da Silva-Júnior AA, Guerra GCB, Brito GADC, Leitão RFDC, de Araújo Júnior RF, Garcia VB, Vasconcelos RC, de Medeiros CACX. Effect of Dexamethasone-Loaded PLGA Nanoparticles on Oral Mucositis Induced by 5-Fluorouracil. Pharmaceutics 2021; 13:pharmaceutics13010053. [PMID: 33406583 PMCID: PMC7823510 DOI: 10.3390/pharmaceutics13010053] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 01/06/2023] Open
Abstract
Oral mucositis (OM) is characterized by the presence of severe ulcers in the oral region that affects patients treated with chemotherapy. It occurs in almost all patients who receive radiotherapy of the head and neck, as well as patients who undergo hematopoietic cell transplantation. The pathophysiology of OM is complex, and there is no effective therapy. The aim of this study was to evaluate the effect of dexamethasone-loaded poly(d,l-Lactic-co-glycolic) nanoparticles (PLGA-DEX NPs) on an OM model induced in hamsters. The NPs were synthesized using the emulsification-solvent evaporation method and were characterized by the size, zeta potential, encapsulation efficiency, atomic force microscopy, physicochemical stability, and the in vitro release. The OM was induced by the administration of 5-FU on the first and second days and mechanical trauma on the 4th day of the experiment. PLGA-DEX NPs were administered to treat OM. The animals were euthanized on the 10th day. Macroscopic and histopathological analyses were performed, measurement of malonaldehyde (MDA) and ELISA was used to determine the levels of IL-1β and TNF-α. Immunoexpressions of NF-κB, COX-2, and TGF-β were determined by immunohistochemistry, and qRT-PCR was used to quantify the gene expression of the GILZ, MKP1, and NF-κB p65. The PLGA-DEX NPs (0.1 mg/kg) significantly reduced macroscopic and histopathological scores, decreased MDA, TNF-α and IL-1β levels, immunostaining for NF-κB, COX-2, TGF-β, and suppressed NF-κB p65 mRNA expression, but increased GILZ and MKP1 expression.
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Affiliation(s)
- Susana Barbosa Ribeiro
- Post Graduate Program Biotechnology-RENORBIO, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal RN 59078-970, Brazil; (S.B.R.); (M.M.B.O.)
| | - Aurigena Antunes de Araújo
- Post Graduate Program Dental Sciences, Post Graduate Program Pharmaceutical Science, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal RN 59078-970, Brazil;
| | - Maisie Mitchele Barbosa Oliveira
- Post Graduate Program Biotechnology-RENORBIO, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal RN 59078-970, Brazil; (S.B.R.); (M.M.B.O.)
| | - Alaine Maria dos Santos Silva
- Laboratory of Pharmaceutical Technology & Biotechnology (TecBioFar), Post Graduate Program Pharmaceutical Sciences, Pharmacy Department, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Faria St, Petrópolis, Natal RN 59012-570, Brazil; (A.M.d.S.S.); (A.A.d.S.-J.)
| | - Arnóbio Antônio da Silva-Júnior
- Laboratory of Pharmaceutical Technology & Biotechnology (TecBioFar), Post Graduate Program Pharmaceutical Sciences, Pharmacy Department, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Faria St, Petrópolis, Natal RN 59012-570, Brazil; (A.M.d.S.S.); (A.A.d.S.-J.)
| | - Gerlane Coelho Bernardo Guerra
- Post Graduate Program Biochemistry and Molecular Biology, Post Graduate Program Pharmaceutical Science, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal RN 59078-970, Brazil;
| | - Gerly Anne de Castro Brito
- Post Graduate Program Morphofunctional Sciences, Department of Morphology, Faculty of Medicine, Federal University of Ceará, Delmiro de Farias St, Rodolfo Teófilo, Fortaleza CE 60416-030, Brazil; (G.A.d.C.B.); (R.F.d.C.L.)
| | - Renata Ferreira de Carvalho Leitão
- Post Graduate Program Morphofunctional Sciences, Department of Morphology, Faculty of Medicine, Federal University of Ceará, Delmiro de Farias St, Rodolfo Teófilo, Fortaleza CE 60416-030, Brazil; (G.A.d.C.B.); (R.F.d.C.L.)
| | - Raimundo Fernandes de Araújo Júnior
- Post Graduate Program Functional and Structural Biology, Post Graduate Program Health Science, Department of Morphology, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal RN 59078-970, Brazil;
| | - Vinícius Barreto Garcia
- Post Graduate Program Health Science, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Faria St, Petrópolis, Natal RN 59012-570, Brazil;
| | | | - Caroline Addison Carvalho Xavier de Medeiros
- Post Graduate Program Biotechnology-RENORBIO, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal RN 59078-970, Brazil; (S.B.R.); (M.M.B.O.)
- Post Graduate Program Biochemistry and Molecular Biology, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal RN 59078-970, Brazil
- Correspondence: ; Tel.: +55-84-3342-2256
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12
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Palmier NR, Leme AFP, De Rossi T, Telles GP, Morais-Faria K, Kowalski LP, Marta GN, Brandão TB, Arany PR, Migliorati CA, Santos-Silva AR, Prado-Ribeiro AC. Salivary alpha-1-antitrypsin and macrophage migration inhibitory factor may be potential prognostic biomarkers for oncologic treatment-induced severe oral mucositis. Support Care Cancer 2020; 29:2939-2946. [PMID: 33009579 DOI: 10.1007/s00520-020-05805-2] [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: 06/27/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
AIMS Evaluate the abundance of the selected targets, alpha-1-antitrypsin (A1AT) and macrophage migration inhibitory factor (MIF), and correlate these findings with the risk of developing severe oral mucositis (OM). MATERIALS AND METHODS Head and neck squamous cell carcinoma (HNSCC) patients submitted to radiotherapy (RT) or chemoradiotherapy (CRT) were assessed. OM grade and pain were evaluated daily during treatment. Two protein targets, A1AT and MIF, were evaluated, using selected reaction monitoring-mass spectrometry (SRM-MS), in whole saliva, collected prior to oncologic treatment. The results obtained from the targeted proteomic analysis were correlated with OM clinical outcomes. RESULTS A total of 27 patients were included, of whom 21 (77.8%) had locally advanced disease (clinical stage III or IV). Most patients (70.4%) received CRT. OM grades 2 (40.8%) and 3 (33.3%) were the most prevalent during RT with a mean highest reported OM-related pain of 3.22 through the visual analogue scale (VAS). The abundance of A1AT and MIF correlated significantly with severe (grades 3 or 4, p < 0.02) compared with moderate-low (grades 1 or 2, p < 0.04) OM grade. CONCLUSIONS There is a correlation between the abundance of salivary A1AT and MIF and oncologic treatment-induced OM. The correlation of MIF expression with severe OM appears to be compatible with its physiological pro-inflammatory role. These results open up great possibilities for the use of salivary MIF and A1AT levels as prognostic markers for effective therapeutic interventions, such as photobiomodulation therapy, patient-controlled analgesia, or personalized medicaments.
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Affiliation(s)
| | | | - Tatiane De Rossi
- Brazilian Biosciences National Laboratory, LNBio, CNPEM, Campinas, Brazil
| | | | - Karina Morais-Faria
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Central Institute, Hospital das Clínicas of the University of São Paulo Medical School (FMUSP), São Paulo, Brazil
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil.,Department of Radiology and Oncology, Division of Radiation Oncology, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, Sao Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil.,Oral Medicine Department, Hospital Sírio-Libanês, Sao Paulo, Brazil
| | - Praveen R Arany
- Oral Biology and Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
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13
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Vilar CJF, Ribeiro SB, de Araújo AA, Guerra GCB, de Araújo Júnior RF, Brito GADC, Leitão RFC, Pontes DDL, Gasparotto LHDS, Oliveira MMB, Viana AD, de Medeiros WMTQ, Bezerra BGP, de Medeiros CACX. Effect of Gold Nanoparticle on 5-Fluorouracil-Induced Experimental Oral Mucositis in Hamsters. Pharmaceutics 2020; 12:pharmaceutics12040304. [PMID: 32230975 PMCID: PMC7238277 DOI: 10.3390/pharmaceutics12040304] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/05/2019] [Accepted: 12/12/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Oral mucositis (OM) is a severe inflammation of the oral mucosal cells associated with chemotherapy and/or radiotherapy-induced toxicity, resulting in epithelial ulcers and higher risk of death from sepsis. The aim of the present study was to evaluate the nanoparticle (AuNp) effect on OM induced in hamsters. MATERIALS AND METHODS 5-fluorouracil (5FU) was used on the first and second day of the experimental model in Golden sirian hamsters, and on the fourth day, mechanical trauma was applied to induce OM. The animals were divided into groups, i.e., polyvinylpyrrolidone (PVP), mechanical trauma (MT), 5FU, and groups treated with gold nanoparticles (AuNps) (62.5, 125, and 250 μg/kg). On the 10th day, animals were euthanized for macroscopic, histopathological, immunohistochemical, western blot, quantitative polymerase chain reaction (qRT-PCR), and AuNp quantification. RESULTS AuNp (250 μg/kg) reduced TNF-α, IL-1β, COX-2, NF-κB, TGF-β, and SMAD 2/3; increased glutathione levels; decreased the expression of Kelch ECH-associated protein 1 (KEAP1); and induced heme oxygenase 1 (HMOX-1) and NAD (P) H quinone oxidoreductase 1 (NQO1) genes. CONCLUSIONS AuNp (250 μg/kg) prevented 5-FU-induced OM in hamsters and improved the parameters of inflammation and oxidative stress.
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Affiliation(s)
- Carmem Jane Ferreira Vilar
- Post Graduation Program in Biological Sciences, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil;
| | - Susana Barbosa Ribeiro
- Post Graduation Program in Biotechnology-RENORBIO, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (S.B.R.); (M.M.B.O.)
| | - Aurigena Antunes de Araújo
- Post Graduation Program in Dental Sciences/Post Graduation Program in Pharmaceutical Science/Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil;
| | - Gerlane Coelho Bernardo Guerra
- Post Graduation Program in Biological Sciences/Post Graduation Program in Pharmaceutical Science/Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil;
| | - Raimundo Fernandes de Araújo Júnior
- Post Graduation Program in Functional and Structural Biology/Post Graduation Program Health Science/Department of Morphology, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil;
| | - Gerly Anne de Castro Brito
- Post Graduation Program in Morphofunctional Sciences/Department of Morphology, Faculty of Medicine, Federal University of Ceará, Rua Delmiro de Farias s/n, Rodolfo Teófilo, Fortaleza/CE 60416030, Brazil; (G.A.d.C.B.); (R.F.C.L.)
| | - Renata Ferreira Carvalho Leitão
- Post Graduation Program in Morphofunctional Sciences/Department of Morphology, Faculty of Medicine, Federal University of Ceará, Rua Delmiro de Farias s/n, Rodolfo Teófilo, Fortaleza/CE 60416030, Brazil; (G.A.d.C.B.); (R.F.C.L.)
| | - Daniel de Lima Pontes
- Post Graduation Program of Chemistry/Institute of Chemistry, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (D.d.L.P.); (L.H.D.S.G.); (A.D.V.); (W.M.T.Q.d.M.); (B.G.P.B.)
| | - Luiz Henrique Da Silva Gasparotto
- Post Graduation Program of Chemistry/Institute of Chemistry, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (D.d.L.P.); (L.H.D.S.G.); (A.D.V.); (W.M.T.Q.d.M.); (B.G.P.B.)
| | - Maisie Mitchele Barbosa Oliveira
- Post Graduation Program in Biotechnology-RENORBIO, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (S.B.R.); (M.M.B.O.)
| | - Anderson Dias Viana
- Post Graduation Program of Chemistry/Institute of Chemistry, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (D.d.L.P.); (L.H.D.S.G.); (A.D.V.); (W.M.T.Q.d.M.); (B.G.P.B.)
| | - Wendy Marina Toscano Queiroz de Medeiros
- Post Graduation Program of Chemistry/Institute of Chemistry, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (D.d.L.P.); (L.H.D.S.G.); (A.D.V.); (W.M.T.Q.d.M.); (B.G.P.B.)
| | - Breno Gustavo Porfírio Bezerra
- Post Graduation Program of Chemistry/Institute of Chemistry, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (D.d.L.P.); (L.H.D.S.G.); (A.D.V.); (W.M.T.Q.d.M.); (B.G.P.B.)
| | - Caroline Addison Carvalho Xavier de Medeiros
- Post Graduation Program in Biological Sciences, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil;
- Post Graduation Program in Biotechnology-RENORBIO, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 3000, Lagoa Nova, Natal/RN 59078970, Brazil; (S.B.R.); (M.M.B.O.)
- Correspondence: or ; Tel.: +55-84-33422256
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14
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Villa A, Sonis ST. An update on pharmacotherapies in active development for the management of cancer regimen-associated oral mucositis. Expert Opin Pharmacother 2020; 21:541-548. [DOI: 10.1080/14656566.2020.1718652] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Alessandro Villa
- Divisions of Oral Medicine and Dentistry, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Oral Medicine, Infection and Immunity. Harvard School of Dental Medicine, Boston, MA, USA
- Primary Endpoint Solutions, Watertown, MA, USA
| | - Stephen T. Sonis
- Divisions of Oral Medicine and Dentistry, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Oral Medicine, Infection and Immunity. Harvard School of Dental Medicine, Boston, MA, USA
- Primary Endpoint Solutions, Watertown, MA, USA
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15
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Jung H, Kim HS, Lee JH, Lee JJ, Park HS. Wound Healing Promoting Activity of Tonsil-Derived Stem Cells on 5-Fluorouracil-Induced Oral Mucositis Model. Tissue Eng Regen Med 2019; 17:105-119. [PMID: 32002842 DOI: 10.1007/s13770-019-00226-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/10/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We first determined the efficacy of lesional injection of tonsil-derived MSCs (mesenchymal stem cells) for the treatment of 5-fluorouracil induced oral mucositis. METHODS Oral mucositis was induced in hamsters by administration of 5-fluorouracil (day 0, 2, 4) followed by mechanical trauma (day 1, 2, 4). The experimental groups included MT (mechanical trauma only), 5-FU + MT (mechanical trauma with 5-fluorouracil administration), TMSC (mechanical trauma with 5-fluorouracil administration, tonsil-derived mesenchymal stem cells injection), DEXA (mechanical trauma with 5-fluorouracil administration, dexamethasone injection), and saline (mechanical trauma with 5-fluorouracil administration, saline injection). RESULTS On day 10, gross and histologic analyses showed that nearly complete healing and epithelialization of the cheek mucosa of the TMSC group, whereas the other groups showed definite ulcerative lesions. Compared with the MT and DEXA groups, CD31 expression was greater in the TMSC group on days 10 and 14. Tendency towards a decrease in MMP2 expression with the time in the TMSC group was observed. In addition, the TMSC group showed higher expression of TGF-β, and NOX4 on day 10 compared with the other groups. Scratch assay demonstrated that the conditioned media harvested from tonsil-derived MSCs significantly increased migratory efficacy of NIH3T3 cells. Transwell assay showed that the preferential migration of tonsil-derived MSCs to the wound area. CONCLUSION Intralesional administration of tonsil-derived MSCs may accelerate wound healing of 5-fluorouracil induced oral mucositis by upregulating neovascularization and effective wound contraction. In addition, tonsil-derived MSCs might contribute to oral ulcer regeneration via the stimulation of fibroblast proliferation and migration.
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Affiliation(s)
- Harry Jung
- Institute of New Frontier Research Team, Hallym University, Hallym Clinical and Translation Science Institute, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, Republic of Korea
| | - Han Su Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Seoul, 07985, Republic of Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chuncheon Sacred Heart Hospital, Hallym University, 77 Sakju-ro, Chuncheon, Gangwon-do, 24253, Republic of Korea
| | - Jae Jun Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, 77 Sakju-ro, Chuncheon, Gangwon-do, 24253, Republic of Korea
| | - Hae Sang Park
- Institute of New Frontier Research Team, Hallym University, Hallym Clinical and Translation Science Institute, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, Republic of Korea. .,Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chuncheon Sacred Heart Hospital, Hallym University, 77 Sakju-ro, Chuncheon, Gangwon-do, 24253, Republic of Korea.
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16
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Eğilmez OK, Kökten N, Kalcıoğlu MT, Ekici AID, Şerifler S, Yeşilada E. Investigation of the Protective Effect of Nigella Sativa Oil in Cisplatin Induced Oral Mucositis: An Experimental Study. Turk Arch Otorhinolaryngol 2019; 58:10-15. [PMID: 32313889 DOI: 10.5152/tao.2020.4733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this experimental study was to investigate the histopathologic effect of Nigella Sativa oil (NSO) on cisplatin (Cis) induced oral mucositis (OM) in rats. Methods Twenty-four rats were divided into four equal groups. The animals in Group 1 and Group 2 were given 5 mg/kg intraperitoneal (ip) Cis systemically on the 1st, 3rd and 5th days of the study. Additionally, 15 mL NSO were given to the rats in Group 2, with gavage feeding on days 1, 3, 5, 7, and 9. The animals in Group 3 were given per oral 15 ml NSO on days 1, 3, 5, 7 and 9. As the control group, Group 4 received a total of 15 mL 0.9% saline solution divided into 5 doses on days 1, 3, 5, 7 and 9 by oral gavage. On the 14th day, animals were euthanized and buccal mucosa from both sides, including submucosal tissues, were excised and taken to histopathological examination. Results The mean mucosal thicknesses of the groups were 224.58 μm, 276.1 μm, 323.33 μm, and 331.33 μm, respectively for Groups 1, 2, 3, and 4 (p<0.05). When the degree of mucosal inflammation was examined, the most intense inflammation was detected in Group 1 and the least intense inflammation was in Group 4 (p<0.01). The degree of inflammation in Group 2 and Group 3 were similar to Group 4 (p>0.05). Conclusion According to the results of this study, NSO, for which anti-inflammatory and antioxidant properties have been shown in previous studies, may also be effective in preventing Cis-induced OM.
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Affiliation(s)
- Oğuz Kadir Eğilmez
- Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Numan Kökten
- Department of Otorhinolaryngology, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Mahmut Tayyar Kalcıoğlu
- Department of Otorhinolaryngology, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | | | - Serkan Şerifler
- Department of Otorhinolaryngology, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Erdem Yeşilada
- Department of Pharmacognosy, Yeditepe University School of Pharmacy, İstanbul, Turkey
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17
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Barbosa SCM, Pereira VBM, Wong DVT, Santana APM, Lucetti LT, Carvalho LL, Barbosa CRN, Callado RB, Silva CAA, Lopes CDH, Brito GAC, Alencar NMN, Lima-Júnior RCP. Amifostine reduces inflammation and protects against 5-fluorouracil-induced oral mucositis and hyposalivation. ACTA ACUST UNITED AC 2019; 52:e8251. [PMID: 30810625 PMCID: PMC6393848 DOI: 10.1590/1414-431x20188251] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 11/23/2018] [Indexed: 01/30/2023]
Abstract
Oral mucositis (OM) is a common and dose-limiting side effect of cancer treatment, including 5-fluorouracil (5-FU) and radiotherapy. The efficacy of the therapeutic measures to prevent OM is limited and disease prevention is not fully observable. Amifostine is a cytoprotective agent with a described anti-inflammatory potential. It is clinically used to reduce radiotherapy and chemotherapy-associated xerostomia. This study investigated the protective effect of amifostine on an experimental model of OM. Hamsters were divided into six groups: saline control group (5 mL/kg), mechanical trauma (scratches) of the right cheek pouch; 5-FU (60 and 40 mg/kg, ip, respectively, administered on days 1 and 2); amifostine (12.5, 25, or 50 mg/kg) + 5-FU + scratches. Salivation rate was assessed and the animals were euthanized on day 10 for the analysis of macroscopic and microscopic injury by scores. Tissue samples were harvested for the measurement of neutrophil infiltration and detection of inflammatory markers by ELISA and immunohistochemistry. 5-FU induced pronounced hyposalivation, which was prevented by amifostine (P<0.05). In addition, 5-FU injection caused pronounced tissue injury accompanied by increased neutrophil accumulation, tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β) tissue levels, and positive immunostaining for TNF-α, IL-1β, and inducible nitric oxide synthase (iNOS). Interestingly, amifostine prevented the inflammatory reaction and consequently improved macroscopic and microscopic damage (P<0.05 vs 5-FU group). Amifostine reduced inflammation and protected against 5-FU-associated oral mucositis and hyposalivation.
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Affiliation(s)
- S C M Barbosa
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - V B M Pereira
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - D V T Wong
- Departamento de Patologia e Medicina Legal, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - A P M Santana
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - L T Lucetti
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - L L Carvalho
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - C R N Barbosa
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - R B Callado
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - C A A Silva
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - C D H Lopes
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - G A C Brito
- Departamento de Morfologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - N M N Alencar
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
| | - R C P Lima-Júnior
- Departamento de Fisiologia e Famacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil
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18
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Delavarian Z, Pakfetrat A, Ghazi A, Jaafari MR, Homaei Shandiz F, Dalirsani Z, Mohammadpour AH, Rahimi HR. Oral administration of nanomicelle curcumin in the prevention of radiotherapy-induced mucositis in head and neck cancers. SPECIAL CARE IN DENTISTRY 2019; 39:166-172. [DOI: 10.1111/scd.12358] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/01/2019] [Accepted: 01/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Zahra Delavarian
- Oral and Maxillofacial Diseases Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - Atessa Pakfetrat
- Oral and Maxillofacial Diseases Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - Ala Ghazi
- Oral and Maxillofacial Diseases Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - Mahmoud Reza Jaafari
- Nanotechnology Research Center; Pharmaceutical Technology Institute; Mashhad University of Medical Sciences; Mashhad Iran
| | | | - Zohreh Dalirsani
- Oral and Maxillofacial Diseases Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | | | - Hamid Reza Rahimi
- Department of New Science and Technologies; School of Medicine; Mashhad University of Medical Sciences; Mashhad Iran
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Tancharoen S, Shakya P, Narkpinit S, Dararat P, Kikuchi K. Anthocyanins Extracted from Oryza sativa L. Prevent Fluorouracil-Induced Nuclear Factor-κB Activation in Oral Mucositis: In Vitro and In Vivo Studies. Int J Mol Sci 2018; 19:ijms19102981. [PMID: 30274314 PMCID: PMC6213925 DOI: 10.3390/ijms19102981] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/23/2018] [Accepted: 09/27/2018] [Indexed: 02/07/2023] Open
Abstract
This study aims to investigate the immunomodulatory effect of anthocyanins (ANTs) from Oryza sativa L. extracts on 5-fluorouracil (5-FU)-induced oral mucositis, using a rat model and oral keratinocytes. ANTs were detected by high-performance liquid chromatography (HPLC)-electrospray ionization mass spectrometry. Animals were randomly given varying doses of ANT-rich extract treatment (500 mg/kg and 1000 mg/kg) in the absence or presence of 5-FU-induced mucositis. Buccal mucosae were photographed and scored for macroscopic analysis and incisional biopsies of cheek pouches were collected for microscopic examination of oral mucositis. 5-FU caused marked hemorrhage, extensive ulcerations and abscesses compared to non-treated animals with slight erythema. Histologically, a loss of collagen bundles and inflammatory cell infiltrates was observed. After 29 days of ANT treatment, lesions resolved, and abundant collagen fibers were evident in the lamina propria. Buccal mucosa of 5-FU-injected rats showed increased Nuclear factor-kappa B (NF-κB) p50 and p65 in oral keratinocytes. The administration of ANT reduced NF-κB-positive cells in 5-FU rats (p < 0.001) compared to the non-treatment group. In oral keratinocytes, ANT treatment significantly restored 5-FU-induced growth inhibition and impaired the nuclear accumulation of NF-κB p50 and p65. Our study demonstrated that ANT from Oryza sativa L. exhibited effective anti-inflammatory properties against 5-FU-induced oral mucositis by inhibiting NF-κB activation.
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Affiliation(s)
- Salunya Tancharoen
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
| | - Prana Shakya
- Maxillofacial Prosthetic Service, Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
| | - Somphong Narkpinit
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand.
| | - Pornpen Dararat
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
| | - Kiyoshi Kikuchi
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
- Division of Brain Science, Department of Physiology, Kurume University School of Medicine, Kurume 8300011, Japan.
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Barbosa MM, de Araújo AA, de Araújo Júnior RF, Guerra GCB, de Castro Brito GA, Leitão RC, Ribeiro SB, de Aragão Tavares E, Vasconcelos RC, Garcia VB, de Medeiros CACX. Telmisartan Modulates the Oral Mucositis Induced by 5-Fluorouracil in Hamsters. Front Physiol 2018; 9:1204. [PMID: 30210365 PMCID: PMC6123383 DOI: 10.3389/fphys.2018.01204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 08/10/2018] [Indexed: 01/20/2023] Open
Abstract
Oral mucositis (OM) is a common adverse effect resulting from cancer therapy. The OM it has implications that may compromise oncologic treatment and decrease the patient's quality of life. The therapeutic options to prevent or treat the symptoms of OM are scarce; there is no effective therapy that improves the symptoms. Based on the need for further research for the treatment of OM, the present study objective was to evaluate the effect of telmisartan (TELM) on the OM induced by 5-fluorouracil (5-FU), using as animal model Golden Syrian hamsters. 5-FU followed by mechanical trauma on day 4 was used to induce OM in hamsters. Euthanasia occurred on the day 10. The experiments were constituted by the groups saline, mechanical trauma, 5-FU, and TELM in three doses (1, 5, or 10 mg/kg). Macroscopic, histopathological, and immunohistochemical analyses as well as immunofluorescence experiments were performed on the oral mucosa of the animals. The samples also were used for analysis enzyme-linked immunosorbent assays and quantitative real-time polymerase chain reactions (qPCR). TELM (5 or 10 mg/kg) was able to reduce the inflammatory ulceration and infiltration in the oral mucosa of the animals, decreasing the levels of the cytokines TNF-α and IL-1β. These treatments was minimize the immunostaining for cyclooxygenase-2, matrix metalloproteinase-9, transforming growth factor-β, and smad 2/3. The nuclear transcription factor kappa B (NFκB) p65 and inducible nitric oxide synthase were reduced in the oral mucosa. Finally, TELM (10 mg/kg) increased the PPARγ gene expression and reduced STAT1 and NFκB p65 gene expression relative to the 5-FU group. Therefore, TELM prevents the OM produced by 5-FU on animal model.
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Affiliation(s)
- Maisie M Barbosa
- Post Graduation Program in Biological Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Aurigena A de Araújo
- Post Graduation Program Public Health/Post Graduation Program in Pharmaceutical Science, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Raimundo F de Araújo Júnior
- Post Graduation Program in Functional and Structural Biology/Post Graduation Program Health Science, Department of Morphology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Gerlane C B Guerra
- Post Graduation Program in Biological Sciences/Post Graduation Program in Pharmaceutical Science, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Gerly A de Castro Brito
- Post Graduation Program of Morphological Science, Department of Morphology, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Renata C Leitão
- Post Graduation Program of Morphological Science, Department of Morphology, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Susana B Ribeiro
- Post Graduation Program in Biotechnology RENORBIO, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Roseane C Vasconcelos
- Post Graduation Program Public Health, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Vinícius B Garcia
- Post Graduation in Program of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Caroline A C X de Medeiros
- Post Graduation Program in Biological Sciences/Post Graduation Program in Biotechnology RENORBIO, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
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Sonis ST, Villa A. Phase II investigational oral drugs for the treatment of radio/chemotherapy induced oral mucositis. Expert Opin Investig Drugs 2018; 27:147-154. [PMID: 29323575 DOI: 10.1080/13543784.2018.1427732] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Oral mucositis is a significant unmet clinical need for many cancer patients. The biological complexity of mucositis' pathogenesis provides a number of mechanistic targets suitable as pharmacologic targets. The diversity of targets has stimulated drug development in search of an effective intervention. In this paper, we review a range of agents that are currently being evaluated. AREAS COVERED Drugs for management of oral mucositis vary in formulation, route of administration and biological target. Most propose to interrupt the initiation of injury by suppressing activation of the innate immune response or countering oxidative stress, or minimizing downstream inflammatory responses. Overwhelmingly, the population most studied is patients being treated with concomitant chemoradiation for cancers of the head and neck as this is the cohort that most consistently suffers severe mucositis for long periods of time. The Phase 2 pipeline is robust. Preliminary data reported for a number of agents is optimistic. Genomics may be important in interpreting and comparing responses to agents across widely demographically diverse populations. EXPERT OPINION Oral mucositis remains a significant toxicity for patients undergoing cancer treatment. Incremental reports of successes have been noted for a number of targeted agents.
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Affiliation(s)
- Stephen T Sonis
- a Divisions of Oral Medicine and Dentistry , Brigham and Women's Hospital and the Dana-Farber Cancer Institute , Boston , MA , USA.,b Primary Endpoint Solutions , Watertown , MA , USA
| | - Alessandro Villa
- a Divisions of Oral Medicine and Dentistry , Brigham and Women's Hospital and the Dana-Farber Cancer Institute , Boston , MA , USA.,b Primary Endpoint Solutions , Watertown , MA , USA
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