Anti-Inflammatory Treatment

Fistarol, Susanna K.; Itin, Peter

doi:10.1159/000321051

Cited by 15 publications

(12 citation statements)

References 45 publications

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“…Dampening excessive inflammation creates a microenvironment for oral mucositis healing 13–16 . The antagonistic effect of Smad7 on both TGF-β and NF-κB signaling 18 could make Smad7 a more efficient anti-inflammatory molecule than other agents targeting only NF-κB.…”

Section: Discussionmentioning

confidence: 99%

“…Two Palifermin clinical trials in head and neck cancer patients showed that Palifermin reduced severe oral mucositis incidence from 67% and 69% to 51% and 54%, respectively 5,6 . Other oral mucositis drugs in clinical trials or pre-clinical studies include growth factors 7–9 , agents for radioprotection 10–12 , anti-inflammatory agents or immune modulators 13–16 .…”

mentioning

confidence: 99%

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Preventive and therapeutic effects of Smad7 on radiation-induced oral mucositis

Han

Bian

et al. 2013

Nat Med

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We report that K5.Smad7 mice, which express Smad7 transgene by a keratin-5 promoter, were resistant to radiation-induced oral mucositis, a painful oral ulceration. In addition to NF-κB activation known to contribute to oral mucositis, we found activated TGF-β signaling in oral mucositis. Smad7 dampened both pathways to attenuate inflammation, growth inhibition and apoptosis. Additionally, Smad7 promoted oral epithelial migration to close the wound. Further analyses revealed that TGF-β signaling Smads and their co-repressor CtBP1 transcriptionally repressed Rac1, and Smad7 abrogated this repression. Knocking down Rac1 in mouse keratinocytes abrogated Smad7-induced migration. Topically applying Smad7 protein with a cell permeable Tat-tag (Tat-Smad7) to oral mucosa showed preventive and therapeutic effects on radiation-induced oral mucositis in mice. Thus, we have identified novel molecular mechanisms involved in oral mucositis pathogenesis and our data suggest an alternative therapeutic strategy to block multiple pathological processes of oral mucositis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Preventive and therapeutic effects of Smad7 on radiation-induced oral mucositis

Han

Bian

et al. 2013

Nat Med

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“…The role of TCIs in the treatment of inflammatory mucosal disorders [98], and in particular of LS, has been recently reviewed [99]. The use of TCIs in LS is off label.…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis and Treatment of Lichen Sclerosus

2012

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Lichen sclerosus (LS) is a chronic, inflammatory, mucocutaneous disorder of genital and extragenital skin. LS is a debilitating disease, causing itch, pain, dysuria and restriction of micturition, dyspareunia, and significant sexual dysfunction in women and men. Many findings obtained in recent years point more and more towards an autoimmune-induced disease in genetically predisposed patients and further away from an important impact of hormonal factors. Preceding infections may play a provocative part. The role for Borrelia is still controversial. Trauma and an occlusive moist environment may act as precipitating factors. Potent and ultrapotent topical corticosteroids still head the therapeutic armamentarium. Topical calcineurin inhibitors are discussed as alternatives in the treatment of LS in patients who have failed therapy with ultrapotent corticosteroids, or who have a contraindication for the use of corticosteroids. Topical and systemic retinoids may be useful in selected cases. Phototherapy for extragenital LS and photodynamic therapy for genital LS may be therapeutic options in rare cases refractory to the already mentioned treatment. Surgery is restricted to scarring processes leading to functional impairment. In men, circumcision is effective in the majority of cases, but recurrences are well described. Anogenital LS is associated with an increased risk for squamous cell carcinoma of the vulva or penis. This review updates the epidemiology, clinical presentation, histopathology, pathogenesis, and management of LS of the female and male genitals and extragenital LS in adults and children.

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“…The topical calcineurin inhibitors pimecrolimus and tacrolimus have a significant anti-inflammatory activity, immunomodulatory effects and a low systemic immunosuppressive potential; however, they are off-label and considered dangerous to develop tumours [21,22]. Treatment of LS with topical testosterone was dropped out due to its very limited efficacy and to the noticeable superiority, in terms of clinical results, of corticosteroids [23,24].…”

Section: Introductionmentioning

confidence: 99%

Genital Lichen Sclerosus in Male Patients: A New Treatment with Polydeoxyribonucleotide

Zucchi¹,

Cai²,

Cavallini³

et al. 2016

Urol Int

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Lichen sclerosus (LS) is an inflammatory and chronic disease that causes itching, pain, dysuria, urinary retention, dyspareunia and sexual dysfunction, in both men and women. The first line pharmacological treatment is based on the use of topical steroids, which have proved their efficacy in 60-70% of cases but with a high rate of relapses in time (50-80% of the patients of both sexes). The purpose of our non-randomised prospective pilot study was to evaluate the efficacy and tolerability of a new loco regional therapy with polydeoxyribonucleotides (PDRN) in the treatment of male genital LS. PDRN is an healing and anti-dystrophic drug with anti-inflammatory effects, through the reduction of cytokine. Twenty one male patients suffering from genital LS were recruited. All the patients were submitted to treatment using loco-regional intradermal injections with PDRN. Dermatology Life Quality Index (DLQI), International Index of Erectile Function (IIEF-5) and PGI-I questionnaires were administered at baseline and at the end of treatment in order to evaluate the results of this treatment. The statistical evaluation of the data obtained with the DLQI questionnaire showed a marked improvement of the overall conditions in terms of quality of life, with an average change of scores from 15 to 4 (p < 0.0001). PGI-I questionnaire showed that 80% of the patients treated considered their post-treatment conditions as ‘improved'. There was no significant change in terms of sexual function according to the IIEF questionnaire (p = 0.189). The results obtained show the excellent tolerability and the therapeutic efficacy of PDRN, with clear improvement of the local symptoms and of the quality of life.

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Anti-Inflammatory Treatment

Cited by 15 publications

References 45 publications

Preventive and therapeutic effects of Smad7 on radiation-induced oral mucositis

Preventive and therapeutic effects of Smad7 on radiation-induced oral mucositis

Diagnosis and Treatment of Lichen Sclerosus

Genital Lichen Sclerosus in Male Patients: A New Treatment with Polydeoxyribonucleotide

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