Oral Mucositis: An Update on Innate Immunity and New Interventional Targets

Chen, Chider; Zhang, Q.; Yu, Wei; Chang, Bao‐Li; Le, Anh D.

doi:10.1177/0022034520925421

Cited by 32 publications

(30 citation statements)

References 82 publications

(126 reference statements)

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“…OM is one of the most incapacitating side effects of RT, CT, or CRT for HNC and thus one of the most extensively studied ( 5 , 49 – 51 ). The World Health Organization’s OM Toxicity Scale ranges from grade 1 to 4: (1) soreness with or without erythema, (2) ulcers with erythema without dysphagia to solid foods, (3) ulcers with extensive erythema and dysphagia to solid foods, and (4) mucositis with complete dysphagia ( 5 ).…”

Section: Radiation Therapy and Changes In The Head And Neck Microbiomementioning

confidence: 99%

The Effect of Radiation and Chemoradiation Therapy on the Head and Neck Mucosal Microbiome: A Review

et al. 2021

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Radiation (RT) and chemoradiation therapy (CRT) play an essential role in head and neck cancer treatment. However, both cause numerous side effects in the oral cavity, paranasal sinuses, and pharynx, having deleterious consequences on patients’ quality of life. Concomitant with significant advances in radiation oncology, much attention has turned to understanding the role of the microbiome in the pathogenesis of treatment-induced tissue toxicity, to ultimately explore microbiome manipulation as a therapeutic intervention. This review sought to discuss current publications investigating the impact of RT and CRT-induced changes on the head and neck microbiome, using culture-independent molecular methods, and propose opportunities for future directions. Based on 13 studies derived from a MEDLINE, EMBASE, and Web of Science search on November 7, 2021, use of molecular methods has uncovered various phyla and genera in the head and neck microbiome, particularly the oral microbiome, not previously known using culture-based methods. However, limited research has investigated the impact of RT/CRT on subsites other than the oral cavity and none of the studies aimed to examine the relationship between the head and neck microbiome and treatment effectiveness. Findings from this review provide helpful insights on our current understanding of treatment-induced oral mucositis, dental plaque, and caries formation and highlight the need for future research to examine the effect of RT/CRT on the sinonasal and oropharyngeal microbiome. In addition, future research should use larger cohorts, examine the impact of the microbiome on treatment response, and study the effect of manipulating the microbiome to overcome therapy resistance.

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Section: Radiation Therapy and Changes In The Head And Neck Microbiomementioning

confidence: 99%

The Effect of Radiation and Chemoradiation Therapy on the Head and Neck Mucosal Microbiome: A Review

et al. 2021

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“…The findings of our study showed that oral changes caused by oral mucositis were present at 1st CT week. This fact could be explaining because the complex pathophysiological processes of chemoradiotherapy induced OM starts immediately after the administration of the cytotoxic agents ( 10 , 11 ). The early recognition of clinical signs of oral mucositis and, especially, the anatomical sites commonly affected by chemoradiotherapy-induced OM is essential to prevent worsening of the condition.…”

Section: Discussionmentioning

confidence: 99%

“…The early recognition of clinical signs of oral mucositis and, especially, the anatomical sites commonly affected by chemoradiotherapy-induced OM is essential to prevent worsening of the condition. This approach contributes, for example, to do not be necessary reduction and even cessation of cancer treatment ( 11 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients

Guimarães¹,

Carvalho²,

Damascena³

et al. 2021

Med Oral

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Background Childhood cancer is one of the main causes of child mortality and its treatment has debilitating effects on the oral cavity. Several oral mucositis (SOM) is one of the most common and may cause undesirable symptoms such as pain and risk of systemic infection. Material and Methods This was a longitudinal, retrospective, and observational study determining the incidence of severe oral mucositis (SOM) and its occurrence sites in pediatric oncologic patients, in João Pessoa, Brazil, between 2013 and 2018. Data from 56 patients aged 1 to 18 years were collected from their medical records and through an oral mucosa examination, from the 1st to 5th week of chemotherapy treatment (CT) using the modified Oral Assessment Guide, by previously calibrated examiners (Kappa index > 0.7). The data were analyzed by the Chi-square test, and Odds Ratios were calculated. Results Most patients were females (54.5%), aged 8.8 years (± 4.8), with hematologic tumors (73.2%), predominantly Acute Lymphoid Leukemia (50.0%). An increase in the occurrence of SOM was observed throughout the CT ( P = 0.05), ranging from 12.5% in the 1st to 35.7% in the 5th CT week. In the 1st CT week, there was a predominance of alterations in the lips (5.5%) and saliva (5.5%), while in the 5th, the jugal / palate mucosa (21.4%) remained the most affected site by SOM. Differences in the severity of SOM in the jugal / palate mucosa ( P = 0.01) and labial mucosa ( P = 0.04) were observed over time. In the 5th CT week, the likelihood of developing SOM was 13.3-fold higher (95% CI: 1.5 - 105.6) in patients with hematologic tumors. Conclusions The incidence of SOM was higher in the 5th CT week, most commonly affecting the jugal / palate mucosa, and patients with hematologic tumors were more prone to develop SOM. Key words: Mucositis, oncology, pediatric dentistry.

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“…In fact, in a follow-up Chernobyl study, 4 of 15 survivors reported experiencing xerostomia ( Gottlöber et al, 2001 ). Salivary damage and subsequent dry mouth can lead to a variety of problems, from difficulty chewing and talking to increased dental caries, oral mucositis, osteonecrosis, and so on ( Dirix et al, 2006 ; Gomez et al, 2011 ; Tolentino et al, 2011 ; Sroussi et al, 2017 ; Chen et al, 2020 ). While studies of the oral microbiome following a nuclear accident are limited, there are many research studies that examine the changes in the oral microbiota following head and neck radiation exposure in oncology ( Anjali et al, 2020 ).…”

Section: The Effects Of Radiation On the Microbiomementioning

confidence: 99%

Acute Radiation Syndrome and the Microbiome: Impact and Review

et al. 2021

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Study of the human microbiota has been a centuries-long endeavor, but since the inception of the National Institutes of Health (NIH) Human Microbiome Project in 2007, research has greatly expanded, including the space involving radiation injury. As acute radiation syndrome (ARS) is multisystemic, the microbiome niches across all areas of the body may be affected. This review highlights advances in radiation research examining the effect of irradiation on the microbiome and its potential use as a target for medical countermeasures or biodosimetry approaches, or as a medical countermeasure itself. The authors also address animal model considerations for designing studies, and the potential to use the microbiome as a biomarker to assess radiation exposure and predict outcome. Recent research has shown that the microbiome holds enormous potential for mitigation of radiation injury, in the context of both radiotherapy and radiological/nuclear public health emergencies. Gaps still exist, but the field is moving forward with much promise.

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Oral Mucositis: An Update on Innate Immunity and New Interventional Targets

Cited by 32 publications

References 82 publications

The Effect of Radiation and Chemoradiation Therapy on the Head and Neck Mucosal Microbiome: A Review

The Effect of Radiation and Chemoradiation Therapy on the Head and Neck Mucosal Microbiome: A Review

The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients

Acute Radiation Syndrome and the Microbiome: Impact and Review

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