Quantitative Analysis of Acute Phase Proteins in Post Chemo-Radiation Mucositis

Chethana,; Rao, Pratima; Madathil, Lal P; Rao, Suresh; Shetty, Pushparaja; Patidar, Madhvika

doi:10.7860/jcdr/2015/13732.6591

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Surgery caused a 4-fold increase in CRP levels, while at T3 the levels of CRP showed a trend of returning to the pre-treatment values, although still at more than double the normal values. This is in accordance with the study by Mohammed et al and Cheethana et al, who used ESR and CRP as biomarkers of radiation induced mucositis [ 23 , 24 ]. After 1 year the CRP levels were practically identical to the preoperative values, but still above normal, which could indicate an ever-present subtle inflammation in the radiation-damaged mucosa.…”

Section: Discussionsupporting

confidence: 92%

Effect of surgery and radiotherapy on complete blood count, lymphocyte subsets and inflammatory response in patients with advanced oral cancer

et al. 2018

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BackgroundThe immune system has a known role in the aetiology, progression and final treatment outcome of oral squamous cell cancers. The aim of this study was to evaluate the influence of radical surgery and radiotherapy on advanced oral squamous cell carcinoma blood counts, lymphocyte subsets and levels of acute inflammatory response markers.MethodsBlood samples were obtained from 56 patients 5 days before and 10 days after surgery, 30 days and 1 year after radiotherapy. The whole blood count, lymphocyte subsets and inflammatory response markers (C-reactive protein, erythrocyte sedimentation rate, leukocyte count, expression of index CD64 and index CD163 on neutrophils and monocytes) were measured, statistically analysed and correlated with clinical treatment outcomes.ResultsThe post-operative period was characterised by the onset of anaemia, thrombocytosis, lymphopenia with reduced B lymphocyte, T helper cell and NK cell counts, and a rise in acute phase reactants. Immediately after radiotherapy, the anaemia improved, the lymphopenia worsened, and thrombocyte levels returned to pre-treatment values. There was a drop in counts across the T and B cell lines, including a reduction in B lymphocytes, naïve and memory T cells with reduced CD4+ and CD8+ counts and a decreased CD4/CD8 ratio. One year after radiotherapy all the lymphocyte subsets remained depressed, the only exception being NK cells, whose levels returned to pre-treatment values.ConclusionsWe concluded that surgery resulted in a stronger acute phase response than radiotherapy, while radiotherapy caused a long-lasting reduction in lymphocyte counts. There was no correlation between any of the pre-treatment parameters and the clinical outcome.

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Section: Discussionsupporting

confidence: 92%

Effect of surgery and radiotherapy on complete blood count, lymphocyte subsets and inflammatory response in patients with advanced oral cancer

et al. 2018

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“…The C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) are two important markers which assessment is routinely done to diagnose the presence of an inflammation process through blood test. Their levels have been found high in the blood of patients at the end of RT [ 132 – 135 ]. Notably, Ki et al, have found a correlation between the increase in CRP, but not ESR, levels and mucositis progression [ 132 ], while Chethana et al, have found a correlation between OM and CRP levels only in the first weeks of treatment [ 135 ] (Table 2 ).…”

Section: Introductionmentioning

confidence: 99%

Oral mucositis: the hidden side of cancer therapy

Pulito¹,

Cristaudo

Porta

et al. 2020

J Exp Clin Cancer Res

241

135

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Inflammation response of epithelial mucosa to chemo- radiotherapy cytotoxic effects leads to mucositis, a painful side effect of antineoplastic treatments. About 40% of the patients treated with chemotherapy develop mucositis; this percentage rises to about 90% for head and neck cancer patients (HNC) treated with both chemo- and radiotherapy. 19% of the latter will be hospitalized and will experience a delay in antineoplastic treatment for high-grade mucositis management, resulting in a reduction of the quality of life, a worse prognosis and an increase in patient management costs. Currently, several interventions and prevention guidelines are available, but their effectiveness is uncertain. This review comprehensively describes mucositis, debating the impact of standard chemo-radiotherapy and targeted therapy on mucositis development and pointing out the limits and the benefits of current mucositis treatment strategies and assessment guidelines. Moreover, the review critically examines the feasibility of the existing biomarkers to predict patient risk of developing oral mucositis and their role in early diagnosis. Despite the expression levels of some proteins involved in the inflammation response, such as TNF-α or IL-1β, partially correlate with mucositis process, their presence does not exclude others mucositis-independent inflammation events. This strongly suggests the need to discover biomarkers that specifically feature mucositis process development. Non-coding RNAs might hold this potential.

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“…Results of our studies and previous findings illustrated profiles of CRP to be parallel with the development of OM. 48 , 49 After supplementation of VFJ during 6-week CCRT, changes of hs-CRP did not differ from the control group. It implies that supplementation of VFJ consumption to alleviate the development of ulcerative OM may not be mediated by modulating the production of pro-inflammatory mediator, hs-CRP.…”

Section: Discussionmentioning

confidence: 78%

“… 47 It has also been indicated as an objective measure to study the complexities of radiation mucositis, which is documented as one of the worst side effects of HNC therapy. 48 Ki et al. reported significant correlations between changes in CRP levels and progression of the mean grade of mucositis according to the radiation fraction number among advanced stages of patients with HNC receiving total radiation doses ranging from 70.0 to 74.2 Gy in 35 fractions.…”

Section: Discussionmentioning

confidence: 99%