The combination of oral and small intestinal mucositis, pediatrics and biomarkers: A particularly tricky problem!

Keefe, Dorothy; Gibson, Rachel J.

doi:10.4161/cbt.5.10.3508

Cited by 10 publications

(12 citation statements)

References 23 publications

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“…Gastrointestinal mucositis affects a large population of the oncology patients (40–100% depending on the particular treatment schedule) . It has a huge clinical and economic impact because it increases the prevalence of pain, infection, and hemorrhage leading to impaired quality of life and higher time and cost of hospitalization . Moreover, patients may require reductions in dosing or may no longer be able to continue cancer therapy in severe cases .…”

Section: Introductionmentioning

confidence: 99%

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May cannabinoids prevent the development of chemotherapy‐induced diarrhea and intestinal mucositis? Experimental study in the rat

Abalo

Uranga

Pérez-García

et al. 2016

Neurogastroenterology Motil

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Background The antineoplastic drug 5‐fluoruracil (5‐FU) is a pirimidine analog, which frequently induces potentially fatal diarrhea and mucositis. Cannabinoids reduce gastrointestinal motility and secretion and might prevent 5‐FU‐induced gut adverse effects. Here, we asked whether cannabinoids may prevent diarrhea and mucositis induced by 5‐FU in the rat. Methods Male Wistar rats received vehicle or the non‐selective cannabinoid agonist WIN 55,212‐2 (WIN; 0.5 mg kg−1 injection−1, 1 injection day−1, 4 consecutive days) by intraperitoneal (ip) route; on the first 2 days, animals received also saline or 5‐FU (150 mg kg−1 injection−1, cumulative dose of 300 mg kg−1). Gastrointestinal motor function was radiographically studied after barium contrast intragastric administration on experimental days 1 and 4. Structural alterations of the stomach, small intestine and colon were histologically studied on day 4. PAS staining and immunohistochemistry for Ki67, chromogranin A and CD163 were used to detect secretory, proliferating, and endocrine cells, and activated macrophages respectively. Key Results As shown radiographically, 5‐FU induced significant gastric emptying delay (on days 1 and 4) and diarrhea (on day 4). WIN did not significantly alter the motility curves obtained for either control or 5‐FU‐treated animals but tended to reduce the severity of 5‐FU‐induced diarrhea and increased permanence of barium from day 1 to the beginning of day 4 in 5‐FU‐treated animals. 5‐FU‐induced mucositis was severe and not counteracted by WIN. Conclusions and Inferences 5‐FU‐induced diarrhea, but not mucositis, was partly prevented by WIN at a low dose. Cannabinoids might be useful to prevent chemotherapy‐induced diarrhea.

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Section: Introductionmentioning

confidence: 99%

“…Moreover, patients may require reductions in dosing or may no longer be able to continue cancer therapy in severe cases . 5‐fluorouracil (5‐FU), a pyrimidine analog frequently used to treat breast or colorectal cancer (CRC), induces mucositis in 50–80% of patients, resulting in abdominal bloating and vomiting and diarrhea …”

Section: Introductionmentioning

confidence: 99%

May cannabinoids prevent the development of chemotherapy‐induced diarrhea and intestinal mucositis? Experimental study in the rat

Abalo

Uranga

Pérez-García

et al. 2016

Neurogastroenterology Motil

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“…Although this drug is not specific for cancer cells and also acts on healthy cells, it can cause mucositis, a common collateral effect of cancer chemotherapy and radiotherapy. This problem can affect the entire gastrointestinal tract, causing odynophagia, vomiting, abdominal pain and diarrhea [5,6]. These symptoms are associated with decreased food consumption, weight loss and diminished nutritional status [7].…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 40% of patients are affected by mucositis when they receive normal doses of chemotherapy, and almost all patients have this problem when they receive higher doses, for example, in cases of treatment for leukemia and bone marrow transplantation [8]. Mucositis has a huge clinical and economic impact because it increases the prevalence of infection and hemorrhage and prolongs the time and cost of hospitalization [6]. …”

Section: Introductionmentioning

confidence: 99%

Pretreatment with Saccharomyces boulardii does not prevent the experimental mucositis in Swiss mice

Maioli

Silva

Dias

et al. 2014

J Negat Results BioMed

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BackgroundThe antimetabolite chemotherapy 5-Fluorouracil is one of the most commonly prescribed drugs in clinical cancer treatment. Although this drug is not specific for cancer cells and also acts on healthy cells, it can cause mucositis, a common collateral effect. Dysbiosis has also been described in 5-fluorouracil-induced mucositis and is likely to contribute to the overall development of mucositis. In light of this theory, the use of probiotics could be a helpful strategy to alleviate mucositis. So the aim of this study was evaluate the impact of the probiotic Saccharomyces boulardii in a model of mucositis.ResultsAfter induced of mucositis, mice from the Mucositis groups showed a decrease in food consumption (p < 0.05) and therefore had a greater weight loss (p < 0.05). The treatment with Saccharomyces boulardii did not reverse this effect (p > 0.05). Mucositis induced an increase in intestinal permeability and intestinal inflammation (p < 0.05). There were no differences in mucosal lesions, intestinal permeability and sIgA secretion (p > 0.05) in mice pretreated with S. boulardii.ConclusionsS. boulardii was not able to prevent the effects of experimental mucositis induced by 5- Fluorouracil.

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“…Tooley et al performed a small clinical trial in pediatric cancer patients, and concluded that SBT possibly non-invasively detect gut damage [63]. However, this was a small sample size [64]. Furthermore, so far, this is the only clinical trial performed with SBT during mucositis.…”

Section: Potential Tests Of Intestinal Damage In Urine or Breath Samplesmentioning

confidence: 99%

Biomarkers and non-invasive tests for gastrointestinal mucositis

Kuiken

Rings

Blijlevens

et al. 2017

Support Care Cancer

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Gastrointestinal mucositis is a complex inflammatory reaction of the mucous membranes, a side effect of both chemotherapy and radiotherapy. Currently, assessment scales are used to diagnose mucositis. However, a biomarker which would determine whether there is mucositis and thereby establish the severity objectively would be very useful. This will give the opportunity to evaluate studies, to determine risk factors and incidence, and it will make it possible to compare studies. Moreover, this biomarker might improve clinical management for patients. In this paper, we reviewed studies concerning potential biomarkers in blood samples and fecal samples, and potential tests in breath samples and urine samples. We include biomarkers and tests studied in animal models and/or in clinical trials, and discuss the validity, diagnostic accuracy, and applicability.

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The combination of oral and small intestinal mucositis, pediatrics and biomarkers: A particularly tricky problem!

Cited by 10 publications

References 23 publications

May cannabinoids prevent the development of chemotherapy‐induced diarrhea and intestinal mucositis? Experimental study in the rat

May cannabinoids prevent the development of chemotherapy‐induced diarrhea and intestinal mucositis? Experimental study in the rat

Pretreatment with Saccharomyces boulardii does not prevent the experimental mucositis in Swiss mice

Biomarkers and non-invasive tests for gastrointestinal mucositis

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