The Role of the Innate Immune Response in Oral Mucositis Pathogenesis

Abstract

Oral mucositis (OM) is a significant complication of cancer therapy with limited management strategies. Whilst inflammation is a central feature of destructive and ultimately ulcerative pathology, to date, attempts to mitigate damage via this mechanism have proven limited. A relatively underexamined aspect of OM development is the contribution of elements of the innate immune system. In particular, the role played by barriers, pattern recognition systems, and microbial composition in early damage signaling requires further investigation. As such, this review highlights the innate immune response as a potential focus for research to better understand OM pathogenesis and development of interventions for patients treated with radiotherapy and chemotherapy. Future areas of evaluation include manipulation of microbial–mucosal interactions to alter cytotoxic sensitivity, use of germ-free models, and translation of innate immune-targeted agents interrogated for mucosal injury in other regions of the alimentary canal into OM-based clinical trials.

Oral cryotherapy by Kangfuxin for prophylaxis of oral mucositis in patients undergoing autologous hematopoietic stem cell transplantation

“…The production of amine substances and anti-in ammatory thiocyanate can cause ulceration and erosion [12] . A large amount of acidic substances produced in the oral cavity can act on the ulcer display, causing the wound to be prolonged and affecting the patient's diet, immune function, and forming a vicious cycle [13][14][15] .…”

Gastrointestinal mucositis: a sign of a (systemic) inflammatory response

“…A recent review by Bowen nicely highlighted the role of innate immune responses in the pathogenesis of oral mucositis that is also relevant and applicable to the pathogenesis in the gut [15 ▪ ]. PRRs constitute a continuous surveillance system for the presence of endogenous-damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs) and are expressed on both the external and internal cellular compartments of immune and epithelial cells [16].…”