RESUMO
@#Mucositis is a common gastrointestinal complication in cancer patients undergoing chemoradiotherapy, including oral mucositis and gastrointestinal mucositis, with clinical manifestations of oral ulcers, vomiting, diarrhea and pain that seriously reduce the quality of life of patients and even affect anticancer therapy. Toll-like receptor (TLR) are important receptors involved in innate immunity and in the development of chemoradiation-induced mucositis by mediating the effect between microorganisms and the host. A comprehensive understanding of the role of TLR in mucositis is helpful to guide the prevention and treatment of mucositis. This paper reviews the available studies on TLR and mucositis. The results of the literature review indicate that different TLR have different roles in chemoradiation-induced mucositis: TLR2 is an important receptor in the inflammatory cascade of chemoradiation-induced mucositis; TLR4 activation can increase gastrointestinal mucosal inflammation and lead to oral epithelial ulceration; TLR5 agonists can reduce the degree of radiation-induced mucositis damage; and antagonizing or knocking out TLR9 can reduce chemoradiation-induced gastrointestinal mucositis. However, no TLR agonists or inhibitors have yet been applied in clinical practice, and additional studies are needed to explore the role of different TLR in mucositis in the future to provide a reference for the precise prevention and treatment of chemoradiation-induced mucositis.
RESUMO
Objective@#To systematically evaluate the efficacy and safety of Bifidobacteria in preventing caries.@*Methods @#Databases including PubMed, Embase, The Cochrane Library, Web of Science, Scopus, Clinicaltrials. gov, CNKI, WanFang Data and VIP were electronically searched from inception to April 2020 to collect randomized controlled trials of Bifidobacterium for caries. Meta-analysis was performed using Revman 5.4 software. @*Results@# In total, 10 randomized controlled trials (RCT) of 518 patients, including 262 in the test group and 256 in the control group, were included. Meta-analysis results reveal no statistically significant differences in salivary Streptococcus mutans counts (SMD=-0.31, 95%CI -0.66 to 0.04, P=0.08) (RR=0.53, 95%CI 0.17 to 1.66, P=0.28) and salivary Lactobacilli counts (SMD=-0.07, 95%CI -0.39 to 0.26, P=0.69) (RR=0.87, 95%CI 0.59 to 1.29, P=0.50). No statistical differences in the counts of Streptococcus mutans and Lactobacillus counts were noted in dental plaque, and no statistical difference in the occurrence of caries in deciduous teeth. Three of the 10 RCTS included in this study did not report adverse events, 5 had no adverse reactions, and 2 reported gastrointestinal discomfort.@*Conclusion@# Current evidence suggests that Bifidobacteria do not effectively reduce Streptococcus mutans counts and Lactobacillus counts in saliva and dental plaque, or reduce the occurrence of caries in deciduous teeth. The safety of this treatment also requires further investigation.