Research progress on probiotics for the prevention and treatment of oral and gastrointestinal chemoradiotherapy mucositis / 口腔疾病防治

@#http://www.kqjbfz.com/article/2021/2096-1456/2096-1456-29-8-567.shtml

The role of Toll-like receptors in chemoradiotherapy-induced gastrointestinal mucositis / 口腔疾病防治

@#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.

Research progress on biomarkers related to radiotherapy and/or chemotherapy-induced oral mucositis / 口腔疾病防治

@#Radiotherapy and/or chemotherapy-induced oral mucositis is a common oral complication in tumor patients undergoing radiotherapy and/or chemotherapy, which seriously compromises patients’ quality of life and even affects anti-tumor treatment. Biomarkers are signal indicators that appear at different biological levels before or during disease. A comprehensive understanding of the biomarkers associated with oral mucositis contributes to the early identification of high-risk patients with oral mucositis and aids in the screening of patients prone to develop severe oral mucositis, guiding the prevention and treatment of oral mucositis. This article reviews the existing biomarkers associated with oral mucositis. The literature review results showed that the biomarkers associated with oral mucositis included growth factors, inflammatory cytokines, genes, plasma antioxidants, and pro-apoptotic proteins/inhibitor of apoptosis proteins. These biomarkers can be used to predict the risk of oral mucositis or facilitate early discrimination of patients prone to exhibit severe radiotherapy and/or chemotherapy-induced oral mucositis. EGF, TNF-α, IL-6, IL-1β and CRP can be used to predict and evaluate the risk and development of oral mucositis, whereas genes such as excision repair cross complementing 1(ERCC1), X-ray repair cross complementing 1(XRCC1), methylenetetrahydrofolate reductase (MTHFR) and tumor necrosis factor receptor superfamily member 1A (TNFRSF1A) have been focus of research in recent years. The genotypes and expression levels of some of these genes exhibit variable capacities to predict the risk and severity of oral mucositis. However, no biomarkers have been used in clinical practice, and more studies are needed in the future to verify the reliability and accuracy of these biomarkers, to provide a reference for the early accurate prevention and treatment of radiation and chemotherapy oral mucositis.

Research progress on animal models of oral mucositis caused by radiotherapy and chemotherapy / 口腔疾病防治

@#Inflammation of the oral mucosa induced by radiotherapy and/or chemotherapy may cause pain, difficulty speaking and swallowing, an increased risk of local and systemic infections, and even interrupt cancer treatment, which can seriously affect a patient′s quality of life. The pathogenesis of oral mucositis is complicated. There is still a lack of prevention and treatment modalities for oral mucositis in the clinic. Animal models play a vital role in exploring the pathogenesis of oral mucositis and developing better prevention and treatment methods. This article reviews the current research progress on the establishment and assessment of animal models of oral mucositis. The literature review results showed that animal models of oral mucositis have been established, such as mouse, rat, and gold hamster models. In the replication of animal models, radiotherapy-induced oral mucositis is generally induced by local single-dose or fractionated irradiation using X-ray equipment, either alone or in combination with the chemotherapy drugs 5-fluorouracil or cisplatin; cesium can also be used used as a radioactive source for local irradiation. Oral mucositis induced by the chemotherapy drug 5-fluorouracil alone is generally mild, so 5-fluorouracil was combined with mechanical trauma or acetic acid. The main methods for assessing oral mucositis are gross observation as well as histopathological observation.