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Medical Oncology (Northwood, London,... Apr 2023The superiority of oral cryotherapy (OC) for prevention of chemotherapy-induced oral mucositis (OM) has been demonstrated in several trials. In clinical settings,... (Randomized Controlled Trial)
Randomized Controlled Trial
The superiority of oral cryotherapy (OC) for prevention of chemotherapy-induced oral mucositis (OM) has been demonstrated in several trials. In clinical settings, cooling is usually initiated prior to the chemotherapy infusion. It then continues during the infusion, and for a period after the infusion has been completed. While the cooling period post-infusion depends on the half-life of the chemotherapeutic drug, there is no consensus on when cooling should be initiated prior to the infusion. The lowest achieved temperature in the oral mucosa is believed to provide the best condition for OM prevention. Given this, it was of interest to investigate when along the course of intraoral cooling this temperature is achieved. In total, 20 healthy volunteers participated in this randomized crossover trial. Each subject attended three separate cooling sessions of 30 min each, with ice chips (IC) and the intraoral cooling device (ICD) set to 8 and 15 °C, respectively. At baseline and following 5, 10, 15, 20 and 30 min of cooling, intraoral temperatures were registered using a thermographic camera. The greatest drop in intraoral temperature was seen after 5 min of cooling with IC, ICD and ICD, respectively. A statistically significant difference, corresponding to 1.4 °C, was seen between IC and the ICD (p < 0.05). The intraoral temperature further declined throughout the 30 min of cooling, showing an additional temperature reduction of 3.1, 2.2, and 1.7 °C for IC, ICD and ICD, respectively.
Topics: Humans; Temperature; Cryotherapy; Stomatitis; Mouth Mucosa
PubMed: 37058178
DOI: 10.1007/s12032-023-01989-9 -
Cell Death & Disease Jul 2023Oral and intestinal mucositis (OIM) are debilitating inflammatory diseases initiated by oxidative stress, resulting in epithelial cell death and are frequently observed...
Oral and intestinal mucositis (OIM) are debilitating inflammatory diseases initiated by oxidative stress, resulting in epithelial cell death and are frequently observed in cancer patients undergoing chemo-radiotherapy. There are currently few preventative strategies for this debilitating condition. Therefore, the development of a safe and effective mucositis mitigating strategy is an unmet medical need. Hyaluronic acid (HA) preparations have been tentatively used in oral mucositis. However, the protective effects of HA in chemotherapy-induced mucositis and their underlying mechanisms remain to be fully elucidated. This study aimed to assess these mechanisms using multiple formulations of enriched HA (Mucosamin), cross-linked (xl-), and non-crosslinked high molecular weight HA (H-MW-HA) in an oxidative stress-induced model of human oral mucosal injury in vitro and an in vivo murine model of 5-flurouracil (5-FU)-induced oral/intestinal mucositis. All tested HA formulations protected against oxidative stress-induced damage in vitro without inducing cytotoxicity, with H-MW-HA also significantly reducing ROS production. Daily supplementation with H-MW-HA in vivo drastically reduced the severity of 5-FU-induced OIM, prevented apoptotic damage and reduced COX-2 enzyme activity in both the oral and intestinal epithelium. In 5-FU-injected mice, HA supplementation also significantly reduced serum levels of IL-6 and the chemokine CXCL1/KC, while the serum antioxidant activity of superoxide dismutase was elevated. Our data suggest that H-MW-HA attenuates 5-FU-induced OIM, at least partly, by impeding apoptosis, inhibiting of oxidative stress and suppressing inflammatory cytokines. This study supports the development of H-MW-HA preparations for preventing OIM in patients receiving chemotherapy.
Topics: Humans; Animals; Mice; Mucositis; Hyaluronic Acid; Molecular Weight; Stomatitis; Apoptosis; Antineoplastic Agents
PubMed: 37479691
DOI: 10.1038/s41419-023-05934-6 -
Journal of the Royal Society of Medicine Jan 1984
Topics: Deficiency Diseases; Female; Humans; Male; Recurrence; Stomatitis, Aphthous
PubMed: 6699843
DOI: No ID Found -
Yakugaku Zasshi : Journal of the... 2019Aphthous stomatitis is induced by chemotherapy and radiotherapy. It has been reported that 100% of patients administered high-dose chemotherapy and 80% of patients... (Review)
Review
Aphthous stomatitis is induced by chemotherapy and radiotherapy. It has been reported that 100% of patients administered high-dose chemotherapy and 80% of patients receiving radiotherapy develop stomatitis. The most serious cases are accompanied by pain and bleeding of the ulcers, which cause significant suffering and reduce patients' quality of life. Rebamipide (RB) was developed in Japan as a treatment for gastric ulcer. In this study, we prepared and evaluated a mouthwash for stomatitis taking into consideration the solubilization of RB. RB nanoparticles were prepared by the wet-milling technique using various forms of hydroxypropyl cellulose (HPC-L, -SL, and -SSL) and sodium lauryl sulfate (SLS). RB nanoparticles sized between 126.6 and 286.8 nm were obtained under various conditions. From the results of zeta potential measurement and evaluation of their dispersibility, it appeared that the prepared nanosuspensions were stable. Furthermore, adhesion of the nanoparticles to the mucous membrane in the oral cavity was evaluated using quartz crystal microbalance with dissipation monitoring (QCM-D) technology. From the changes in the thickness of the gold sensor observed in QCM-D measurement, it was suggested that HPC-SSL molecules interact with mucin mounted on the gold sensor. It appears feasible to utilize RB nanoparticles dispersed in HPC-SSL solution in mouthwash to prevent stomatitis.
Topics: Alanine; Cellulose; Chemical Phenomena; Drug Compounding; Drug-Related Side Effects and Adverse Reactions; Humans; Mouthwashes; Nanoparticles; Pharmacy Service, Hospital; Quinolones; Radiotherapy; Sodium Dodecyl Sulfate; Solubility; Solutions; Stomatitis
PubMed: 31582612
DOI: 10.1248/yakushi.19-00121-2 -
Archivum Immunologiae Et Therapiae... Jun 2014Recurrent aphthous stomatitis (RAS; recurrent aphthous ulcers; canker sores) belongs to the group of chronic, inflammatory, ulcerative diseases of the oral mucosa. Up to... (Review)
Review
Recurrent aphthous stomatitis (RAS; recurrent aphthous ulcers; canker sores) belongs to the group of chronic, inflammatory, ulcerative diseases of the oral mucosa. Up to now, the etiopathogenesis of this condition remains unclear; it is, however, considered to be multifactorial. The results of currently performed studies indicate that genetically mediated disturbances of the innate and acquired immunity play an important role in the disease development. Factors that modify the immunologic response in RAS include: food allergies, vitamin and microelement deficiencies, hormonal and gastrointestinal disorders (e.g., celiac disease, Crohn's disease, ulcerative colitis), some viral and bacterial infections, mechanical injuries and stress. In this paper, we presented the main etiopathogenetic factors of RAS with a special emphasis on the mechanisms of the immune response modification. Moreover, we discussed the crucial clinical symptoms and types of RAS together with epidemiologic data based on the current medical literature reports and our own observations.
Topics: Animals; Comorbidity; Humans; Immunity, Innate; Immunomodulation; Infections; Recurrence; Stomatitis, Aphthous
PubMed: 24217985
DOI: 10.1007/s00005-013-0261-y -
Dental and Medical Problems 2020Denture stomatitis (DS) is a multifactorial disease, but the proliferation of Candida albicans (C. albicans) is the main causative factor. Different modalities have been... (Review)
Review
Denture stomatitis (DS) is a multifactorial disease, but the proliferation of Candida albicans (C. albicans) is the main causative factor. Different modalities have been suggested for the prevention and treatment of DS. Among the different approaches that have been implemented to inhibit and control DS there are the topical application of antifungal agents, the surface modification of the denture base and the incorporation of antimicrobial agents into the denture base material. Antifungal agents can effectively control DS, but the recurrence of the disease is common. Accordingly, it has been suggested that coating the surface of the acrylic denture base may result in a decreased fungal adhesion. In recent years, nanotechnology has dominated the research, and several nanoparticles have demonstrated antifungal effects. Therefore, the aim of this article was to review the antifungal effects of the different methods that have been suggested for the prevention and/or control of DS as well as the antimicrobial activity of denture base acrylic resin additives, including nanoparticles. Studies reporting the incorporation of antifungal/antimicrobial agents into the polymethyl methacrylate (PMMA) denture base were included in this review. The PubMed, Web of Science, Google Scholar, and Scopus databases were searched for the articles published between January 2000 and December 2018 using the following key words: dental prosthesis, denture stomatitis, candidiasis, antifungal agents, biofilm formation, polymethyl methacrylate, and PMMA. The antimicrobial material incorporated into the resin may have a superior effect in preventing DS over simply coating the surface of the denture base. However, some antimicrobial fillers can have adverse effects on the physical and mechanical properties of the denture base resin.
Topics: Acrylic Resins; Antifungal Agents; Candida albicans; Denture Bases; Humans; Stomatitis, Denture
PubMed: 32307934
DOI: 10.17219/dmp/112861 -
International Journal of Environmental... Feb 2023One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an... (Review)
Review
One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.
Topics: Female; Humans; Aged; Stomatitis, Denture; Dentures; Antifungal Agents; Dentists; Professional Role; Candidiasis, Oral; Stomatitis; Candida albicans
PubMed: 36833718
DOI: 10.3390/ijerph20043029 -
Current Opinion in Oncology Jul 2010Mucositis has long been viewed as an unavoidable consequence of high-dose chemotherapy and/or radiation. Management has been directed to supportive care including oral... (Review)
Review
PURPOSE OF REVIEW
Mucositis has long been viewed as an unavoidable consequence of high-dose chemotherapy and/or radiation. Management has been directed to supportive care including oral pain control, nutritional support, infection treatment and control of diarrhea. Whereas these interventions have been valuable for clinical management, they have not been collectively directed to molecularly targeted prevention and treatment. This review addresses recent advances regarding mucosal injury in cancer patients, with emphasis on symptom clusters, genetically based tissue susceptibility and risk prediction, imaging technology, and computational biology.
RECENT FINDINGS
Modeling of symptom clusters in cancer patients continues to mature. Although integration of mucositis into the paradigm is at an early stage, recent studies suggest that important molecular and clinical insights will emerge in this regard. Initial studies of genetic-based tissue risk are also providing a research basis that may lead to clinical risk prediction models. These advances are in part being engineered via new imaging and computational biology technologies, drawing upon literature in nonmucositis systems. Just as the past decade has been hallmarked by linkage of pathobiology with clinical expression of mucosal toxicity, the next decade promises to identify new molecular interactions and risk prediction models based on novel application of the analytic technologies.
SUMMARY
Recent research has culminated in convergence of molecular pathobiology with models of symptom clusters, genetic-based risk, and imaging and computational biology. The field is poised to further delineate this paradigm, with the goal of development of molecularly targeted drugs and devices for mucositis management.
Topics: Biomedical Research; Computational Biology; Humans; Neoplasms; Pathology, Molecular; Stomatitis
PubMed: 20485169
DOI: 10.1097/CCO.0b013e32833a9fab -
International Journal of Molecular... Sep 2019The oral cavity is suggested as the reservoir of bacterial infection, and the oral and pharyngeal biofilms formed by oral bacterial flora, which is comprised of over 700... (Review)
Review
The oral cavity is suggested as the reservoir of bacterial infection, and the oral and pharyngeal biofilms formed by oral bacterial flora, which is comprised of over 700 microbial species, have been found to be associated with systemic conditions. Almost all oral microorganisms are non-pathogenic opportunistic commensals to maintain oral health condition and defend against pathogenic microorganisms. However, oral Streptococci, the first microorganisms to colonize oral surfaces and the dominant microorganisms in the human mouth, has recently gained attention as the pathogens of various systemic diseases, such as infective endocarditis, purulent infections, brain hemorrhage, intestinal inflammation, and autoimmune diseases, as well as bacteremia. As pathogenic factors from oral Streptococci, extracellular polymeric substances, toxins, proteins and nucleic acids as well as vesicles, which secrete these components outside of bacterial cells in biofilm, have been reported. Therefore, it is necessary to consider that the relevance of these pathogenic factors to systemic diseases and also vaccine candidates to protect infectious diseases caused by Streptococci. This review article focuses on the mechanistic links among pathogenic factors from oral Streptococci, inflammation, and systemic diseases to provide the current understanding of oral biofilm infections based on biofilm and widespread systemic diseases.
Topics: Aged; Autoimmune Diseases; Autoimmunity; Bacterial Adhesion; Biofilms; Biomarkers; DNA-Binding Proteins; Humans; Male; Stomatitis; Streptococcal Infections; Streptococcus; Virulence; Virulence Factors
PubMed: 31540175
DOI: 10.3390/ijms20184571 -
Frontiers in Immunology 2021Oral-gut inflammation has an impact on overall health, placing subjects at risk to acquire chronic conditions and infections. Due to neuromotor disturbances, and...
Oral-gut inflammation has an impact on overall health, placing subjects at risk to acquire chronic conditions and infections. Due to neuromotor disturbances, and medication intake, cerebral palsy (CP) subjects present intestinal constipation, impacting their quality of life (QOL). We aimed to investigate how oral inflammatory levels predicted gut phenotypes and response to therapy. A total of 93 subjects aging from 5 to 17 years were included in the study, and assigned into one of the 4 groups: CP with constipation (G1, = 30), CP without constipation (G2, = 33), and controls without CP with constipation (G3, = 07) and without CP and without constipation (G4, = 23). In addition to characterizing subjects' clinical demographics, medication intake, disease severity levels, salivary cytokine levels [TNF-α, interleukin (IL)-1β, IL-6, IL-8, IL-10], and Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). Statistical significance was evaluated by Shapiro-Wilks, Student's -Test, ANOVA, and ANCOVA analysis. Salivary proinflammatory cytokines were highly correlated with the severe form of gut constipation in G1 ( < 0.001), and out of all cytokines IL-1β levels demonstrated highest correlation with all gut constipation < 0.05). A significant relationship was found between the type of medication, in which subjects taking Gamma-Aminobutyric Acid (GABA) and GABA+ (GABA in association with other medication) were more likely to be constipated than the other groups ( < 0.01). Cleary salivary inflammatory levels and gut constipation were correlated, and impacted QOL of CP subjects. G1 presented a lower QOL mean score of CPCHILD (49.0 ± 13.1) compared to G2 (71.5 ± 16.7), when compared to G3 (88.9 ± 7.5), and G4 (95.5 ± 5.0) ( < 0.01). We accounted for gingival bleeding as a cofounder of oral inflammation, and here were no differences among groups regarding gender ( = 0.332) and age ( = 0.292). Collectively, the results suggest that saliva inflammatory levels were linked to gut constipation, and that the clinical impact of medications that controlled gut was reliably monitored via oral cytokine levels, providing reliable and non-invasive information in precision diagnostics.
Topics: Adolescent; Biomarkers; Cerebral Palsy; Child; Child, Preschool; Cross-Sectional Studies; Cytokines; Female; Gastroenteritis; Humans; Inflammation Mediators; Male; Phenotype; Population Surveillance; Quality of Life; Saliva; Stomatitis; Symptom Assessment
PubMed: 33717115
DOI: 10.3389/fimmu.2021.619262