scholarly journals Effects of chemotherapy on oral mucosa

2020 ◽  
Vol 6 ◽  
pp. 11-15
Author(s):  
Sakshi Sharma
Keyword(s):  
Oral Mucosa ◽  
Direct Effect ◽  
Oral Mucositis ◽  
Treatment Modality ◽  
Chemotherapeutic Agents ◽  
Host Cells ◽  
Oral Complications ◽  
Lichenoid Reactions ◽  
Cancerous Cells ◽  
Malignant Condition

Cancer leads to several oral and dental complications arise during the course of a malignant condition, oral or non-oral. These are largely due to the direct effect of cancer but may also result from the complication of treatment modality undertaken to cure the malignancy. This article elaborates on complications of the chemotherapeutic agents, which when employed to combat cancerous cells, may target the host cells. The oral complications of such a therapy results in several conditions like oral mucositis, infections, hemorrhage, salivary alterations, dysgeusia, lichenoid reactions amongst others. Thus, an in-depth understanding of these complications is a must in order to provide better care for an already frail and ailing patient.

A gyermekkori malignus kórképek kemoterápiájának leggyakoribb mellékhatása, az oralis mucositis. Irodalmi áttekintés

2018 ◽  
Vol 159 (13) ◽  
pp. 495-502 ◽  
Author(s):  
Judit Nemes ◽  
Ágnes Jenei ◽  
Ildikó Márton
Keyword(s):  
Oral Mucosa ◽  
Oral Mucositis ◽  
Chemotherapeutic Agents ◽  
Assessment Tools ◽  
Prevention And Treatment ◽  
Dividing Cells ◽  
Oral Complication ◽  
Pharmacologic Agents ◽  
Scoring Tools

Abstract: Mucositis is the most common oral complication of cancer therapy. Oral mucositis in childhood is more frequent and severe compared to adults, especially in children with leukemia. Lesions develop as the chemotherapeutic agents attack the rapidly dividing cells of the oral mucous membrane. Patients may experience trouble in eating, drinking, swallowing or even speaking due to the significant pain caused by the ulceration of the oral mucosa. Oral mucositis has a direct impact on the quality of life and may affect survival. The regular assessment of the oral mucosa is crucial during chemotherapy to evaluate the effectiveness of the oral mucositis prevention and treatment. Several oral mucositis scoring tools have been developed for adults to qualify the symptoms, but there is no universally accepted assessment scale for children. The prevention and treatment of therapy-related mucositis is difficult, though several methods and pharmacologic agents have been tested. Here we discuss the pathogenesis of chemotherapy-induced oral mucositis, the available assessment tools and their applicability to pediatric patients and the available therapeutic and preventive strategies. Orv Hetil. 2018; 159(13): 495–502.

scholarly journals Prevention and Treatment of Oral Mucositis in Children with Cancer

2012 ◽  
Vol 17 (4) ◽  
pp. 340-350 ◽  
Author(s):  
Misty M. Miller ◽  
David V. Donald ◽  
Tracy M. Hagemann
Keyword(s):  
Oral Mucositis ◽  
Keratinocyte Growth Factor ◽  
Oral Intake ◽  
Chemotherapeutic Agents ◽  
Increased Risk ◽  
Significant Burden ◽  
Dividing Cells ◽  
Tissue Changes ◽  
New Research ◽  
Pharmacologic Agents

Oral mucositis affects more than three-fourths of patients undergoing chemotherapy and represents a significant burden to patients and caregivers. Lesions develop as a result of chemotherapeutic agents attacking the rapidly dividing cells of the gastrointestinal tract. Severity can range from mild, painless tissue changes to bleeding ulcerations that prevent oral intake and require narcotic pain relievers. Oral mucositis also leads to an increased risk of infection and can often delay further chemotherapy treatment. A number of assessment scales have been developed to better qualify the symptoms associated with this condition. Few pharmacologic agents have been approved to either prevent the development or alleviate the symptoms of oral mucositis. Current options include the use of antimicrobial mouthwashes, amino acid rinses, and topical healing agents. Palifermin, a keratinocyte growth factor, may be a future option after its use in children is explored. With achievements in other areas of supportive care in patients undergoing chemotherapy, oral mucositis should represent the forefront of new research. This review will provide a comprehensive examination of available options for children who have oral mucositis.

scholarly journals Evaluation of Effect of Astringent on Oral Mucosa as a Non-surgical Preprosthetic Treatment Modality in Edentulous Patients: An In Vivo Study

2014 ◽  
Vol 14 (S1) ◽  
pp. 93-97 ◽  
Author(s):  
Usha Radke ◽  
Anita Kahar ◽  
Prajakta Zade ◽  
Dipti Lambade ◽  
Saee Deshpande ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Treatment Modality ◽  
In Vivo Study ◽  
Edentulous Patients

scholarly journals Significant expression of FURIN and ACE2 on oral epithelial cells may facilitate the efficiency of SARS-CoV-2 entry

2020 ◽  
Author(s):  
Mei Zhong ◽  
Bing-peng Lin ◽  
Hong-bin Gao ◽  
Andrew J Young ◽  
Xin-hong Wang ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Oral Mucosa ◽  
Cardiac Tissue ◽  
Clinical Care ◽  
Host Cells ◽  
Mucosal Tissues ◽  
Mucosal Cells ◽  
Key Factor ◽  
Significant Expression ◽  
Epithelial Layers

AbstractBackgroundLeading to a sustained epidemic spread with >2,000,000 confirmed human infections, including >100,000 deaths, COVID-19 was caused by SARS-CoV-2 and resulted in acute respiratory distress syndrome (ARDS) and sepsis, which brought more challenges to the patient’s treatment. The S-glycoprotein, which recognized as the key factor for the entry of SARS-CoV-2 into the cell, contains two functional domains: an ACE2 receptor binding domain and a second domain necessary for fusion of the coronavirus and cell membranes. FURIN activity, exposes the binding and fusion domains, is essential for the zoonotic transmission of SARS-CoV-2. Moreover, it has been reported that ACE2 is likely to be the receptor for SARS-CoV-2. In addition, FURIN enzyme and ACE2 receptor were expressed in airway epithelia, cardiac tissue, and enteric canals, which considered as the potential target organ of the virus. However, report about the expression of FURIN and ACE2 in oral tissues was limited.MethodsIn order to investigate the potential infective channel of new coronavirus in oral cavity, we analyze the expression of ACE2 and FURIN that mediate the new coronavirus entry into host cells in oral mucosa using the public single-cell sequence datasets. Furthermore, immunohistochemical staining experiment was performed to confirm the expression of ACE2 and FURIN in the protein level.ResultsThe bioinformatics results indicated the differential expression of ACE2 and FURIN on epithelial cells of different oral mucosal tissues and the proportion of FURIN-positive cells was obviously higher than that of ACE2-positive cells. IHC experiments revealed that both the ACE2-positive and FURIN-positive cells in the target tissues were mainly positioned in the epithelial layers, partly expressed in fibroblasts, which further confirm the bioinformatics results.ConclusionsBased on these findings, we speculated that SARS-CoV-2 could effectively invade oral mucosal cells though two possible routes: binding to the ACE2 receptor and fusion with cell membrane activated by FURIN protease. Our results indicated that oral mucosa tissues are susceptible to SARS-CoV-2, which provides valuable information for virus-prevention strategy in clinical care as well as daily life.

scholarly journals Formulation Development of Mucoadhesive Microparticle-Laden Gels for Oral Mucositis: An In Vitro and In Vivo Study

Pharmaceutics ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 603
Author(s):  
Hiroomi Sakurai ◽  
Yuri Ikeuchi-Takahashi ◽  
Ayaka Kobayashi ◽  
Nobuyoshi Yoshimura ◽  
Chizuko Ishihara ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Oral Mucositis ◽  
Formulation Development ◽  
Scanning Calorimetry ◽  
In Vivo Experiments ◽  
Drug Retention ◽  
Drug Concentrations ◽  
Diffraction Patterns

In order to relieve pain due to oral mucositis, we attempted to develop mucoadhesive microparticles containing indomethacin (IM) and gel preparations with IM microparticles that can be applied to the oral cavity. The mucoadhesive microparticles were prepared with a simple composition consisting of IM and polyvinyl alcohol (PVA). Two kinds of PVA with different block properties were used, and microparticles were prepared by heating-filtration and mixing-drying. From the X-ray powder diffraction patterns, differential scanning calorimetry thermograms, and morphological features of the IM microparticles, IM should exist as polymorphic forms in the microparticles. Rapid drug release properties were observed in the IM microparticles. Increased drug retention was observed in IM microparticles containing PVA, and the IM-NK(50) gel, using a common block character PVA and heating-filtration, showed good long-term drug retention properties. In vivo experiments showing significantly higher drug concentrations in the oral mucosa were observed with IM microparticles prepared by heating-filtration, and the IM-NK(50) gel maintained significantly higher drug concentrations in the oral mucosa. From these results, the IM-NK(50) gel may be useful as a preparation for relieving oral mucositis pain.

scholarly journals Lip Repositioning Surgery: A Newer Paradigm in Periodontal Aesthetics

2018 ◽  
Vol 2 (1) ◽  
pp. 20-22
Author(s):  
Manoj Humagain ◽  
Asmita Dawadi
Keyword(s):  
Oral Mucosa ◽  
Significant Role ◽  
Surgical Procedures ◽  
Alternative Treatment ◽  
Treatment Modality ◽  
Aesthetic Surgery ◽  
Self Esteem ◽  
The Common ◽  
Smile Aesthetics ◽  
Gummy Smile

Periodontal plastic or aesthetic surgery by its definition comprises of surgical procedures performed to correct or eliminate anatomic, developmental or traumatic deformities of the gingiva or oral mucosa. ‘Perfect smile’ has been the common desire of many people in this era. Smile has significant role in the expression, appearance and in the development of self-esteem. Excessive gingival display, which is commonly termed as ‘gummy smile’ will adversely affects smile aesthetics and is therefore undesirable to many people. It is one of the several developmental or acquired deformities and conditions that manifest in the periodontium. Different literature reveals common consensus on considering gingival display of greater than 3 mm is gummy smile and is unaesthetic. Lip repositioning surgery has been establishing as a promising less invasive alternative treatment modality in aesthetic rehabilitation for the cases of excessive gingival display. Perseverance and application of such technique shall provide many more a horizon to this young but highly imaginative and creative technique in periodontal therapy to charter.

scholarly journals Severe Oral Mucositis in Pediatric Cancer Patients: Survival Analysis and Predictive Factors

2020 ◽  
Vol 17 (4) ◽  
pp. 1235
Author(s):  
Lecidamia Cristina Leite Damascena ◽  
Nyellisonn Nando Nóbrega de Lucena ◽  
Isabella Lima Arrais Ribeiro ◽  
Tarciana Liberal Pereira ◽  
Luiz Medeiros Araújo Lima-Filho ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Solid Tumors ◽  
Oral Mucositis ◽  
Associated Factors ◽  
Pediatric Patients ◽  
Hematologic Malignancies ◽  
Chemotherapeutic Agents ◽  
Cancer Type ◽  
Pediatric Cancer Patients ◽  
Severe Oral Mucositis

This paper investigates the occurrence of severe oral mucositis and associated factors in blood and solid cancer pediatric patients subjected to cancer treatment, using a survival analysis. A longitudinal, descriptive, observational and inductive study of 142 pediatric patients aged from 0 to 19 years was conducted from 2013 to 2017. Data were collected using a form to record the sociodemographic characteristics and health-related aspects of patients and the modified Oral Assessment Guide (OAG). Survival analysis was performed using the Kaplan–Meier method and Cox semiparametric model. The median times to occurrence of severe oral mucositis were 35.3 and 77.1 days for patients with hematologic malignancies and solid tumors, respectively. The Cox model showed that white cell changes and platelet counts as well as the use of natural chemotherapeutic agents are risk factors for the occurrence of oral mucositis among patients with hematologic malignancies. Nonetheless, among patients with solid tumors, the occurrence of oral mucositis was associated with female sex, mixed ethnicity, the presence of metastasis, abnormal creatinine levels, a combination of chemotherapy, radiotherapy, and surgery, and the administration of chemotherapeutic agents included in the miscellaneous group. The time to occurrence of severe oral mucositis and its associated factors varied according to cancer type.

scholarly journals Photobiomodulation Therapy in the Treatment of Oral Mucositis, Dysphagia, Oral Dryness, Taste Alteration, and Burning Mouth Sensation Due to Cancer Therapy: A Case Series

2019 ◽  
Vol 16 (22) ◽  
pp. 4505 ◽  
Author(s):  
Marwan El Mobadder ◽  
Fadi Farhat ◽  
Wassim El Mobadder ◽  
Samir Nammour
Keyword(s):  
Quality Of Life ◽  
Cancer Therapy ◽  
Oral Mucositis ◽  
Case Series ◽  
Oral Complications ◽  
Oral Dryness ◽  
Burning Mouth ◽  
Taste Alteration ◽  
Burning Mouth Sensation

Oral complications of cancer therapy, such as oral dryness, dysphagia, and taste alteration, are associated with a negative impact in the quality of life of the patients. Few supportive care measures are available for such complications. This case series reveals the effectiveness of the photobiomodulation (PBM) therapy when used in a specific protocol and parameters, in the management of oral complications related to cancer therapy. Dysphagia was measured using the functional outcome swallowing scale for staging oropharyngeal dysphagia (FOSS). Oral mucositis was measured according to the National Cancer Institute scale. The quantity of the whole resting and stimulated saliva was measured in order to assess the oral dryness. In addition, the taste alteration was measured according to a protocol suggested by the International Standards organization (ISO). Sensation of burning mouth was measured using a visual analogue scale. These measurements were made before treatment, during, and at the end of the treatment. Diode laser 635 nm was used in 3 J/cm2. Five sessions interleaved with 24 h breaks were conducted for the dysphagia and oral dryness, and 10 sessions were conducted for the taste alteration and burning mouth sensation. Regardless of the limitations of this case series, PBM can be considered safe, time saving, and a promising approach for the management of the oral complications due to cancer therapy and the quality of life of cancer patients.

New Cooling Device for Oral Mucosa Better Tolerated and Equally Effective As Ice Cooling

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5806-5806
Author(s):  
Java Walladbegi ◽  
Anncarin Svanberg ◽  
Gunnar Birgegard ◽  
Mats Jontell
Keyword(s):  
Healthy Volunteers ◽  
Oral Mucosa ◽  
Oral Mucositis ◽  
Buccal Mucosa ◽  
Research Funding ◽  
Poor Quality ◽  
Cooling Device ◽  
Circulating Water ◽  
Temperature Reduction ◽  
Thermographic Camera

Abstract Introduction: Oral mucositis (OM) is an inflammation of the oral mucosa affecting up to 80% of all patients receiving myeloablative therapy prior to stem cell transplantation. The complication manifests as ulcerations and may require high doses of morphine for pain alleviation.OM may also interfere with food intakeand result in parenteral nutrition, weight loss and impaired quality of life. Current literature indicates very few evidence-based interventions for prevention of OM. Cryotherapy (CT),using ice chips has reported to efficiently reduced grade and extent of OM, although clinical use is still limited due to several disadvantages. These include adverse teeth sensations, nausea and uneven cooling of the oral mucosa. Moreovercontinuous supply of ice chips is needed during treatment sessions and thewater from which ice chips are made may be of poor quality, leading to health hazards. Objectives: The primary endpoint of the present study was to evaluate the tolerability of an intraoral cooling device (Cooral) compared with ice chips. Secondary endpoints were temperature reduction and cooling distribution. Methods:To avoid the adverse effects and reduce the disadvantages of ice chips an optimal fitting mouth-cooling device (Fig. 1), shaped and dimensioned to cool the gums, cheeks, tongue, palate and base of the mouth was designed. Thecooling device is made of a closed channel system with continuous circulating water and has the advantage over ice chips as the water temperature can be adjusted. 20 healthy volunteers (mean age: 24 years) (17 women; 3 men) were enrolled in this cross over study. Each individual used the cooling device and ice chips for 60 minutes in two separate sessions with at least 24 hours apart. Prior to inclusion, the procedure was explained in writing and a written informed consent was obtained. Baseline- and final temperatures were measured (Fig. 2) in eight intraoral locations (right buccal mucosa, left buccal mucosa, upper labial mucosa, lower labial mucosa, anterior and posterior dorsal tongue, ventral tongue and hard palate) using an infrared thermographic camera (FLIR-60). Following each cooling session a questionnaire, specifically developed for the study to assess tolerability, was completed. In total 700 thermographic images were analysed using FlIR-60 tools software and BioPix. Results: The cooling device was found to be significantly better tolerated compared to ice chips and was preferred by 16 out of 20 participants (P=0.0118; Fig. 3). Three individuals preferred ice chips as they were frequently habitually chewing on ice. One individual reported that the device was experienced as too big, a problem that will be solved in the future, as three different sizes of the device will be produced. Finally, the device was found to be as efficient as ice chips in terms of cooling reduction and cooling distribution. Conclusions: The cooling device was significantly better tolerated and provided as efficient temperature reduction and cooling distribution as ice chips in healthy volunteers. The device has the potential not just to improve the comfort but in the long term also optimize the effect of cryotherapy with the aim of preventing oral mucositis. The next step in this research will be to evaluate the cooling device in a clinical setting to establish its tolerability and efficacy of preventing oral mucositis. FormulŠrets nederkant Disclosures Walladbegi: BraincCool: Employment, Research Funding. Svanberg:BrainCool: Employment, Research Funding. Jontell:BrainCool: Research Funding.

Effect of a mouth rinse formulation with human trefoil factor 1-secreting Lactococcus lactis in experimental oral mucositis in hamsters

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e14570-e14570 ◽  
Author(s):  
P. Rottiers ◽  
S. Caluwaerts ◽  
L. Steidler ◽  
K. Vandenbroucke ◽  
B. Watkins ◽  
...  
Keyword(s):  
Lactococcus Lactis ◽  
Oral Mucosa ◽  
Oral Mucositis ◽  
Systemic Exposure ◽  
Pharmacokinetic Studies ◽  
Clinical Approach ◽  
Mouth Rinse ◽  
Weight Changes ◽  
Hamster Model ◽  
Radiation Induced

e14570 Background: Oral mucositis (OM) is a painful and dose-limiting toxicity of cancer chemotherapy and irradiation, characterized by breakdown of the oral mucosa. Trefoil factors (TFFs) are involved in protecting and healing mucosal tissue, and might thus represent a pharmacological tool for treatment of OM. Local delivery of recombinant TFFs at the oral mucosa by living, genetically modified Lactococcus (L.) lactis bacteria (ActoBiotics) seems a promising, safe and cost-effective clinical approach for the prevention and attenuation of oral mucositis. Methods: An environmentally contained Lactococcus lactis strain (AG013), engineered to express human (h)TFF1, was formulated for topical administration in the form of a mouth rinse. Efficacy of AG013 was assessed in a clinically relevant hamster model of acute, radiation-induced OM. The dosing regimen was 1.3 x 109 CFU/dose, once (qd) or three rinses (tid) daily, from day 0 (=day of radiation) to day 18. OM was scored from day 6 to day 28 using the WHO grading scale, and compared to the score of placebo-treated hamsters. The viability and survival of live L. lactis and the pharmacokinetics of the hTFF1 secreted were studied in healthy and OM hamsters. Results: Topical application of AG013 to the oral mucosa significantly reduced the severity and course of radiation-induced OM. In the AG013-treated groups, the number of animals days with ulcerative mucositis (grade 3 or higher) was significantly reduced to 27.5% and 30.8% (qd and tid respectively; P < 0.001), compared to 45.8 % in the placebo-treated group. Based on the observed survival and weight changes, AG013 appeared to be well-tolerated. Pharmacokinetic studies demonstrated that both living L. lactis and the hTFF1 secreted could be recovered from the administration site, for maximum 24 hours post-dosing, without systemic exposure. Conclusions: Oral administration of AG013 is safe and effective in reducing the severity and the course of OM in the hamster model, and therefore supports proof-of-concept for a mouth rinse formulation of AG013 to treat OM patients. [Table: see text]

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