Abstract
Oral mucositis (OM) is a common complication of chemotherapy and remains a significant unmet need. The aim of this study was to investigate the role of oral bacteriota and HSV-1 in OM. Forty-six patients admitted for autologous hematopoietic stem cell transplantation were longitudinally evaluated for OM, Candida, HSV-1, and leukocyte count, and buccal mucosal bacterial samples were obtained during their admission period. The bacterial communities collected at the baseline and post-chemotherapy, chosen from the time with the highest severity, were analyzed by sequencing the 16S rRNA gene. Twenty (43.5%) patients developed OM, the severity of which ranged from 1 to 5 according to the Oral Mucositis Assessment Scale (OMAS). Chemotherapy significantly increased the prevalence of HSV-1 detection but not that of Candida. The bacterial communities of patients after conditioning chemotherapy were characterized by aberrant enrichment of minor species and decreased evenness and Shannon diversity. After adjustment for age, gender, and neutropenia, the presence of HSV-1 was associated with the incidence of OM (odds ratio = 3.668, p = 0.004), while the decrease in Shannon diversity was associated with the severity of OM (β = 0.533 ± 0.220, p = 0.015). The control of HSV-1 and restoration of oral bacterial diversity may be a novel option to treat or prevent OM.
Highlights
Oral mucositis (OM) refers to erythematous and/or ulcerative lesions in the oral cavity that occur secondary to cancer therapy
We previously reported that OM has a strong association with herpes simplex virus (HSV)-1 but no association with Candida, plaque index, or decayed, missing, and filled surface (DMFS) scores in patients with hematological malignancies undergoing intensive chemotherapy or hematopoietic stem cell transplantation (HSCT) [2]
OM Is Associated with the Detection of HSV-1
Summary
Oral mucositis (OM) refers to erythematous and/or ulcerative lesions in the oral cavity that occur secondary to cancer therapy. It is a common complication of chemotherapy. Patients who receive a concomitant radiation therapy in the head and neck area, intensive chemotherapy for acute leukemia, or myeloablative conditioning for hematopoietic stem cell transplantation (HSCT) are at high risk for OM [1]. OM is associated with severe pain, increased use of opioid analgesics, dysphagia, interruption of planned chemotherapy, bloodstream infection, and increased medical costs [1]. Clinical practice guidelines for the intervention and management of OM have been published by the Multinational Association of Supportive Care in Cancer, OM remains a significant unmet need [5]. A clear understanding of the etiopathological mechanisms for OM is important to the development of new, effective, targeted therapies
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