Abstract
Oral mucositis is an acute side effect of radiation therapy that is especially common with head and neck cancer treatment. In recent years, several studies have revealed the predisposing factors for mucositis, leading to the pre-treatment of patients to deter the development of opportunistic oral fungal infections. Although many clinical protocols already advise the use of probiotics to counteract inflammation and fungal colonization, preclinical studies are needed to better delineate the mechanisms by which a host may acquire benefits via co-evolution with oral microbiota, probiotics, and fungal commensals, such as Candida albicans, especially during acute inflammation. Here, we review the current understanding of radiation therapy-dependent oral mucositis in terms of pathology, prevention, treatment, and related opportunistic infections, with a final focus on the oral microbiome and how it may be important for future therapy.
Highlights
Unproven, it is highly likely that alterations in the composition individual oral microbiome represent an important risk factor in the predisposi
The World Health Organization (WHO) Oral Toxicity scale measures OM anatomical, symptomatic, and functional elements, while the Western Consortium for Cancer Nursing Research scale only describes the anatomical changes associated with OM [15]
It has been found that by using 16S rRNA gene sequencing, it is possible to assess that alteration of the oral core microbiome or dysbiosis may be considered a risk factor for OM in HN patients, since a particular microbial signature may exacerbate the severity of mucositis [10,20]
Summary
Studying the potential differences in the microbiome in relation to disease severity, and the beneficial effects of probiotics, is likely to provide insights into the causative or protective roles of bacteria in OM pathology In this context, OM pathology is defined by a variety of clinical scales available for OM grading. Considering the available studies, the change of the core microbiome is happening more conspicuously during the ulceration phase, where colonization of certain bacteria occurs and overall microbial diversity is reduced, as indicated by 16S sequencing technology or cultures (Figure 1) [10,17] In this phase, the occurrence of opportunistic infections is shown (Figure 1) [6].
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call