Abstract

Oral mucositis is a common inflammatory complication among patients with cancer. This study evaluated the histopathological, stereological, and antioxidant markers of 2% eucalyptus extract in induced oral mucositis in male golden hamsters. In this animal study, oral mucositis was induced in 30 male golden hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle once daily on days 3 and 4. On days 14-17, 2% eucalyptus hydroalcoholic extract gel and Calendula officinalis extract gel groups were treated and then compared with a non-treated control group. The histopathological and stereological scores and the pouch content of malondialdehyde, as well as the activities of glutathione and myeloperoxidase in the pouch tissue, were evaluated. Histopathologic scores of oral mucositis were lower in the eucalyptus gel group than those of the calendula and control groups (p<0.05). Also, a lower malondialdehyde level and higher myeloperoxidase and glutathione activities were detected in the eucalyptus group in comparison to the calendula and control groups (p<0.001). The thickness of the mucosa and submucosa increased in the eucalyptus group. The numerical density of the fibroblast and the volume density of the collagen significantly increased in the eucalyptus group. In conclusion, the use of eucalyptus hydroalcoholic extract may be associated with reduced intensity of oral mucositis, diminished concentration of malondialdehyde, increased activity of myeloperoxidase and glutathione, increased volume of mucosa and submucosa, increased fibroblast and collagen in the induced oral mucositis in golden hamsters undergoing 5-FU consumption.

Highlights

  • Head and neck cancer is the sixth leading cancer by incidence worldwide and eighth by death [1]

  • Histopathological Assessment Histopathological changes according to the determined scores showed that the peak inflammation of Oral mucositis (OM) happened on the 12th day, and the treatment was initiated on this day

  • Epithelialization and wound healing were detected in the eucalyptus-treated group whereas extensive infiltration of inflammatory cells, hemorrhage, and ulcers were observed in the control and gel-based groups

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Summary

Introduction

Head and neck cancer is the sixth leading cancer by incidence worldwide and eighth by death [1]. Radiation, and chemotherapy are the mainstays of treatment for most head and neck cancers and remain the standard of care in most cases. Oral mucositis (OM) is a frequent complication of treatments with radiotherapy or chemotherapy. Pain and loss of taste perception can cause difficulty in swallowing, speaking, and receiving nutrition, which can lead to weakness, low quality of life, and higher treatment costs [2]. Cascade production of free radicals, which cause oxidative stress and reactive oxygen species, is the initial oral mucosal layer and blood vessel injuries. Apoptotic changes appear in the form of mucositis in early radiotherapy or chemotherapy [3]

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