Abstract
Objectives: High doses of chemotherapy generate DNA damage in patients undergoing bone marrow transplantation (BMT), due to the production of reactive oxygen species (ROS). In order to evaluate the local defensive effectiveness of the patient undergoing BMT, the concentrations of the antioxidants superoxide dismutase (SOD) and uric acid (UA) were measured in saliva. Study Design: Basal saliva samples were collected from 20 patients undergoing BMT at the Oncology Department, Sanatorio Allende (Córdoba), in the stages: initial, prior to conditioning therapy (I); middle: 7 to 10 days after BMT (M) and final stage, 30 days after discharge from isolation (F). SOD levels were determined using a RANDOX kit (RANSOD superoxide dismutase manual), and for uric acid enzymatic UOD / PAP spectrophotometric method, ( Trinder Color Kit , Wiener Lab) was used. Results: 85% of the patients developed oral mucositis. SOD concentration in the M stage was significantly higher (p<0.01) compared with stage I, and it reversed in stage F. UA concentration was significantly lower (p<0.001) in stage M compared with stage I, and in stage F it recovered the initial values. Conclusions: SOD increase in stage M coincided with the appearance of mucositis, which could be interpreted as a defensive mechanism of saliva against oxidative stress produced by chemotherapy. UA decrease in stage M would favour the development of higher degrees of mucositis. Key words:Bone marrow transplantation, mucositis, superoxide dismutase, uric acid.
Highlights
Immunosuppressive and toxic treatments prior to the bone marrow stem cells transplantation (BMT) generate reactive oxygen species (ROS), which damage the DNA of the oral epithelium and submucosa
Immunosuppression induced by chemotherapy during the conditioning period prior to bone marrow transplantation secondarily alters the capacity to respond to antigenic stimuli
Informed consent was obtained from each participant, the study was approved by the Medical Ethics Committee of Sanatorio Allende and it was inscribed in REPIS (Provincial Register of Research on Human Health) under number 1189 (15/04/09). -The following oral health indexes were registered: Plaque index aimed at quantifying plaque deposits in the gingival margin [16]
Summary
Immunosuppressive and toxic treatments prior to the bone marrow stem cells transplantation (BMT) generate reactive oxygen species (ROS), which damage the DNA of the oral epithelium and submucosa. This damage generates clinical and histological alterations in oral mucosa and periodontal tissues, as well as dysfunctions in the salivary glands and changes in saliva [1]. The identification of antioxidants in tissues, blood and saliva provides an idea of the effective local or systemic defensive systems Based on these antecedents, the aim of our work was to evaluate the effective local defense of patients with mucositis undergoing BMT by measuring salivary antioxidants such as SOD and UA
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