The Quest for Effective Treatments of Mucositis

Abstract

egimen-related mucosal toxicity (mucosi-tis) is a largely unsolved medical need as-sociated with cancer treatment. Despite itslong history, patients continue to suffer and cli-nicians are frustrated by the diffuse, painful ul-cerative lesions of the mouth, esophagus, intes-tine, and rectal mucosa that are commonlyinduced by a range of chemotherapeutics andradiation therapies and which largely defy effec-tive intervention. This review by Bowen andcolleagues largely captures the past and currentroles animal modeling plays in regard to ourunderstanding of mucositis and the quest for ef-fective treatments.Until the late 1990s the biological complexityof mucositis was underappreciated. Prior to thattime, the condition was considered to be solelythe consequence of nonspecific direct damage torapidly dividing epithelial “stem” cells. Anythoughts of intervention were focused on pallia-tion or modifying proliferating normal cells. At-tempts to better understand the pathogenesiswere largely limited to the use of cadaveric ma-terial.