Development Of Mucositis Research Articles

Evaluation of the Incidence and Stage of Oral Mucositis in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Study.

This study aims to retrospectively evaluate the incidence and stage of oral mucositis in patients undergoing hematopoietic stem cell transplantation. A total of 102 patient records of patients hospitalized between 2014 and 2019 in the adult hematopoietic stem cell transplantation clinic of a tertiary university hospital in Turkey were evaluated. Data were collected through a retrospective evaluation of patient records. Records made according to the WHO Oral Toxicity Scale included in the patient records during hospitalization in the adult hematopoietic stem cell transplantation clinic were evaluated. Oral mucositis data from recordings were analyzed at baseline, and on days 5, 10, 15, and 30). 96.1% (n=98) of 102 patients developed oral mucositis; only 10.7% had Grade 3, and 2.7% had Grade 4. Oral mucositis development time was 8.28 ± 0.32 days, and recovery time was 14.25 ± 0.78 days. It was determined that smoking, diagnosis, transplantation type, and preparatory regimen affected the oral mucositis healing process. While the incidence of oral mucositis in patients undergoing hematopoietic stem cell transplantation in our study was similar to be similar with the reported findings in the literature, the proportions of Grade 3 and 4 oral mucositis were lower in our study.

Photobiomodulation Therapy in the Prevention of Chemotherapy Induced Oral Mucositis in Children with Acute Myeloid Leukemia: A Randomized, Double-blind, Clinical trial.

Many preventive modalities have been advocated to reduce the incidence and severity of chemotherapy-induced Oral Mucositis (OM). Photobiomodulation, also known as Low-Level laser. Therapy, has shown promising results. This clinical trial was performed to evaluate the effectiveness of Photobiomodulation (PBM) for the prevention of chemotherapy-induced oral mucositis (OM) in children with Acute Myeloid Leukemia (AML). A double-blinded randomized clinical trial was performed, including forty-two children diagnosed with Acute Myeloid Leukemia (AML) admitted to receiving chemotherapy (CT) at Children's Cancer Hospital 57357, Cairo, Egypt. Patients were randomly assigned to either the control or test group. Both groups followed the standard preventive protocol for oral mucositis. In the control group I sham therapy, while in the Laser group I had Photobiomodulation sessions for five consecutive days once a day performed by Diode laser (Sirrolaser Blue ™, USA) 660nm, 15watt, 10 s. Laser sessions began on day 1 of chemotherapy and were repeated on days 2,3, 4, and 5. The response to both groups was evaluated according to the development of oral mucositis; graded using the classification criteria of the World Health Organization (WHO) and the National Cancer Institute scale (NCI - Common Terminology Criteria for Adverse Events, version 4.0). Incidence of oral mucositis was evaluated from baseline to 5, 12, 19, and 30 days after treatment. A clinical significant difference between the laser and control group was observed. The laser group showed a higher prevalence of no oral mucositis with decreased incidence of OM, while on day 12, the control group showed a higher prevalence of grades I and II (P-value <0.001, effect size = 0.796). However, the laser group showed higher prevalence of mucosa free of OM; on day 19, the control group showed higher rates of grades II and III, (P-value <0.001, effect size = 0.670). while on day 30 there was higher rates of grades I and II (P-value <0.001, effect size = 0.576) with higher rates of healthy oral mucosa in the laser group. Photobiomodulation effectively reduces the incidence and severity of chemotherapy-induced oral mucositis in pediatric patients diagnosed with AML.

Efficacy of Mucosamin Spray as an Adjunct for Prevention of Oral Mucositis in Children under Chemotherapy: A Two-Center Randomized Clinical Trial.

Chemotherapy-induced mucositis is the most common complication during cancer treatment. This complication can lead to pain, increased risk of infection and malnutrition. Therefore, it is important to find a solution to reduce the severity and duration of side effects. This study aimed to assess the efficacy of Mucosamin spray as an adjunct for prevention of oral mucositis in children under chemotherapy. This parallel-design clinical trial evaluated 48 patients aged 5 to 15 years with leukemia and lymphoma presenting to the Hematology Department of Mofid and Mahak Hospitals. The patients were randomly divided into two groups (n=24). Before starting chemotherapy, all patients received oral hygiene instructions (toothbrushing without flossing). Patients in both groups were requested to use a mouthwash composed of nystatin, aluminum-magnesium hydroxide suspension (aluminum MgS), and diphenhydramine for 1 min every morning on a daily basis starting the day before treatment. Patients in the intervention group were also requested to spray their entire oral mucosa with Mucosamin spray 3 times a day in addition to using the mouthwash. Patients were requested to refrain from eating and drinking for 1h after spraying. The patients were clinically examined by a senior dental student once every other day for 20 days regarding the occurrence, severity, and duration of oral mucositis. Data were analyzed using the Chi-square and Mann-Whitney tests, Kaplan-Meier survival analysis, and log rank test. No significant difference was noted between the two groups in the incidence, severity, or time of development of mucositis (p> 0.05). The 7-day non-recovery percentage was 72.7% (SE= 13.4) and 25.0% (SE= 15.3) in the control and test groups, respectively, indicating shorter duration (faster healing) of mucositis in the intervention group (p= 0.01). Within the limitations of this study, it seems that prophylactic application of Mucosamin spray can shorten the course of oral mucositis, in case of its occurrence.

RIP3 regulates doxorubicin-induced intestinal mucositis via FUT2-mediated α-1,2-fucosylation.

Intestinal mucositis is one of the common side effects of anti-cancer chemotherapy. However, the molecular mechanisms involved in mucositis development remain incompletely understood. In this study, we investigated the function of receptor-interacting protein kinase 3 (RIP3/RIPK3) in regulating doxorubicin-induced intestinal mucositis and its potential mechanisms. Intestinal mucositis animal models were induced in mice for in vivo studies. Rat intestinal cell line IEC-6 was used for in vitro studies. RNA‑seq was used to explore the transcriptomic changes in doxorubicin-induced intestinal mucositis. Intact glycopeptide characterization using mass spectrometry was applied to identify α-1,2-fucosylated proteins associated with mucositis. Doxorubicin treatment increased RIP3 expression in the intestine and caused severe intestinal mucositis in the mice, depletion of RIP3 abolished doxorubicin-induced intestinal mucositis. RIP3-mediated doxorubicin-induced mucositis did not depend on mixed lineage kinase domain-like (MLKL) but on α-1,2-fucosyltransferase 2 (FUT2)-catalyzed α-1,2-fucosylation on inflammation-related proteins. Deficiency of MLKL did not affect intestinal mucositis, whereas inhibition of α-1,2-fucosylation by 2-deoxy-D-galactose (2dGal) profoundly attenuated doxorubicin-induced inflammation and mucositis. RIP3-FUT2 pathway is a central node in doxorubicin-induced intestinal mucositis. Targeting intestinal RIP3 and/or FUT2-mediated α-1,2-fucosylation may provide potential targets for preventing chemotherapy-induced intestinal mucositis.

Nuclear Receptors and Stress Response Pathways Associated with the Development of Oral Mucositis Induced by Antineoplastic Agents.

Oral mucositis (OM) is one of the common adverse events associated with cancer treatment that decreases the quality of life and affects treatment outcomes. However, the medications used to manage OM are generally only palliative, and our knowledge of the syndrome is limited. The etiology of the syndrome is thought to be complex and multifactorial. We investigated the trends and characteristics of OM and estimated molecular initiating events (MIEs) associated with the development of the syndrome using the FDA Adverse Event Reporting System. The study of trends and characteristics suggested that OM is significantly more likely to occur in females and nonelderly patients and is likely to be induced by protein kinase inhibitors such as afatinib and everolimus. Next, we used Toxicity Predictor, an in-house quantitative structure-activity relationship system, to estimate OM-associated MIEs. The results revealed that the agonist activity of the human pregnane X receptor, thyroid-stimulating hormone-releasing hormone receptor, and androgen receptor may be associated with OM development. Our study findings are expected to help avoid the risk of OM induction during the drug discovery process and clinical use of antineoplastic agents.

Evaluation of oral mucositis level and affecting factors in cancer patients receiving chemotherapy.

This study aimed to evaluate the severity of oral mucositis and the contributing factors among cancer patients undergoing chemotherapy. This study was planned cross-sectional. The study was conducted at a medical oncology clinic between January and July 2022. The sample consisted of 245 patients with cancer receiving chemotherapy. Data were collected using a personal, oral health and disease-related characteristics questionnaire and the World Health Organization Oral Mucositis Assessment Scale by researchers. Intraoral examination of the patients was carried out by researchers. The data were analyzed by independent-sample t-tests, Chi-square tests, paired-sample t-tests, and multivariate logistic regression (p < 0,05). The patients had mean age 62.31 ± 10.70. Patients of 32.7% were with lung cancer. 52%of the patients (n = 128) receiving chemotherapy developed oral mucositis. The independent variables the presence chronic disease(OR:1.85), chemotherapy protocol (OR:3.52) and the dependent variables ECOG performance score (OR:2.25) were variable that affected the development of oral mucositis (p < 0.05). Patients of 35.5% were oral mucositis score of 1. Patients those who had breast cancer, who received doxorubicin or cyclophosphamide chemotherapy protocols, and who had previously developed oral mucositis were found to have a higher rate of oral mucositis (p < 0.05). In addition, oral mucositis was more prevalent in patients with chronic diseases other than cancer (57%), those who used medication continuously (57.2%), those with oral and dental diseases (56.9%), those who had dental check-ups before cancer treatment (79.2%), and those who had information about oral mucositis(70.2%) (p < 0.05). In conclusion, nearly half of the patients (52%, n = 128) receiving chemotherapy developed oral mucositis and of all patients of 35.5% had an oral mucositis score of 1 in the second round of chemotherapy. Patients those who had breast cancer, who received doxorubicin or cyclophosphamide chemotherapy protocols, and who had previously developed oral mucositis were found to have a higher rate of oral mucositis.

The Effect of Oral Care Protocols on Mucositis in Pediatric Cancer Patients: A Randomized Controlled Trial

Background/Aims: Standard oral care protocols can reduce the incidence of mucositis. This study aimed to evaluate the effect of the "Oral Care Protocol" containing sodium bicarbonate or saline on mucositis development, degree, and duration in pediatric cancer patients. Methods: This study is a blind, parallel trial design, randomized controlled study. Patients (n = 43) who received inpatient chemotherapy treatment for more than three days at the Pediatric Hematology and Oncology Unit were included. The oral care protocol with saline was given to the patients in the control group (n = 22), and the oral care protocol with sodium bicarbonate was given to the patients in the study group (n = 21). The primary outcome was the development of mucositis. The secondary outcomes were mucositis degree, patient data at the time of mucositis development, and the duration of mucositis. The characteristics of the patients in the study and control groups and the data of patients with and without mucositis were compared with Fisher's exact test, t-test, and chi-square analysis. Results: No statistically significant difference was found between the study and control groups in terms of mean age, gender, diagnosis, relapse status, treatment stage, risk group, and treatment protocols. Mucositis developed in 18.2% of the patients in the control group and 9.5% of the patients in the study group. No statistically significant difference was found in terms of mucositis development, degree, and duration. Conclusions: The oral care protocol with sodium bicarbonate can be used to prevent mucositis in pediatric cancer patients. ClinicalTrials.gov Identifier: NCTXXX.

The Effect of Gastrointestinal Mucositis Care Training Given to Pediatric Leukemic Patients and Caregivers on Mucosal Barrier Injury

Background Management of chemotherapy-induced mucosal barrier damage and oral/anal mucositis in leukemia is challenging. Objective The aim of this study was to investigate the effect of mucositis care training given to children receiving leukemia treatment and their caregivers on caregiver knowledge and skills, the development of gastrointestinal mucositis in children, the mean oral mucositis area in children, and the mucosal barrier injury laboratory-confirmed bloodstream infection in the clinic. Methods A stepped-wedge, quasi-experimental, unpaired control group design was used. The participants in the control group were given routine training, and the intervention group members were given mucositis care training in accordance with the guideline recommendations. Results No significant difference was found between groups in developing anal mucositis, but a significant difference in developing oral mucositis was documented, with the mean mucositis area of children being 8.36 ± 3.97 cm2 in the control group and 4.66 ± 2.90 cm2 in the intervention group. The mucosal barrier injury laboratory-confirmed bloodstream infection ratio was 4 per 1000 catheter days in the control group and 3 per 1000 catheter days in the intervention group. Conclusion Mucositis care training had a significant positive effect on caregivers’ knowledge and skills, the development of oral mucositis, and the mean oral mucositis area in children. However, the training had no effect on the development of anal mucositis or the infection rate in the clinic. Implications for Practice Nurses might increase the knowledge and skill levels of caregivers with training on mucositis care, prevent the development of mucositis, and reduce the mean mucositis area. Training might also contribute to the reduction in the infection rate of the clinic.

The predictive value of hematological inflammatory markers for severe oral mucositis in patients with nasopharyngeal carcinoma during intensity-modulated radiation therapy: A retrospective cohort study

BackgroundThis study aims to investigate the predictive value of the circulating blood cell count, including neutro-philto-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and thesystemic inflammation index (SII) for the development of severe oral mucositis (SOM) induced by radiation in patients undergoing radiotherapy for nasopharyngeal carcinoma (NPC). MethodsIn this retrospective study, 142 NPC patients were screened, and based on mucositis toxicity grade, they were categorized into two groups: SOM and nonSOM. Peripheral blood cell counts were conducted prior to Intensity-Modulated Radiation Therapy (IMRT). Associations between blood cell count, NLR, PLR, SII, and SOM occurrence were examined. ResultsRevealed elevated NLR and SII levels, along with reduced lymphocyte (LYM), eosinophil (EOS), and basophil (BAS) in patients with SOM. LYM, EOS, BAS, NLR, and SII were effective predictors of the severity of radiation-induced oral mucositis (RIOM) in NPC patients. ConclusionsThe occurrence of SOM was strongly linked to the hematological status at the start of Radiation Therapy (RT). Integrating BAS count and NLR into comprehensive risk prediction models could prove valuable for predicting SOM in NPC patients.

Development of an Ex Vivo Functional Assay for Prediction of Irradiation Related Toxicity in Healthy Oral Mucosa Tissue.

Radiotherapy in the head-and-neck area is one of the main curative treatment options. However, this comes at the cost of varying levels of normal tissue toxicity, affecting up to 80% of patients. Mucositis can cause pain, weight loss and treatment delays, leading to worse outcomes and a decreased quality of life. Therefore, there is an urgent need for an approach to predicting normal mucosal responses in patients prior to treatment. We here describe an assay to detect irradiation responses in healthy oral mucosa tissue. Mucosa specimens from the oral cavity were obtained after surgical resection, cut into thin slices, irradiated and cultured for three days. Seven samples were irradiated with X-ray, and three additional samples were irradiated with both X-ray and protons. Healthy oral mucosa tissue slices maintained normal morphology and viability for three days. We measured a dose-dependent response to X-ray irradiation and compared X-ray and proton irradiation in the same mucosa sample using standardized automated image analysis. Furthermore, increased levels of inflammation-inducing factors-major drivers of mucositis development-could be detected after irradiation. This model can be utilized for investigating mechanistic aspects of mucositis development and can be developed into an assay to predict radiation-induced toxicity in normal mucosa.

Results of the study of factors predicting the risk of the development of grade III radiation-induced mucositis during radiation or chemoradiation therapy in patients with oral cavity and oropharynx cancer.

Today, a number of methods and ways of prevention and treatment of radiation- -induced mucositis of the oral cavity and oropharynx have been developed, but the represented approaches are still not effective enough. Therefore, to increase the effectiveness of the prevention and treatment of radiation-induced mucositis, it is necessary to approach this problem comprehensively and individually, and to evaluate the factors affecting the development of mucositis. In this single-center prospective controlled non-randomized clinical trial, the results of clinical observation of the development of complications of radiation and chemoradiation therapy in 105 patients with a newly diagnosed squamous cell cancer of the oral cavity and oropharynx were analyzed. Factors affecting the risk of the development of grade III radiation-induced mucositis including the age, gender of the patients, their general condition before the treatment according to World Health Organisation scales, type of the treatment and its doses, additional use of immunotherapy with alpha/beta defensins, characteristic signs of the tumor process and all indices of the immune status of the patients before the treatment have been analyzed. The method of construction and analysis of one-factor logistic regression models, where 24 indices were analyzed as factorial features, showed that the reduction of the risk of the development of grade III radiation-induced mucositis is predicted by several factors: immunotherapy, gender, serum concentrations of IgG and IgA. A decrease (P &lt; 0.001) in the risk of the development of grade III radiation-induced mucositis was revealed if immunotherapy with alpha/beta defensins (with a total dose of 40 mg) was included into the treatment scheme (relative odds (RO) 0.05; 95% reference interval (RI) 0.02-0.18), in comparison with patients of the groups where it was not present or this immune agent was used in a total dose of 60 mg (P = 0.001, RO 0.06; 95% RI 0.01-0.30). The next factorial sign was gender, namely the risk of the development of grade III radiation-induced mucositis was lower for men (P = 0.003; RO 0.15; 95% RI 0.04-0.53) compared to women. An increase (P = 0.024) in the risk of the development of grade III radiation-induced mucositis with an increase in the initial level of IgG serum concentration was revealed, (RO 1.08; 95% RI 1.01-1.16) for each 1 mg/mL, as well as an increase (P = 0.044) in the possibility of the appearance of grade III radiation-induced mucositis with an increase in the serum concentration of IgA (RO 1.23; 95% RI 1.01-1.50) for every 1 mg/mL also before the beginning of the treatment. Multifactorial analysis has also confirmed that the risk of the development of grade III radiation-induced mucositis increases (P = 0.008) with a high serum IgG concentration before the treatment or with an increase in this index during therapy (RO 1.13; 95% RI 1.03-1.09) for every 1 mg/mL (when standardized by other risk factors). It was determined that when standardizing according to other factors (gender, IgG level), the risk of the development of grade III radiation-induced mucositis in the use of the immune agent alpha/beta defensins in a total dose of 40 mg per course decreases (P &lt; 0.001; RO 0.08; 95% RI 0.02-0.27) compared to patients with oral cavity and oropharynx cancer who were not treated with immunotherapy. The risk of the development of grade III radiation-induced mucositis also decreases (P = 0.001) in the use of immunotherapy in a higher dose, i.e. 60 mg per course (RO 0.03; 95% RI 0.004-0.24 compared to patients whose treatment did not include immunotherapy (when standardized by other factors). As a result of this controlled clinical study, some factors were determined in addition to the radiation as those affecting the risk of the development of grade III radiation-induced mucositis in patients with oral cavity and oropharynx cancer during special treatment. These factors comprise the inclusion of immunotherapy with alpha/beta defensins into the specific treatment; gender, and baseline levels of serum IgG and IgA concentrations suggest a pattern in which the higher the serum IgG and IgA concentrations are before the start of the treatment, the greater is the likelihood of severe radiation-induced mucositis degree during special therapy. The results of the study of humoral state of the immune system in patients with oral cavity and oropharynx cancer before the beginning of chemoradiation therapy can be used as prognostic risk factors for the development of severe gamma-irradiation-induced mucositis of the oropharyngeal area, as well as an indication for the use of immunotherapeutic agents (in particular, alpha/beta defensins) that are able to polarize the immune response towards type 1 T-helpers through their immunomodulatory action.

Endoplasmic reticulum stress in the pathogenesis of chemotherapy-induced mucositis: Physiological mechanisms and therapeutic implications.

Chemotherapy is a common and effective treatment for cancer, but these drugs are also associated with significant side effects affecting patients' well-being. One such debilitating side effect is mucositis, characterized by inflammation, ulcerations, and altered physiological functions of the gastrointestinal (GI) tract's mucosal lining. Understanding the mechanisms of chemotherapy-induced intestinal mucositis (CIM) is crucial for developing effective preventive measures and supportive care. Chemotherapeutics not only target cancer cells but also rapidly dividing cells in the GI tract. These drugs disrupt endoplasmic reticulum (ER) homeostasis, leading to ER-stress and activation of the unfolded protein response (UPR) in various intestinal epithelial cell types. The UPR triggers signaling pathways that exacerbate tissue inflammation and damage, influence the differentiation and fate of intestinal epithelial cells, and compromise the integrity of the intestinal mucosal barrier. These factors contribute significantly to mucositis development and progression. In this review, we aim to give an in-depth overview of the role of ER-stress in mucositis and its impact on GI function. This will provide valuable insights into the underlying mechanisms and highlighting potential therapeutic interventions that could improve treatment-outcomes and the quality of life of cancer patients.

Effect of Photobiomodulation on Salivary Cytokines in Head and Neck Cancer Patients with Oral Mucositis: A Systematic Review.

Background: Oral mucositis is a common and distressing side effect of head and neck oncology treatment. Photobiomodulation therapy can be utilized to prevent and treat oral mucositis. Its impact on salivary cytokines has yet to be thoroughly investigated. This is the first systematic review aiming to evaluate the effect of photobiomodulation on salivary cytokines in patients undergoing anticancer treatment. Methods: Numerous data resources, from the Web of Science, Embase, ScienceDirect, PubMed, Cochrane Library, and Scopus were sought. Articles published up until February 2024 were included if they met the following inclusion criteria: clinical trials reporting the effect on salivary cytokines in patients undergoing anticancer therapy. The methodological quality was assessed using several appraisal tools. Results: Four studies were deemed eligible for inclusion. All the studies were conducted in Brazil and used an InGaAlP diode laser with a wavelength of 660 nm. The included studies had a relatively low risk of bias. The head and neck cancer patients' salivary cytokines that were assessed by the studies, along with photobiomodulation therapy, included IL-12p70, TNF-α, IL-6, IL-8, IL-10, CXCL8, and IL-1β. The results varied among the studies. Conclusions: Our results show that photobiomodulation demonstrated positive results for reducing the severity of OM in all the included studies. Among the examined salivary cytokines, IL-6 is the most relevant cytokine for oral mucositis development and severity. A variation in the cytokine levels between the studies was noted due to differences in the type of anticancer treatment and saliva sampling.

The relevance of dental management prior to radiation therapy with severe oral mucositis in head and neck cancer patients

Background/purposeDental management prior to radiotherapy is often time-critical, and there are no studies on whether manipulations such as tooth extraction influence the risk of severe radiation-induced oral mucositis (ROM) during radiotherapy. Therefore, the aim of this study was to describe the relationship between dental management and the incidence of severe ROM. Materials and methodsA retrospective analysis was conducted on 144 head and neck cancer (HNC) patients who received dental management before radiotherapy at Peking University Cancer Hospital, from January 2016 to December 2017. Demographic characteristics, primary tumor features, cancer treatment characteristics, and severity of oral mucositis during radiotherapy were recorded. Univariate analysis and logistic regression analysis were used to explore factors associated with severe radiation-induced oral mucositis. ResultsThe incidence of grade 3 mucositis was 14.5% (22/144); univariate analysis showed that the number of extracted teeth (OR = 1.313; 95%CI = 1.012–1.702; P = 0.040) and patients with primary oral cancer had a higher risk of developing grade 3 mucositis (OR = 3.848; 95% CI = 1.508–9.822; P = 0.005). No statistical correlation was found between pre-radiation therapy prophylaxis, dental restoration, endodontic treatment, and grade 3 mucositis (P > 0.05). Logistic regression analysis showed that the number of extracted teeth (OR = 1.421, 95%CI = 1.071–1.885, P = 0.015) and primary tumor location in the oral cavity (compared with other head and neck cancers) (OR = 5.165, 95%CI = 1.636–16.311, P = 0.005) were significantly associated with grade 3 mucositis. ConclusionIn HNC patients undergoing radiotherapy, the primary site located in the oral cavity and a higher number of teeth extracted are independent risk factors for the development of severe mucositis.

EFFECT OF KECEMCEM (Spondias pinnata) EXTRACT ON ANGIOGENESIS OF GINGIVA AFTER CURETASE OF WISTAR RATS

Background: Curettage procedure cause wounds that require adjuvant therapy. One of adjuvant therapies used is hyaluronic acid. However, recently, several studies have focused on antioxidant and anti-inflammatory properties of various natural products such as the bark of kecemcem tree (Spondias pinnata) which has protective effect against oxidative and inflammatory changes occurs during development of mucositis. Based on this, researchers were interested examining effect of giving kecemcem bark extract on formation of new blood vessels (angiogenesis) in gingiva after curettage. Materials and Methods: Wistar rats were divided into 3 groups, negative control, positive control, and treatment group. Previously, rats had induced periodontal pockets by tying silk threads on mandibular incisors and after that they were curettage using a gracey curette. Negative control group was given CMC-Na, positive control group was given hyaluronic acid and treatment group was given 70% kecemcem bark extract gel. Rats were sacrificed on day 3, 5 and 7 and then histological preparations were made. Results and discussion: Average number of new blood vessels in the treatment group was higher than control group and positive control with two-way ANOVA test showed that average number of new blood vessels in each group had significant difference (p&lt;0.05). This supports hypothesis that compounds found in the bark of the kecemcem tree such as beta-sitosterol, phenols, and flavonoids have effect on increasing angiogenesis in gingival wounds after curettage of Wistar rats. Conclusion: 70% kecemcem bark extract gel has effect on increasing angiogenesis in gingival wounds after curettage of Wistar rats.

Возможности применения энтеропротективной комбинации VERIS (пектин + инулин) + СЭР (солевой энтеральный раствор) для коррекции нарушения функции кишечника на фоне полихимиотерапии

Treatment of patients with oncopathology may be accompanied by a large number of adverse reactions, the most common symptoms of damage to the gastrointestinal tract (GIT) as development of mucositis. This condition significantly complicates the treatment of such patients due to an increase in the duration of hospitalization, the need to interrupt the course of chemotherapy, the need for additional nutritional support, symptomatic drug therapy and a significant deterioration in the quality of life. The presented clinical case demonstrates the possibility of using an enteroprotective combination of SES (saline enteral solution) + VERIS (Pectin+Inulin) as an additional therapy in order to reduce the severity of mucosal lesions Gastrointestinal tract on the background of chemoradiotherapy.

Comprehensive analysis of the elemental composition and surface relief of titanium abutments from contemporary manufactures

Relevance. The transgingival part of the prosthetic components of implant systems is a substrate for the primary adaptation of soft tissues and the formation of the gingiva collar - a complex of tissues acting as a biological barrier and ensuring the normal functioning of artificial supports in the microenvironment of the oral cavity. At the same time, the morphology of the surface of the abutment which will be in constant contact with the gingiva part during the loading period is of great importance. A change in the properties of the surface morphology of the transgingival part of orthopedic structures is fraught with the formation of a microbial bio-film in the subgingival zone with the with the subsequent development of mucositis and peri-implantitis. Based on the above, the study of the surface characteristics of orthopedic components of implantation systems seems relevant in the light of understanding the pathogenesis of inflammatory processes and assessing risk factors for the development of complications of dental implantation.Purpose. Study of differences in the elemental composition and features (or characteristics) of the surface morphology of orthopedic components - transgingival implant abutments from a number of modern manufacturers.Materials and methods. Prosthetic components from five manufacturing companies were selected for the study. For the assessment, elemental analysis of the surface of the components was used using a Hitachi S-3400N scanning electron microscope with an Oxford Instruments X-Max20 energy dispersive spectrometer, as well as morphological analysis using a TESCAN VEGA 3 scanning electron microscope. The samples were assessed for surface uniformity, the presence of inclusions, cracks and marks.Results. The study revealed significant differences in the components both in elemental composition and surface topography. The results obtained can be summarized in the form of a table.Conclusion. The method of comprehensive surface assessment used in the study can be recommended for describing and comparing orthopedic components from different manufacturing companies.

Hypomagnesemia May Predict Better Survival and Reduced Nonrelapse Mortality in Allogeneic Hematopoietic Stem Cell Transplantation Recipients

Magnesium (Mg) is an essential element that is required as a cofactor for many cellular reactions, including immunologic pathways. The aim of this study was to investigate the potential impact of serum Mg levels on allogeneic hematopoietic stem cell transplantation (alloHSCT) outcomes. Medical records of 340 alloHSCT recipients (median age: 45 [18-71] years; M/F: 210/130) were reviewed for this retrospective study. Serum Mg levels on days -28, -7, 0, +7, +14, +21, +30, +60, and +90 were included in the analysis. Serum Mg+14 levels predicted nonrelapse mortality (NRM) (P = .025) and had a significant impact on the development of mucositis (P = .027), fungal infection (P = .006), engraftment syndrome (P < .001), sinusoidal obstruction syndrome (SOS) (P = .001), cytomegalovirus (CMV) reactivation (P = .039), and acute graft vs host disease (GvHD) (P < .001). Based on the optimal threshold of serum Mg+14 level (1.33 mg/dL; area under the curve: 0.581 [0.515-0.648]; P = .018), the study group was divided into 2 subgroups as low- and high-Mg+14. The incidence of acute GvHD (P = .002), SOS (P = .013), engraftment syndrome (P = .013), CMV reactivation (P = .001), and Epstein Barr virus reactivation (P = .005) was significantly lower in low-Mg+14 group. The probability of overall survival (OS) was significantly better (P = .002), whereas NRM was lower in the low-Mg+14 group (P = .001). Hypomagnesemia seems to provide a considerable advantage for the post-transplant outcome, which may confirm its potential role in the immunologic microenvironment and adaptive immunity.

The role of oral microbiota in the development of oral mucositis in pediatric oncology patients treated with antineoplastic drugs: a systematic review

BackgroundIn the pediatric oncology population, oral mucositis as a consequence of chemotherapy is a highly prevalent complication which strongly affects both the quality of life and treatment possibilities of the patients. Still, the etiopathological mechanisms carrying to its development are not fully understood, although a possible role of oral dysbiosis has been previously investigated with unclear conclusions. The aim of this systematic review was to assess the available evidence on the role of microbiota in the development of oral mucositis.MethodsA systematic literature search was performed following PRISMA guidelines. Three electronic databases were searched up until April 2023 and a following manual search included the reference lists of the included studies and reviews. Studies reporting microbiological and clinical data of pediatric patients treated by antineoplastic drugs were included.ResultsThirteen studies met the inclusion criteria, reporting an average mucositis prevalence of 57,6%. Candida albicans infections were frequently observed in studies performing microbiological analysis on oral lesions, in contrast with the low rate detection of the Herpes simplex viruses. Bacterial species such as coagulase-negative Staphylococci and Streptococcus viridans were detected more frequently on lesion sites. Studies reporting a quantitative analysis of the general flora did not show comparable results. Risk of bias assessment among studies was generally considered high or very high.ConclusionsWhile the specific role of certain microbiological agents, such as Candida albicans, was frequently reported among studies, data regarding the general dynamics of oral microbiota in the development of oral mucositis are lacking in the current literature. Thus, more studies are needed to provide the knowledge required in order to improve protocols for the prevention and treatment of this threatening complication.

The Effect of Dental Implants on Secretory Iga Level in Saliva

Background and aims: The host immune response is altered by a series of physiological and pathological factors such as age, gender, inflammation, surgery, and medications. This study was conducted to evaluate differences in salivary IgA (S-IgA) levels in individuals who underwent dental implant surgery and compare them to individuals who were not exposed to dental treatments. S-IgA levels were determined at least 3 months after implant installation. Methods: A total of 60 healthy individuals were included in the study; 30 participants received implant treatment (Implant Group) and were compared with 30 participants with no implant treatment as controls (Control Group). 1.5 ml of unstimulated saliva was obtained for all participants. The quantitative enzyme-linked immunosorbent assay (ELISA) technique was used for the measurement of salivary IgA levels. Results: The age range of the participants in the implant group was 38-62 years, with a mean age of 47.9 years; 18 (60%) were males and 12 (40%) were females. The age range of the study's controls was 38-59 years, with a mean age ± SD of 45.2 ± 5.2 years for 18 (60%) males and 12 (40%) females. The mean number of implants was 2.7 ± 0.83, and the mean period after implant placement was 19.2 ± 8.2 months. A low sIgA level (&lt; 250 μg/mL) was present in 10% of implant patients, but not in any cases in the control group. In contrast, only 6.7% of implant patients had this amount at a level greater than 351 μg/mL, compared to 53.3% in the control group. The mean ± SD for cases was 302.7 ± 36.8 g/mL versus 370.8 ± 59.2 μg/mL for controls, indicating that all normal distribution values were significantly lower in the implant patient group compared to higher values in healthy controls. Males had higher normal values across the board in both groups (cases and controls). Male dental implant patients' mean and standard deviation (312.2 ± 38.3 vs. 408.2 ± 42.2 µg/ml) showed a statistically significant decrease. Female dental implant patients' mean and standard deviation (287.3 30.6 vs. 314.7 ± 27.6 µg/ml) showed a statistically significant decrease. Overall, there was a significant decrease in the mean ±SD of dental implant patients (302.7 ± 36.8 µg/ml) versus the rising level in the total healthy control group (370.8 ± 36.8 µg/ml). The observed averages of sIgA for the presence of peri-implant mucositis in the two independent samples (yes, no) differed significantly by 60.7, with a 95% confidence interval of 41.1-80.3, and this finding is very significant (p&lt;0.0001). Conclusion: Salivary immunoglobulin A level values were significantly lower statistically in implant patients compared to the control group. The results, however, showed that there is a connection between lower sIgA levels in saliva and the development of pre-implant mucositis, meaning that low sIgA levels are risk factors for peri-implant mucositis or that peri-implant mucositis causes lower sIgA levels to be produced in mouth saliva.