Oral Ulcers Research Articles

Patient-reported outcomes in CodeBreaK 200: Sotorasib versus docetaxel for previously treated advanced NSCLC with KRAS G12C mutation

BackgroundIn the CodeBreaK 200 phase III, open-label trial, sotorasib significantly improved efficacy versus docetaxel in previously treated KRAS G12C-mutated advanced non-small cell lung cancer (NSCLC). Patient-reported outcomes (PROs) for global health status, physical functioning, dyspnea, and cough favored sotorasib over docetaxel. Here, we report sotorasib’s additional impact on quality of life (QOL). MethodsIn CodeBreaK 200, 345 patients who had progressed after prior therapy received sotorasib (960 mg orally daily) or docetaxel (75 mg/m2 intravenously every 3 weeks). Validated questionnaires captured patients’ perception of their QOL and symptom burden for key secondary and exploratory PRO endpoints, including the European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30 (EORTC QLQ-C30) and Quality-of-life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13), question GP5 from the Functional Assessment of Cancer Therapy Tool General Form (FACT-G GP5), PRO-Common Terminology Criteria for Adverse Events (PRO-CTCAE), and 5-level EuroQOL-5 dimensions (EQ-5D-5L) including visual analog scale (EQ-5D VAS). Change from baseline to week 12 was assessed with generalized estimating equations for ordinal outcomes. ResultsPatients receiving sotorasib were less bothered by treatment side effects than those receiving docetaxel (odds ratio [OR] 5.7) and experienced symptoms at lower severity (pain: OR 2.9; aching muscles: OR 4.4; aching joints: OR 4.2; mouth or throat sores: OR 4.3). Further, patients’ symptoms interfered less with usual/daily activities (pain: OR 3.2; aching muscles: OR 3.9; aching joints: OR 10.7). QOL remained stable with sotorasib but worsened with docetaxel (change from baseline in EQ-5D VAS score: 1.5 vs –8.4 at cycle 1 day 5 and 2.2 vs –5.8 at week 12). ConclusionsPatients receiving sotorasib reported less severe symptoms than those receiving docetaxel. In addition to improving clinical efficacy outcomes, sotorasib maintained QOL versus docetaxel, suggesting sotorasib may be a more tolerable treatment option for patients with pretreated, KRAS G12C-mutated advanced NSCLC.

Development of a chitosan/propolis-based polymeric system: Characterization, biocompatibility, and modulation of transcription factor expression

Chitosan (CHT) and propolis (P) are natural materials with antiseptic, anti-inflammatory, antimicrobial, and mucoadhesive properties with many applications in orthopaedia dentistry. The objective of this study was to develop a low molecular weight (LMW) and medium molecular weight (MMW) chitosan polymeric system with propolis at different concentrations (0.31%, 0.62%, 1.25%, 2.5%, and 5%) and to evaluate the effect in terms of their cell interaction with dental pulp fibroblasts. FTIR spectra of both molecular weights CHT’s films with propolis show increased transmittance bands at 1730–1720 cm−1 and 1460 cm−1, indicating the presence of propolis ethanolic extract in the organic matrix. Contact angles test to determine hydrophobicity CHT films functionalized with propolis exhibit a more hydrophobic surface as propolis concentration increases. Cytotoxicity showed synergy between chitosan and propolis; the highest proliferation was observed in LMW CHT with 0.31% of propolis. Membranes made with CHT of both molecular weights plus propolis in an inflammatory stage (cells previously treated with LPS) can inhibit the expression of NF-k-B, MAPK, and VEGF. A polymeric system based on chitosan/ethanolic extract propolis could be a future alternative treatment for oral ulcers.

Evaluationof feeding different forms of therapeutic diet on the feed intake, digestibility, feed efficiency, and growth of calves experimentally infected with foot-mouth disease virus.

Oral ulcers induce acute weight loss due to anorexia in foot-and-mouth disease virus (FMDV) infected cattle. We hypothesized that providing a palatable form of a therapeutic diet (TD) in different physical forms would increase the feed intake, digestibility and restoration of body weight. A TD was formulated with 19% CP and 2.9 Mcal ME/kg on dry matter basis. Bull calves of 10-12months with mean body weight of 123 ± 1.3kg were experimentally infected with FMDV (n = 18) and offered one of the following three forms of the TD (n = 6/group) for 6weeks post-FMDV infection (WPI): (i) TD in mash form (TDM) (ii) TD in cooked form (TDC) and (iii) TDC + customised nutrient supplement (TDCNS) such as Zn, Cu, Cr, Mn, and Se. The CNS was fed before the TDC. A group of uninfected control (n = 4) was fed TDM. Green fodder was offered in the afternoon. Dry matter intake (DMI) of TD and green fodder were recorded at 24h interval till WPI 6. Body weight (BW) was recorded at weekly interval. Digestibility trial was conducted at WPI 6. The palatability of the TD was scored from 1- 4 and healing of tongue ulcers was analyzed by Kaplan-Meier survival curve. The results indicated that the physical form of TD increased the total DMI by WPI 3, which was supported by the restoration of BW and higher palatability score. The digestibility of all the proximate principles except EE was significantly higher (P < 0.05) in the groups that were fed TDC. It was concluded that feeding TD irrespective of the physical form, restored the ADG and DMI in the calves by WPI 3. Further, feeding cooked form of TD increased the digestibility in the FMDV infected calves and supplementation of CNS hastened the healing of glossal ulcers.

Dampened inflammatory response in oral ulcer after topical therapy of adipose mesenchymal stem cell secretome

ObjectivesResearch has demonstrated that modulating inflammation can significantly accelerate the healing of oral ulcers. Our study focused on the adipose mesenchymal stem cell secretome (AdMSCS), which is rich in immunoregulatory molecules capable of dampening the immune response and interfering with inflammatory pathways. We assessed both inflammatory pathway expression and macrophage phenotypes at the sites of oral ulcers. MethodsWe induced oral ulcers in the inferior fornix mucosa of 20 healthy male Wistar rats (Rattus norvegicus). These subjects were treated topically with adipose MSC metabolite (AdMSCM) oral gel three times daily, for durations of 3 and 7 days. We performed immunohistochemical analyses to evaluate the expression of Toll-like receptor 4 (TLR4) and nuclear factor kappa B (NF-κB) p65 at the ulcer sites. Additionally, we assessed macrophage polarization by examining the ratio of M2/M1 macrophages, identified through CD68+Φ (M1) and CD163+Φ (M2) cells. Data were analyzed using one-way analysis of variance, followed by post-hoc Tukey's Honestly Significantly Difference test. ResultsApplication of AdMSCM oral gel significantly reduced the expression of TLR4 and NF-κB p65. This treatment also enhanced macrophage polarization towards the anti-inflammatory M2 phenotype at the ulcer sites (p < 0.05). ConclusionThe topical application of AdMSCM oral gel effectively modulates the inflammatory response, enhancing healing processes in the oral ulcer rat model. This suggests its potential utility as a therapeutic agent in managing oral ulcers.

Kaempferia galanga L. alleviates the expression of COX-2 and NF-kappaB-p65 in the oral mucosa ulcer of Wistar rats and exhibits no irritation toward the vascular membrane of chicken eggs and the skin of albino rabbits

The global incidence of recurrent aphthous stomatitis in 2018 reached 5–66 % of the population, while in Indonesia 8 %. Moreover, the prevalence of oral mucosal fibrosis and recurrent aphthous stomatitis among male doctors and nurses in China was 21.24 % and 24.27 %, respectively. Our previous study has shown that the ethanol extract of Kaempferia galanga L. rhizome (EKGR) revealed an accelerated wound-healing effect in the oral mucosa ulcer of Wistar rats. This study aims to explore the effects of EKGR on the expression of NF-kappaB-p65 and COX-2 in the tongue tissue of male Wistar rats by Western blot analysis and immunohistochemistry technique, its safety towards the vascular membrane of the egg chorioallantoic membrane, and its single-dose application on the skin of male rabbits. The rats were randomly assigned into 7 groups: the normal control; the negative control; the positive control (treated with triamcinolone acetonide); and 4 treatment groups of EKGR (0.5 %; 1 %; 2 %; 4 %). Western blot and immunohistochemistry methods were used to measure the expression of NF-kappaB-p65 and COX-2. The hen's egg test-chorioallantoic membrane assay was employed to predict the safety of EKGR towards the vascular membrane. Moreover, the effect of 200 mg/kg BW EKGR application on the dorsal skin of male albino rabbits was also evaluated. EKGR inhibits the expression of NF-kappaB-p65 and COX-2 as proven by WB and IHC results. In the HET-CAM assay, all concentrations of EKGR do not induce irritation responses, which elicits the safety of EKGR. The administration of EKGR causes mild irritation to the dorsal skin of male rabbits but does not induce erythema and edema, no significant changes in BW, no toxic effects on organ macroscopic examination or histopathology, and does not induce abnormalities in the hematological profile of male albino rabbits. EKGR has confirmed its anti-inflammatory activity by suppressing the expression of COX-2 and NF-kappaB-p65 in the oral mucosa ulcer of Wistar rats. EKGR is safe as it does not exhibit irritating potential and harmful effects.

Gastrointestinal Symptoms in Autism Spectrum Disorder: A Case-Control Study.

Background and objectives This study aimed to explore the frequency of gastrointestinal (GI) symptoms and associated risk factors among children with autism spectrum disorder (ASD). Methods This was a retrospective case-control study including children aged 2-14 years diagnosed with ASD by the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria and the assessment card in the ASD center at King Salman Armed Forces Hospital. Data were obtained using a self-developed questionnaire that included demographic features, nutritional and behavioral characteristics, and GI symptoms in the previous six months. The control group consisted of typically developing (TD) children matched to the ASD group for age and gender. Syndromic autism with defined somatic abnormalities and recognized genetic causes (e.g., fragile X syndrome, tuberous sclerosis) were excluded Results A total of 146 ASD children and 114 normal children were included. No significant demographic differences were found between the groups. The ASD group had a higher frequency of low income and a significantly lower rate of exclusive breastfeeding in the first six months. GI symptoms, specifically constipation, abdominal gases and distension, diarrhea, undigested food particles in stool, and mouth ulcers, were significantly more frequent in the ASD group. Weight abnormalities (both increase and decrease) were also more common. Family history of ASD was significantly more in ASD children with GI symptoms while low maternal education was more in those without. Conclusion This study reveals a high prevalence of GI symptoms in ASD children. Family history of ASD and maternal education may influence the GI symptoms reported in ASD children.

Prevalencia de manifestaciones extraintestinales y otras condiciones asociadas en una cohorte de pacientes con enfermedad inflamatoria intestinal de un centro avanzado en Bogotá, Colombia

Introduction and aimsThe prevalence and incidence of inflammatory bowel disease (IBD) has increased significantly in Latin America. Extraintestinal manifestations (EIMs) have elevated morbidity and are poorly characterized in the region. Our aim was to describe the characteristics of EIMs in patients with IBD at the Hospital Universitario Fundación Santa Fe de Bogotá, utilizing the EIM classification proposed by the European Crohn's and Colitis Organisation (ECCO). Materials and methodsA cross-sectional study was conducted based on an institutional database of patients with IBD and the EIM definition used by the ECCO. Prevalence and prevalence ratios (PRs) of the EIMs were calculated. ResultsThe study included 168 patients, 66 of whom were diagnosed with Crohn's disease (CD) and 102 with ulcerative colitis (UC). A total of 30.4% patients had at least one EIM, and the most frequent were oral ulcers (13.7%), arthritis (10.1%), and uveitis/episcleritis (6.5%). There was a greater prevalence of EIMs in CD (31.8% vs 29.40% in UC) and women (32.47% vs 28.57% in men). There was a significant PR between uveitis/episcleritis and arthritis, erythema nodosum and arthritis, and erythema nodosum and other eye diseases. ConclusionsOur study shows a high prevalence of EIMs, surpassing that of previous Colombian studies, with a predominance of CD. Oral manifestations stand out as the most common. Prevalence studies on EIMs in Colombia are needed to establish multidisciplinary specialized centers, improving the quality of life of patients with IBD.

Pulmonary Artery Aneurysm in Behcet’s Disease Manifesting as Haemoptysis: A Case Report and Literature Review

Abstract Pulmonary artery aneurysm (PAA) in Behcet’s disease is a rare yet potentially life-threatening manifestation, often presenting as haemoptysis. We present a case report of a 33-year-old male with recurrent haemoptysis and a history of oral and genital ulcers, diagnosed with Behcet’s disease complicated by PAA. Diagnostic workup, including imaging and laboratory tests, confirmed the diagnosis, leading to prompt initiation of immunosuppressive therapy and meticulous follow-up. The patient showed significant clinical improvement with reduced ulcer severity and no new episodes of haemoptysis during one-year follow-up. Our case underscores the importance of early recognition, multidisciplinary management, and close monitoring to optimize outcomes in Behcet’s disease with pulmonary involvement. A comprehensive literature review further elucidates the clinical nuances, diagnostic challenges, and therapeutic strategies associated with this rare manifestation, highlighting the need for collaborative care and tailored interventions to mitigate complications and improve patient prognosis.

Tingkat Pengetahuan Tentang Vitamin C Di Apotek Al Fayadh Farma 1 Bantul Yogyakarta

Vitamins are substances needed by the body because they have important functions for the body, vitamin C also has a role in the body's metabolic activities. Vitamin C deficiency can cause deficiencies in various diseases, such as mouth ulcers, anemia, dry skin and gingivitis. The aim of this research was to determine the level of knowledge regarding the use of vitamin C at the Al-Fayadh Potorono Pharmacy, Bantul. This research uses descriptive observational methods and uses prospective research methods. The sample used is 110 respondents. Data collection used a closed questionnaire. Data analysis used the Guttman scale where correct answers were given a score of 1 and wrong answers were given a score of 0, and categorized by percentage into 3 categories, namely good 76-100%, sufficient 56-75%, and less &lt;56%. Based on the research results, it shows that the level of patient knowledge regarding the use of vitamin C is in the good category, 67 respondents (61%), sufficient category is 38 respondents (34%),and less than 5 respondents (5%). So it can be concluded that the level of knowledge of patients at the Al Fayadh Farma Pharmacy regarding the use of Vitamin C is good

Destructive Arthritis in Paediatric Behçet’s Disease: A Case Report

Abstract Introduction Behçet’s disease (BD) is a systemic inflammatory disease that affects blood vessels of any calibre and has a relapsing and remitting course. Its main features include recurrent oral and genital ulcers, other skin lesions such as pseudo-folliculitis and erythema nodosum, but also uveitis and arthritis. Arthritis in BD is usually described as mono or oligoarticular, non-erosive, affecting mainly large peripheral joints of lower limbs. In paediatric BD, up to forty percent of patients have articular involvement. We present a rare case of a patient who was diagnosed with mucocutaneous, ocular and articular involvement at the age of 15. He initially received treatment with prednisolone and colchicine. However, at the age of 20, he failed to attend follow-up appointments and discontinued his treatment. At the age of 42, he saw a rheumatologist due to joint complaints associated with functional limitations. The medical assessment confirmed polyarthritis with extensive erosive arthropathy detected on imaging. Conclusions This case report exemplifies a joint involvement rarely found in BD and even less in paediatric BD. We should be aware of this unusual involvement and treat patients accordingly since this condition can occur with a dramatic impact on the patient’s functional prognosis as in other inflammatory rheumatic arthropathies.

Formulation and Evaluation of Polyherbal Gel for Management of Mouth Ulcer

Formulation and Evaluation of Polyherbal Gel for Management of Mouth Ulcer

Treatment of Behçet disease with oral roflumilast, an observational study.

Mucocutaneous Behcet's disease is often a therapeutic challenge. Roflumilast has shown promise in other inflammatory dermatological conditions. The objective of this study is to evaluate the characteristics, effectiveness and safety of roflumilast in the treatment of Behçet's Disease-associated aphthosis in routine clinical practice. Single cohort ambispective observational study. 11 patients with Behçet disease treated with roflumilast participated. Data collection included demographic, clinical and outcome variables. Statistical analysis compared 12 weeks of treatment with roflumilast with a previous period without treatment and with a period with the previous treatment. During treatment with roflumilast, a reduction in flare-ups and oral ulcers was observed compared to the untreated period and the previous treatment period. A reduction in genital ulcers, pain and ulcer duration was observed between the Whitout treatment period and the Roflumilast treatment period.Adverse effects occurred in 54% of patients, most of which were self-limiting or manageable with dose adjustment. No patient withdrew treatment. Roflumilast appears a promising option in the treatment of Behçet's disease with favourable effectiveness, safety and tolerability profiles. Although further research is needed, roflumilast offers a promising treatment option for Behçet's Disease-associated aphthosis, which could improve patients' quality of life and address unmet therapeutic needs.

Assessment of Motivations, Treatment Risks, and Oral Health in Adults with Fixed Orthodontic Care: A Cross-Sectional Study.

Aim: This cross-sectional study aims to investigate the reasons why adults seek orthodontic treatment, their perceived treatment risks, oral hygiene habits, and awareness of oral health. Materials and Methods: This study, which involved 246 adults, used a self-report questionnaire to collect sociodemographic data and examine the participants' understanding of oral health, self-assessment of oral health status, adherence to oral hygiene routines, and use of oral hygiene products. In addition, the reasons for opting for orthodontic treatment, negative associations, and expected outcomes were examined. The collected data were subjected to statistical analysis, including descriptive and regression methods. Results: The results showed that factors such as previous oral health education and regular use of specialized toothbrushes, including rotary toothbrushes, were significantly associated with higher knowledge levels (p < 0.05). However, daily oral hygiene practices were suboptimal, with the low utilization of aids: only 58.9% reported using interdental brushes, and 36.6% used dental floss regularly. Commonly reported dental problems included food debris between teeth (46.3%), tartar (35.4%), and tooth sensitivity to cold (26.4%). The primary motivations for orthodontic treatment were aesthetic improvement (63.8%), enhancements in oral function (49.6%), and addressing psychosocial concerns (42.7%). In contrast, the most frequently mentioned negative aspects associated with fixed orthodontic treatment were aesthetic concerns (30.9%), treatment duration (27.6%), and mouth ulcers (24.0%). Conclusions: Based on the research findings, regular oral hygiene education is recommended for adult patients considering fixed orthodontic therapy, including the use of additional tools such as interdental brushes and floss to improve oral health and reduce the risk of complications during treatment. The importance of chemical compounds in dentifrices and mouthwashes cannot be overstated, as they play a crucial role in addressing various dental issues. In addition, it is crucial to carefully weigh the pros and cons of therapy and to visit a dentist regularly to maintain oral health and monitor progress during treatment.

Treatment of aphthous ulcers with photodynamic therapy: A randomized controlled clinical study

BackgroundThis study aims to assess whether photodynamic therapy (PDT) offers a clinically effective alternative for treating oral aphthous ulcers, contributing to the ongoing quest for methods to expedite their treatment process amidst the limited understanding of their etiology. Materials and MethodThe study involved thirty volunteers with aphthous ulcers, split equally between a control group and a PDT group. Patients in the PDT group received laser treatment using Indocyanine green upon admission, while the control group received no intervention. Lesion diameter was measured at presentation and on the 3rd, 5th, and 7th days for all patients, with wound healing assessed on the 7th day. Additionally, pain levels were evaluated using the Visual Analog Scale (VAS) preoperatively and on the 1st, 3rd, 5th, and 7th days for the PDT group, and on the corresponding days for the control group. ResultsLesion diameters in the PDT group showed a significant reduction over time (p = 0.001), particularly from preoperative to final measurements. The control group also exhibited a decrease, albeit slower (p = 0.001). The 7th-day healing scores favored the PDT group significantly (p = 0.012). VAS scores in the PDT group decreased significantly over time (p = 0.001), indicating pain reduction. A similar trend was observed in the control group, albeit slower. Between-group differences in healing data and pain data were statistically significant. ConclusionPDT proves effective in reducing aphthous ulcer diameters and pain intensity, facilitating faster healing than the control group. These results advocate for PDT as a viable treatment option for aphthous lesions.

HLA-B5 prevalence in patients with spondyloarthritis and impact on disease phenotype: a multicentric case-control study.

The study aimed to estimate the prevalence of HLA-B51 and HLA-B52 in Lebanese patients with spondyloarthritis (SpA) compared to healthy controls (HC). We further aimed to evaluate the impact of HLA-B51 on phenotype and identify the distribution of the alleles in the HLA-B locus. A case-control study enrolled consecutive SpA patients from three rheumatology clinics in Lebanon, including axial (axSpA), peripheral SpA (pSpA), and psoriatic arthritis (PsA) and HC from blood donors. Demographic and disease data were collected through interviews and file reviews, with testing of the entire HLA-B locus using molecular techniques. The prevalence of HLA-B51 and B52 was estimated in SpA patients versus controls. Prevalence comparisons were made, and logistic regression identified factors associated with HLA-B51 in patients. Data from 120 HC and 86 SpA patients (65 axSpA, 15 pSpA, 6 PsA), mean age 25.6 and 46.4 years, respectively, showed a higher HLA-B51 prevalence in SpA (25.6%), especially axSpA (29.2%) versus HC (12.5%), p = 0.016, and a numerically higher HLA-B52 prevalence (8.1% versus 4.2%, p = 0.230). HLA-B51 correlated with recurrent oral ulcerations (OR 7.99(95%CI 2.14-29.84) and radiographic juxta-articular erosions (OR 7.65(95%CI 1.14-38.03)). HLA-B35 was the most dominant allele in both groups (18.7%), followed by HLA-B27 (15.7%) and HLA-B51 (13.4%) in SpA. HLA-B51 was identified more frequently in patients with SpA compared to HC and was associated with recurrent oral ulcerations and juxta-articular radiographic erosions. Longitudinal studies are needed to determine whether this association indicates a disease overlap or might correlate with a specific SpA phenotype.

Summer scour syndrome in weaned dairy calves: case series

BackgroundSummer scour syndrome (SSS) is a recently identified pathological condition affecting weaned dairy and dairy-beef calves during their first grazing season in Ireland. The syndrome is characterised by diarrhoea, weight loss, weakness, and can ultimately lead to death in some calves. Oral and oesophageal ulcerations are present in some cases. This study aimed to characterise a series of SSS cases in weaned dairy-bred calves on Irish commercial farms.ResultsFive farms with calves having unexplained diarrhoea at grass were referred by private veterinary practitioners (PVP) following preliminary testing to exclude coccidiosis and parasitic gastroenteritis. Farms were visited within 2 to 5 days following PVP’s referrals, or 2 days to 3 weeks relative to the onset of clinical signs. Farm management data, grass and concentrate samples, and biological samples from 46 calves (8 to 10 calves/farm) displaying clinical signs were collected. Two farms were subsequently found positive for coccidiosis and/or had chronic pneumonia problems after a thorough herd investigation and were designated as non-case farms (NCF). The remaining three farms were deemed typical SSS outbreaks (case farms; CF). Mean rumen fluid pH per farm ranged from 6.67 to 7.09 on CF, and 6.43–6.88 on NCF. Mean rumen fluid ammonia concentrations ranged from 17.6 to 29.6 mg/L and 17.2–45.0 mg/L on CF and NCF, respectively. Corresponding blood ammonia concentrations ranged from 129 to 223 µmol/L and 22–25 µmol/L. Mean blood copper and molybdenum concentrations were within normal range on all farms. Grass crude protein concentrations on the paddocks where the calves had grazed, and were currently grazing on the day of visit ranged from 137 to 148 g/kg DM and 106–177 g/kg DM, respectively on CF, and 160–200 g/kg DM and 151–186 g/kg DM, respectively on NCF. On CF, inorganic nitrogen fertiliser was applied 1 to 3 weeks pre-grazing, whereas on the two NCF, inorganic nitrogen fertiliser was applied 2 to 3 weeks pre-grazing on one farm and no fertiliser was applied on the other.ConclusionThese findings suggest that copper or molybdenum toxicity, and ruminal acidosis are not the primary causes of SSS. High blood ammonia concentrations and the timing and level of inorganic nitrogen fertiliser application to paddocks pre-grazing, warrant further investigation.

Bioadhesive and drug-loaded cellulose nanofiber/alginate film for healing oral mucosal wounds

Recurrent oral ulcers are common oral mucosal lesions that severely reduce patients' quality of life. Commercial mucoadhesive films are easily disrupted due to oral movement and complex wet environments, thus reducing drug utilization and even causing toxic side effects. Herein, we report a mucoadhesive film composed of Ca2+-crosslinked carboxymethylated cellulose nanofibers and alginate, in which two drugs of dexamethasone (DXM) and dyclonine hydrochloride (DYC) are loaded for the treatment of oral ulcers. The wet films have a high Young's modulus of 7.1 ± 2.6 MPa and a large strain of 53.6 ± 9.8 % and adhere to tissue strongly, which allows them to resist the deformation caused by frequent oral movement. The films also have nice durability against water and excellent biocompatibility. Moreover, the drug release was controlled at different rates. The fast release of DYC facilitates the quick relief of pain, while the slow release of DXM benefits the long-term treatment of wounds. Finally, the animal experiment demonstrates the films displayed excellent therapeutic efficacy in healing oral ulcers.

Jasminum grandiflorum oral gel as an add-on to standard of care in radiation induced grade 2 oral mucositis - an open label pilot clinical trial

BackgroundRadiation-induced oral mucositis is one of the most critical dose-limiting toxicities associated with radiation therapy for oral cancer which can result in treatment interruption and compromise the quality of the life of cancer patients. Jati (Jasminum grandiflorum) is used in Ayurveda to treat oral conditions like stomatitis and mouth ulcers. ObjectiveTo test the feasibility of Jati oral gel as an add on therapy in grade 2 radiation-induced oral mucositis. Materials and methodsA prospective, open-label, non-randomised pilot trial was conducted on 20 patients with grade 2 radiation-induced oral mucositis at a tertiary cancer hospital. The control group received sodium bicarbonate mouthwash 4–5 times daily as the standard of care, while the intervention arm also received Jati oral gel twice daily. We used the ImageJ software for objective assessment and the Visual Analogue Scale for subjective pain assessment. The study was continued for 15 days or until the mucositis progressed to grade 3 or resolved to grade 1. ResultThere was a significant reduction in the mean pain score and mean area of mucositis in the intervention group compared to the control group. ConclusionJati oral gel is a suitable medicament as an add-on therapy in managing grade 2 radiation-induced oral mucositis.

Silk Fibroin Microneedles Loaded with Lipopolysaccharide-Pretreated Bone Marrow Mesenchymal Stem Cell-Derived Exosomes for Oral Ulcer Treatment.

Oral ulcers, superficial lesions on the surface of the oral mucosa, have a high incidence rate, and their main symptoms include local pain and erosion. Lipopolysaccharide (LPS)-preconditioned bone marrow mesenchymal stem cells and their secreted exosomes (LPS-pre-Exos) have been shown to promote recovery in various inflammatory conditions and wounds. However, studies documenting LPS-pre-Exos as a therapeutic intervention for oral mucosal-like diseases are lacking. In this study, we prepared a silk fibroin microneedle (MN) patch consisting of LPS-pre-Exos and zeolitic imidazolate framework-8 (ZIF-8) that localized at the tip and base, respectively, and used this MN patch for oral ulcer treatment. Upon insertion into the oral mucosa, continuous LPS-pre-Exos release was observed, which promoted macrophage polarization and tissue healing. Additionally, the ZIF-8 framework in the MN patch facilitated the controlled release of Zn2+, which demonstrated potent antimicrobial properties via synergistic effects. The in vitro experimental results showed that the silk fibroin MN patch can continuously release LPS-pre-Exos and Zn2+ for more than 7 days. Thus, the LPS-pre-Exos and ZIF-8-loaded silk fibroin MN patch exhibited good anti-inflammatory and antibacterial properties, promoting oral ulcer healing, and showed good histocompatibility. Hence, it may represent a potentially valuable strategy for facilitating oral ulcer healing.

Mitochondria mediated inhibitory effect of Nyctanthes arbor-tristis (L.) flower extract against breast adenocarcinoma and T-cell lymphoma: An in vitro and in vivo study

Ethnopharmacological relevanceThe flowers of Nyctanthes arbor-tristis (L.) heals mouth ulcers. Its tinctures promote gastric secretions, and improve lung expectoration when taken orally. It has traditionally been used to treats scabies and other skin problems. The leaves of NAT(L.) plant are used in Ayurvedic medicine to treat sciatica, chronic fever, rheumatism, internal worm infections, and as a laxative, diaphoretic, and diuretic. The bark used in treatment of snakebite and bronchitis. In addition to traditional uses, pharmacologically this plant has potent antimalarial, antiarthritic, anticancer and antidiabetic activity. However, the mechanistic antiproliferative potentials of NAT(L.) flower as anticancer therapeutics has not yet been explored. Aim of the studyThe current study is based on a broad range of scientific literature that highlights the nutritional and therapeutic benefits of NAT (L.). Present investigation was carried out to determine the therapeutic efficacy of NAT (L.) against breast adenocarcinoma cells and T-cell lymphoma. Materials and methodsThe ethyl-acetate extract of NAT(L.) was tested against breast cancer cells to assess the anticancer potential. To evaluate apoptosis, intracellular ROS levels and mitochondrial dynamics, fluorescence microscopy and flow cytometry were employed. Additionally, cell cycle analysis and western blotting were also performed. Furthermore, in vivo antitumor efficacy of flower extracts was investigated in T-cell lymphoma-bearing BALB/c mice model. ResultsOur present study revealed that NAT (L.) exert anticancer activity against breast cancer cells effectively at IC50 320 μg/ml while having less impact on normal cells with IC50 more than 480 μg/ml. Fluorescence imaging showed that NAT (L.) treatment elicits a concentration-dependent rise in the occurrence of apoptotic cell deaths with altered mitochondrial dynamics and was subsequently confirmed by flow cytometry. Further, flow cytometric analysis delineates ethyl acetate flower extract exposure promotes arrest of cells in S phase of the cell cycle. The differential expression of apoptotic proteins such as Bax, Bcl-2, cleaved PARP-1, cleaved caspase 3, Cytochrome-c, p53 and VEGF A were influenced by NAT (L.) treatment. The in vivo antitumor activity study delineates that NAT(L.) therapy significantly increased the life span of T-cell lymphoma bearing mice while reducing tumor load and belly size growth pattern without causing significant other distinct side effects as evident by histopathological studies. ConclusionOur current findings unveil that NAT(L.) ethyl acetate flower extract potentially induces mitochondrial pathway of apoptosis, promote cell cycle arrest, reduces tumor load of mice, enhances survivability and could be a promising agent against the triple negative breast cancer and lymphoma.