Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 905
Filtrar
1.
J Cancer Res Clin Oncol ; 146(4): 985-1001, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31955287

RESUMO

PURPOSE: Oral mucositis is a common, painful side effect of cancer treatment-be it locoregional (e.g. irradiation) or systemic (e. g. chemotherapy). Phytotherapy is often used by patients to alleviate symptoms. However, knowledge on which medical plants are recommended by literature about Traditional European Medicine (TEM), their effect(s) on symptoms and their efficacy is severely lacking. Therefore, we developed a novel approach to assess traditional knowledge of herbals used in TEM and searched the online databases for studies reporting effects of these plants. METHODS: At first, online research did not yield a satisfying number of studies (MESH terms: "mucositis" OR "stomatitis" AND "herbal" OR "herbal medicine"). Trials were labelled by the country conducting the study. In parallel, we compiled a list of 78 plants recommended for treating oral mucositis by screening 14 books on TEM. Then, a "hit list" of the plants most often mentioned was composed and used further for a second online investigation using the Latin plant designations as MESH term. Studies of both online searches were pooled for analysis. RESULTS: There is a gap between traditional knowledge and trials investigating medical plants used by TEM. Overall, herbal remedies alleviate oral mucositis and especially, gingivitis well. There is good evidence for using Matricaria recutita L., Salvia officinalis L., Calendula officinalis L. and Thymus spp. L. for treating oral mucositis. CONCLUSION: Clinical trials investigating medical plants known in TEM are rare. However, following our research strategy, we could extrapolate four plants with good evidence for alleviating symptoms of oral mucositis and gingivitis.


Assuntos
Fitoterapia/métodos , Plantas Medicinais , Estomatite/tratamento farmacológico , Antineoplásicos/efeitos adversos , Europa (Continente) , Humanos , Armazenamento e Recuperação da Informação , Medical Subject Headings , Neoplasias/tratamento farmacológico , Estomatite/induzido quimicamente , Revisão Sistemática como Assunto
2.
Arch Oral Biol ; 111: 104664, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31982600

RESUMO

BACKGROUND: Spondias mombin has been used in folk medicine to treat inflammation in the oral cavity. This study aimed to evaluate the antioxidant and anti-inflammatory activity of S. mombin extract in an oral mucositis experimental model. METHODS: Male hamsters were orally pre-treated with hydroethanolic extract of S. mombin leaves (HESM) (50, 100, or 200 mg/kg) for ten days. Cheek pouch samples were subjected to macroscopic, histopathological and immunohistochemical analysis (Cox-2, iNOS, NF-kB p50 NLS and MMP-2). IL-1ß and TNF-α levels were analyzed by ELISA immunoassay, and Superoxide dismutase estimative (SOD), glutathione (GSH) and malondialdehyde (MDA) levels were submitted to spectroscopy analysis. RESULTS: The group treated with HESM at a dose of 200 mg/kg showed the best healing effect, showing no evidence of ulceration in the macroscopic analysis (p < 0.05). Histopathological analysis showed re-epithelialization, discrete mononuclear inflammatory infiltrate and absence of hemorrhage and edema score of 1 (1-1) (p < 0.05), as well as a large amount of collagen fibers and a lower immunoexpression of Cox-2, iNOS, NF-kB p50 NLS and MMP-2. Decrease in SOD (p < 0.05), MDA (p<0.001), IL-1ß (p < 0.05), and TNF-α levels (p < 0.001), with an increase in GSH (p < 0.01) levels. CONCLUSION: HESM (200 mg/kg) reduced oxidative stress and inflammation in the 5-fluorouracil-induced oral mucositis in hamsters.


Assuntos
Anacardiaceae/química , Anti-Inflamatórios/farmacologia , Antioxidantes/farmacologia , Extratos Vegetais/farmacologia , Estomatite/tratamento farmacológico , Animais , Cricetinae , Masculino , Estresse Oxidativo , Folhas de Planta/química
3.
Oral Dis ; 26(1): 111-121, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31677207

RESUMO

OBJECTIVE: This study was designed to investigate whether necroptosis is involved in the pathogenesis of chemoradiation-induced oral mucositis in a murine model and whether 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) ameliorates this disorder. MATERIALS AND METHODS: A chemoradiation-induced oral mucositis model was established by treating mice with concurrent 5-fluorouracil (100 mg/kg, i.p.) and head and neck X-irradiation (20 Gy). Phosphate-buffered saline or PLAG (100 mg/kg or 250 mg/kg, p.o.) was administered daily. Body weights were recorded daily, and mice were sacrificed on Day 9 for tongue tissue analysis. RESULTS: On Day 9, chemoradiotherapy-treated (ChemoRT) mice had tongue ulcerations and experienced significant weight loss (Day 0:26.18 ± 1.41 g; Day 9:19.44 ± 3.26 g). They also had elevated serum macrophage inhibitory protein 2 (MIP-2) (control: 5.57 ± 3.49 pg/ml; ChemoRT: 130.14 ± 114.54 pg/ml) and interleukin (IL)-6 (control: 198.25 ± 16.91 pg/ml; ChemoRT: 467.25 ± 108.12 pg/ml) levels. ChemoRT-treated mice who received PLAG exhibited no weight loss (Day 0:25.78 ± 1.04 g; Day 9:26.46 ± 1.68 g) and had lower serum MIP-2 (4.42 ± 4.04 pg/ml) and IL-6 (205.75 ± 30.41 pg/ml) levels than ChemoRT-treated mice who did not receive PLAG. Tongue tissues of mice who received PLAG also displayed lower phosphorylation levels of necroptotic signalling proteins. CONCLUSION: 1-Palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol mitigated chemoradiation-induced oral mucositis by modulating necroptosis.


Assuntos
Quimiorradioterapia/efeitos adversos , Diglicerídeos/farmacologia , Estomatite/tratamento farmacológico , Animais , Quimiocina CXCL2/sangue , Fluoruracila/efeitos adversos , Interleucina-6/sangue , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Estomatite/etiologia
4.
Anticancer Res ; 39(12): 6531-6536, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810918

RESUMO

BACKGROUND/AIM: Oral mucositis is a significant side effect in cancer treatment. In this study, we aimed to develop a rebamipide-containing film using chitosan and hydroxypropyl methylcellulose (HPMC) to efficiently treat oral mucositis. MATERIALS AND METHODS: A 0.1% (w/v) rebamipide aqueous solution, a 1.4% (w/v) chitosan aqueous solution containing Pluronic® F-127, and a 1.0% (w/v) HPMC aqueous solution were mixed and dried using a square silicon frame to form a film. Cumulative release ratios of rebamipide from sample films were measured in a phosphate buffer (pH 6.8) at 37°C. RESULTS: Chitosan suppressed the release of rebamipide from the film for up to 30 min. HPMC contributed to the sustained release of the film over a relatively long period of time and the maintenance of its shape. CONCLUSION: The combined use of chitosan and HPMC is suitable as a base material for rebamipide-containing films.


Assuntos
Alanina/análogos & derivados , Quitosana/química , Derivados da Hipromelose/química , Quinolonas/química , Estomatite/induzido quimicamente , Alanina/química , Antineoplásicos/efeitos adversos , Preparações de Ação Retardada , Humanos , Estomatite/tratamento farmacológico
5.
Medicine (Baltimore) ; 98(50): e18337, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852129

RESUMO

BACKGROUND: Oral mucositis (OM) is a common and unavoidable side effect in patients suffering from head and neck cancer who are undergoing radiotherapy. It is characterized by unbearable pain, as well as eating and speech disorders. This has serious negative effects on the patients' quality of life and can even reduce radiotherapy tolerance, ultimately resulting in a poor prognosis. At present, many prevention and treatment methods are still in the experimental stage, and the efficacies are controversial. METHODS: Four English databases: Medline via pubmed, EMBASE, the Cochrane Library, Web of Science and another 4 Chinese databases: China National Knowledge Infrastructure (CNKI), China Science and Technology Journal database (VIP), Wanfang Database and CBM, will be searched from inception to August 2019. All randomized controlled trials in Chinese and English language will be included. Literature selection, data extraction and quality assessment will be completed by 2 independent authors. The primary outcomes will include the incidence of OM (1-4 grade) and the pain degree. The onset time of OM, the improvement rate for quality of life, and any adverse effects will be evaluated as the secondary outcomes. The data will be synthesized by Review Manager and Stata software. RESULTS: This study provides a high-quality synthesis from existing evidence for Chinese herbal medicine in radiotherapy induced OM treatment, according to the criteria: incidence of OM, onset time of OM, status changes in quality of life and adverse events. CONCLUSION: This study will provide evidence to help determine whether Chinese herbal medicine is effective and safe for use in the prevention and/or treatment of radiotherapy induced OM. ETHICS AND DISSEMINATION: No additional formal ethical recognition or informed consent is required since no primary data collection is involved. The study result will be published in peer-reviewed journals or at related conferences.PROSPERO registration number: PROSPERO CRD42019141900.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Neoplasias de Cabeça e Pescoço/radioterapia , Fitoterapia/métodos , Lesões por Radiação/tratamento farmacológico , Estomatite/tratamento farmacológico , Humanos , Metanálise como Assunto , Qualidade de Vida , Lesões por Radiação/etiologia , Projetos de Pesquisa , Estomatite/etiologia , Revisão Sistemática como Assunto , Resultado do Tratamento
6.
Int J Mol Sci ; 20(15)2019 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-31382644

RESUMO

Radiation-induced oral mucositis represents an influential factor in cancer patients' accepted radiation therapy, especially in head and neck cancer. This research investigates the treatment effect of Ecdysterone (a steroid derived from the dry root of Achyranthes bidentate) and Paeonol (a compound derived from Cortex Moutan) on radiation-induced oral mucositis and possible underlying mechanisms. Concisely, 20 Gy of X-rays (single-dose) irradiated the cranial localization in rats for the modeling of oral mucositis. The therapeutic effects of Ecdysterone-Paeonol oral cavity directly administered on radiation-induced oral mucositis were investigated by weight changes, direct observations, visual scoring methods, ulcer area/total area, and basic recovery days. Assessments of tumor necrosis factor α and interleukin-6 were performed to evaluate the inflammatory cytokines secretion in the damaged areas of tongues harvested post-treatment, and changes in signaling pathways were investigated by Western blotting. System Drug Target (SysDT) methods revealed the targets of Ecdysterone-Paeonol in order to support compound-target network construction. Four representative targets with different functions were chosen. The binding interactions between the compound and receptor were evaluated by molecular docking to investigate the binding affinity of the ligand to their protein targets. Ecdysterone-Paeonol, administered orally, effectively improved radiation-induced oral mucositis in rats, and the therapeutic effect was better than Ecdysterone administered orally on its own. In this study, calculational chemistry revealed that Ecdysterone-Paeonol affected 19 function targets associated with radiation-induced oral mucositis, including apoptosis, proliferation, inflammation, and wound healing. These findings position Ecdysterone-Paeonol as a potential treatment candidate for oral mucositis acting on multiple targets in the clinic.


Assuntos
Anormalidades Induzidas por Radiação/tratamento farmacológico , Acetofenonas/farmacologia , Ecdisterona/farmacologia , Lesões por Radiação/tratamento farmacológico , Estomatite/tratamento farmacológico , Anormalidades Induzidas por Radiação/patologia , Animais , Apoptose/efeitos dos fármacos , Modelos Animais de Doenças , Combinação de Medicamentos , Humanos , Simulação de Acoplamento Molecular , Boca/efeitos dos fármacos , Boca/patologia , Lesões por Radiação/etiologia , Lesões por Radiação/patologia , Ratos , Transdução de Sinais/efeitos dos fármacos , Estomatite/etiologia , Estomatite/patologia
7.
Support Care Cancer ; 27(10): 3933-3948, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286227

RESUMO

New studies and literature continue to emerge on the management of mucositis secondary to cancer therapy. The evidence-based clinical practice guidelines for mucositis were first published in 2004 and updated in 2007 and 2014 by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The existing 2014 guidelines for mucositis are being updated in line with new literature to inform clinical practice. This paper describes the materials and methods employed for the comprehensive updates to the guidelines for managing mucositis.


Assuntos
Mucosite/tratamento farmacológico , Guias de Prática Clínica como Assunto , Estomatite/tratamento farmacológico , Medicina Baseada em Evidências , Humanos , Oncologia/métodos , Neoplasias/terapia
8.
Support Care Cancer ; 27(10): 3997-4010, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286229

RESUMO

PURPOSE: To update the clinical practice guidelines for the use of natural and miscellaneous agents for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: Recommendation, Suggestion, and No Guideline Possible. RESULTS: A total of 78 papers were identified within the scope of this section, out of which 29 were included in this part, and were analyzed with 27 previously reviewed studies. A new Suggestion was made for oral glutamine for the prevention of OM in head and neck (H&N) cancer patients receiving radiotherapy with concomitant chemotherapy. The previous Recommendation against the use of parenteral glutamine for the prevention of OM in hematopoietic stem cell transplantation (HSCT) patients was re-established. A previous Suggestion for zinc to prevent OM in H&N cancer patients treated with radiotherapy or chemo-radiotherapy was reversed to No Guideline Possible. No guideline was possible for other interventions. CONCLUSIONS: Of the vitamins, minerals, and nutritional supplements studied for the management of OM, the evidence supports a Recommendation against parenteral glutamine in HSCT patients and a Suggestion in favor of oral glutamine in H&N cancer patients for the management of OM.


Assuntos
Glutamina/uso terapêutico , Minerais/uso terapêutico , Mucosite/tratamento farmacológico , Mucosite/prevenção & controle , Estomatite/tratamento farmacológico , Estomatite/prevenção & controle , Vitaminas/uso terapêutico , Suplementos Nutricionais , Glutamina/administração & dosagem , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Neoplasias/tratamento farmacológico
9.
Support Care Cancer ; 27(10): 4011-4022, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286233

RESUMO

PURPOSE: The aim of this study was to update the clinical practice guidelines for the use of agents for the prevention and/or treatment of gastrointestinal mucositis (GIM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, and No Guideline Possible. RESULTS: A total of 78 papers across 13 interventions were examined of which 25 were included in the final review. No new guidelines were possible for any agent due to inadequate and/or conflicting evidence. Existing guidelines for probiotics and hyperbaric oxygen were unchanged. CONCLUSIONS: Of the agents studied for the prevention and treatment of GIM, the evidence continues to support use of probiotics containing Lactobacillus spp. for prevention of chemoradiotherapy and radiotherapy-induced diarrhea in patients with pelvic malignancy, and hyperbaric oxygen therapy to treat radiation-induced proctitis. Additional well-designed research is encouraged to enable a decision regarding palifermin, glutamine, sodium butyrate, and dietary interventions, for the prevention or treatment of GIM.


Assuntos
Quimiorradioterapia/efeitos adversos , Mucosite/tratamento farmacológico , Mucosite/prevenção & controle , Guias de Prática Clínica como Assunto , Proctite/tratamento farmacológico , Estomatite/tratamento farmacológico , Ácido Butírico/uso terapêutico , Fator 7 de Crescimento de Fibroblastos/uso terapêutico , Glutamina/uso terapêutico , Humanos , Oxigenação Hiperbárica , Neoplasias/tratamento farmacológico
10.
Crit Rev Oncol Hematol ; 142: 1-8, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31323533

RESUMO

INTRODUCTION: This study aimed to determine the efficacy of different Leucovorin regimens to reduce oral mucositis in children with acute lymphoblastic leukemia after high-dose Methotrexate (HD-MTX). METHODS: Twelve articles were included in a systematic literature review. Articles were categorized into low/medium/high risk of bias. RESULTS: As no randomized controlled trial assessing the effect of Leucovorin has been performed, the efficacy of Leucovorin to reduce oral mucositis remains unknown. Leucovorin was initiated at 24, 36 or 42 h after HD-MTX at a dose of 15 or 30 mg/m2. No meta-analysis could be performed as treatment regimens differed. When comparing studies with similar HD-MTX doses, we observed lower oral mucositis rates in regimens with higher cumulative doses of Leucovorin and early initiation of Leucovorin after MTX. CONCLUSION: Even though future studies are necessary, higher cumulative Leucovorin doses and early initiation of Leucovorin after start of MTX seem to reduce oral mucositis.


Assuntos
Leucovorina/uso terapêutico , Metotrexato/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Estomatite/tratamento farmacológico , Adolescente , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Criança , Pré-Escolar , Humanos , Lactente , Leucovorina/administração & dosagem , Metotrexato/uso terapêutico , Estomatite/induzido quimicamente , Estomatite/prevenção & controle , Resultado do Tratamento , Adulto Jovem
11.
J Med Case Rep ; 13(1): 201, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31262360

RESUMO

BACKGROUND: Oral topical corticosteroid gels are widely used in dental medicine. Case studies of central serous retinopathy have been reported following administration of corticosteroids, but none so far coinciding with the use of topical fluocinonide gel. This case report further contributes to the database of potential risks of corticosteroid use. CASE PRESENTATION: A 40-year-old South Asian woman presented with decreased vision, pigment epithelial detachments, and serous retinal detachments in both eyes 1 month after starting treatment with topical fluocinonide 0.05%, a topical oral corticosteroid gel. Her condition resolved 6 months after discontinuing the use of the steroid. CONCLUSIONS: To the best of our knowledge, this is the first case of idiopathic central serous retinopathy associated with the use of oral fluocinonide gel. Discontinuing the use of the steroid may result in resolution of the serous retinal detachment and improvement of visual symptoms. Patients and their doctors who prescribe this medication should be aware of this association.


Assuntos
Anti-Inflamatórios/efeitos adversos , Coriorretinopatia Serosa Central/induzido quimicamente , Fluocinonida/efeitos adversos , Administração Tópica , Adulto , Anti-Inflamatórios/administração & dosagem , Feminino , Fluocinonida/administração & dosagem , Géis , Humanos , Estomatite/tratamento farmacológico
12.
J Pak Med Assoc ; 69(6): 811-816, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31189287

RESUMO

OBJECTIVE: To evaluate the effect of different solutions administered to patients undergoing stem cell transplantation on oral mucositis. METHODS: The non-randomised controlled trial was conducted at a Istanbul Medipol Mega university hospital in Turkey between May 2014 and June 2016, and comprised patients undergoing stem cell transplantation. They were divided into three groups. Group 1 had patients using chlorhexidine gluconate and benzydamine hydrochloride solution. Group 2 had those using calcium and phosphate solution. Group 3 patients were using black mulberry syrup. Data was collected using a structured questionnaire and the World Health Organisation mucositis assessment scale. Assessment was done on days 7, 14 and 21. Clinical significance of oral solutions was statistically determined. RESULTS: Of the 83 patients, 30(36%) were in group 1, 28(34%) in group 2, and 25(30%) in group 3. On day 7, there was no significant difference in terms of grades among the groups (p>0.05). On day 14, grade 2 mucositis was seen in 2(8%) patents in group 3, 5(17.9%) in group 2 and 5(16.7%) in group 1; Grade 3 mucositis was seen in 2(6.7%) patients in group 1, but none in the other two groups. On day 21, grade 3 mucositis was present in 2(8.0%) in group 3, 2(7.1%) in group 2, and 4(13.3%) in group 1. CONCLUSIONS: The use of black mulberry and calcium-phosphate solutions was found to be beneficial in preventing and treating oral mucositis.


Assuntos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Neoplasias/terapia , Soluções Farmacêuticas/uso terapêutico , Estomatite/tratamento farmacológico , Adolescente , Adulto , Idoso , Benzidamina/uso terapêutico , Clorexidina/análogos & derivados , Clorexidina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morus , Fosfatos/uso terapêutico , Extratos Vegetais/uso terapêutico , Turquia , Adulto Jovem
13.
Gan To Kagaku Ryoho ; 46(4): 685-689, 2019 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-31164507

RESUMO

BACKGROUND: Oral mucositis and body weight loss are the most critical conditions known to lead to the discontinuation of chemoradiotherapy for head and neck cancer. We investigated the effect of a nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)on body weight loss, oral mucositis, and the completion rate of chemoradiotherapy in patients with oropharyngeal and hypopharyngeal cancer. PATIENTS AND METHODS: The study group comprised patients with oropharyngeal and hypopharyngeal cancer who were treated with concomitant cisplatin and 70 Gy of radiotherapy. These patients received 2 packs of Prosure®per day during chemoradiotherapy. RESULTS: A total of 17 patients were included in this study. The reduction in body weight was significantly improved compared with that in the historical control group that did not receive Prosure®(7.3% vs 10.3%, p<0.01), and the rate of Grade 3-4 oral mucositis was significantly reduced for the patient groups that received Prosure®(CTCAE v3.0 GradeB3; 24% vs 58%, p<0.05). The completion rate of chemoradiotherapy was not significantly different between both groups(77% vs 60%, NS). CONCLUSIONS: A nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)had effects on oral mucositis and body weight loss in head and neck cancer patients treated with chemoradiotherapy.


Assuntos
Ácidos Graxos Ômega-3 , Neoplasias de Cabeça e Pescoço , Mucosite , Estomatite , Quimiorradioterapia , Ácidos Graxos Ômega-3/uso terapêutico , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Mucosite/tratamento farmacológico , Mucosite/etiologia , Estomatite/tratamento farmacológico , Estomatite/etiologia , Perda de Peso
14.
Int J Pharm ; 566: 126-140, 2019 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-31129342

RESUMO

Topical drug delivery in the oral mucosa has its set of challenges due to the unique anatomical and physiological features of the oral cavity. As such, the outcomes of local pharmacological treatments in oral disorders can fail due to unsuccessfully drug delivery. Oral mucositis, a severe inflammatory and ulcerative side effect of oncological treatments, is one of such diseases. Although the damaged tissue is within reach, no approved topical drug treatment is available. Several strategies based on its physiopathology have been implemented and clinically used. Even so, results tend to lack or be insufficient to improve patient's quality of life. The use of corticosteroids has been employed in such strategies due to their strong anti-inflammatory action. Typically, these are administrated in simple liquid formulations, where the drug is dispersed or solubilized, lacking the ability to maintain local concentration. In this work, we propose the development of a biocompatible delivery system with boosted abilities of retention and control release of budesonide, a corticosteroid with an elevated ratio of topical anti-inflammatory to systemic action. Through spray-drying, polymeric particles of Chitosan and Eudragit® E PO were produced and characterized for the vectorization of this drug.


Assuntos
Corticosteroides/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Budesonida/administração & dosagem , Quitosana/administração & dosagem , Sistemas de Liberação de Medicamentos , Ácidos Polimetacrílicos/administração & dosagem , Corticosteroides/química , Anti-Inflamatórios/química , Budesonida/química , Linhagem Celular , Quitosana/química , Liberação Controlada de Fármacos , Humanos , Tamanho da Partícula , Polímeros , Ácidos Polimetacrílicos/química , Estomatite/tratamento farmacológico
15.
J Nutr Sci Vitaminol (Tokyo) ; 65(2): 184-191, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31061288

RESUMO

Zinc in various therapeutic doses was used on patients suffering from oral mucositis during cancer treatment. A meta-analysis was conducted to probe the role of oral zinc as a possible treatment option for oral mucositis. A literature search was done using PubMed, EBSCO, Cochrane, MedLine, ScienceDirect, ResearchGate and Google Scholar with key words. The analysis was directed to recognize and identify the use of zinc supplementations at a confidence interval (CI) 95% with p value significance taken as <0.05. A total number of 21,428 articles was retrieved. After thorough screening and assessment of the eligibility criteria, 10 articles were included in qualitative and quantitative analysis in the study. The 10 articles constituted a total sample size of 299 in the case group and 294 in the control group. Oral zinc doses used were 25 mg, 30 mg, 50 mg and 220 mg capsules and mouthwash of 0.2% zinc, as well as 0.5 g of granules dissolved in 5% sodium alginate solution. Two studies showed no significance, with the overall effect 1.61. Eight studies favored zinc over a placebo with an overall effect size of -0.89 at 95% CI of -1.08 and -0.70 which was statistically significant (Z=9.27, p<0.00001). This analysis suggests that zinc usage has shown significant reduction in the severity of oral mucositis but not prevention. The onset of the reaction was delayed and hastened healing. Pharyngeal mucositis, pain and quality of life of the individuals received no effect from zinc therapy.


Assuntos
Antineoplásicos/efeitos adversos , Radioterapia/efeitos adversos , Estomatite , Zinco/uso terapêutico , Antineoplásicos/uso terapêutico , Feminino , Humanos , Masculino , Neoplasias/complicações , Neoplasias/terapia , Estomatite/classificação , Estomatite/tratamento farmacológico , Estomatite/etiologia
16.
Int J Radiat Oncol Biol Phys ; 104(5): 1141-1152, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31063799

RESUMO

PURPOSE: Despite the development of high-precision radiation therapy, ionizing radiation inevitably damages healthy tissues. Radiodermatitis and radioinduced oral mucositis are frequent and significant side effects among patients with breast and head and neck cancer, respectively. These radiation-related injuries negatively affect patient quality of life and can lead to unplanned therapeutic breaks and compromise treatment outcomes. Currently, no preventive or mitigating agent has emerged to address these issues. Although amifostine, a well-known free radical scavenger, has proven efficacy against specific radio- and chemo-induced toxicities, severe adverse side effects (reversible hypotension, nausea, emesis, etc) combined with logistical hurdles are associated with its recommended intravenous route of administration, limiting its use. METHODS AND MATERIALS: We developed a thermogel containing the active thiol metabolite of amifostine (CPh-1014) that polymerizes at body temperature and serves as a matrix for topical application onto the skin or mucosa. RESULTS: Applied before irradiation, CPh-1014 greatly reduced the severity of oral mucositis and dermatitis induced by either a single dose or fractionated irradiation regimens in in vivo mouse models. The cytoprotective effect of CPh-1014 was confirmed by the decrease in DNA double-strand breaks in the irradiated epithelium. Noticeably, CPh-1014 did not affect radiation therapy efficacy against tumors grafted at submucosal and subcutaneous sites. In contrast to the intravenous administration of amifostine, CPh-1014 oral application did not induce hypotension in dogs. CONCLUSIONS: CPh-1014 confers radioprotective effects in healthy tissues with reduced systemic side effects without compromising radiation therapy efficacy. We propose CPh-1014 as an easy-to-implement therapeutic approach to alleviate radiation therapy toxicity in patients with breast and head and neck cancer.


Assuntos
Amifostina/administração & dosagem , Géis/administração & dosagem , Lesões Experimentais por Radiação/prevenção & controle , Protetores contra Radiação/administração & dosagem , Radiodermatite/prevenção & controle , Estomatite/prevenção & controle , Amifostina/efeitos adversos , Animais , Pressão Sanguínea/efeitos dos fármacos , Neoplasias da Mama/radioterapia , Dano ao DNA , Modelos Animais de Doenças , Cães , Portadores de Fármacos , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Hipotensão Ortostática/induzido quimicamente , Camundongos , Camundongos Endogâmicos C57BL , Lesões Experimentais por Radiação/tratamento farmacológico , Protetores contra Radiação/efeitos adversos , Radiodermatite/tratamento farmacológico , Distribuição Aleatória , Neoplasias Cutâneas/radioterapia , Estomatite/tratamento farmacológico , Estomatite/etiologia
17.
J Dermatol ; 46(6): 531-534, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31021002

RESUMO

Hypereosinophilic syndrome (HES) is often associated with cutaneous manifestations, mostly pruritic lesions, urticaria and angioedema. Mucosal lesions are rarely seen in HES but, when present, are usually the first manifestation of the disease. The clinical presentation may be heterogeneous, including erosions, aphthae or ulcers, and can be easily confused with other mucocutaneous disorders. Here, we present the case of a 64-year-old man with severe chronic erosive oral mucositis simulating pemphigus in which the finding of persistent eosinophilia and elevation of B12 vitamin serum levels raised the suspicion of HES. The FIP1L1-PDGFRA fusion gene (4q12) was detected by fluorescence in situ hybridization and the patient was treated with imatinib mesylate with complete response of the disease.


Assuntos
Síndrome Hipereosinofílica/diagnóstico , Mesilato de Imatinib/uso terapêutico , Proteínas de Fusão Oncogênica/genética , Pênfigo/diagnóstico , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/genética , Estomatite/diagnóstico , Fatores de Poliadenilação e Clivagem de mRNA/genética , Diagnóstico Diferencial , Humanos , Síndrome Hipereosinofílica/tratamento farmacológico , Síndrome Hipereosinofílica/genética , Síndrome Hipereosinofílica/imunologia , Mesilato de Imatinib/farmacologia , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/imunologia , Mucosa Bucal/patologia , Proteínas de Fusão Oncogênica/antagonistas & inibidores , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/antagonistas & inibidores , Índice de Gravidade de Doença , Estomatite/tratamento farmacológico , Estomatite/genética , Estomatite/imunologia , Resultado do Tratamento , Fatores de Poliadenilação e Clivagem de mRNA/antagonistas & inibidores
18.
J Int Med Res ; 47(5): 2126-2134, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30938568

RESUMO

OBJECTIVE: Both compound vitamin B mixtures and GeneTime® have been used in treatment of oral inflammation. This study aimed to assess the therapeutic effects of a compound vitamin B mixture combined with GeneTime® on radiation-induced oral mucositis. METHODS: A total of 100 patients with radiation-induced oral mucositis were randomly divided into a control group (vitamin B alone; n = 50 patients) and an observation group (vitamin B plus GeneTime®, n = 50 patients). Clinical outcomes were compared between the two groups for the following 3 weeks. RESULTS: The observation group had a significantly greater number of grade 0-I patients and significantly fewer grade II-IV patients than the control group. Among patients in the observation group, a significantly greater number of ulcers healed within 1-2 weeks, compared with those in patients in the control group. Significantly fewer ulcers healed among patients in the observation group at 3 weeks; notably, there were fewer ulcers to heal in the observation group, compared with the control group. CONCLUSIONS: Use of a compound vitamin B mixture combined with GeneTime® exerted obvious therapeutic effects on radiation-induced oral mucositis and markedly shortened ulcer healing time. Therefore, this strategy may be useful in clinical applications.


Assuntos
Lesões por Radiação/complicações , Proteínas Recombinantes/uso terapêutico , Estomatite/tratamento farmacológico , Estomatite/etiologia , Complexo Vitamínico B/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Proteínas Recombinantes/farmacologia , Úlcera/tratamento farmacológico , Úlcera/etiologia , Complexo Vitamínico B/farmacologia , Cicatrização/efeitos dos fármacos
19.
JAMA ; 321(15): 1481-1490, 2019 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-30990550

RESUMO

Importance: Oral mucositis causes substantial morbidity during head and neck radiotherapy. In a randomized study, doxepin mouthwash was shown to reduce oral mucositis-related pain. A common mouthwash comprising diphenhydramine-lidocaine-antacid is also widely used. Objective: To evaluate the effect of doxepin mouthwash or diphenhydramine-lidocaine-antacid mouthwash for the treatment of oral mucositis-related pain. Design, Setting, and Participants: A phase 3 randomized trial was conducted from November 1, 2014, to May 16, 2016, at 30 US institutions and included 275 patients who underwent definitive head and neck radiotherapy, had an oral mucositis pain score of 4 points or greater (scale, 0-10), and were followed up for a maximum of 28 days. Interventions: Ninety-two patients were randomized to doxepin mouthwash (25 mg/5 mL water); 91 patients to diphenhydramine-lidocaine-antacid; and 92 patients to placebo. Main Outcome and Measures: The primary end point was total oral mucositis pain reduction (defined by the area under the curve and adjusted for baseline pain score) during the 4 hours after a single dose of doxepin mouthwash or diphenhydramine-lidocaine-antacid mouthwash compared with a single dose of placebo. The minimal clinically important difference was a 3.5-point change. The secondary end points included drowsiness, unpleasant taste, and stinging or burning. All scales ranged from 0 (best) to 10 (worst). Results: Among the 275 patients randomized (median age, 61 years; 58 [21%] women), 227 (83%) completed treatment per protocol. Mucositis pain during the first 4 hours decreased by 11.6 points in the doxepin mouthwash group, by 11.7 points in the diphenhydramine-lidocaine-antacid mouthwash group, and by 8.7 points in the placebo group. The between-group difference was 2.9 points (95% CI, 0.2-6.0; P = .02) for doxepin mouthwash vs placebo and 3.0 points (95% CI, 0.1-5.9; P = .004) for diphenhydramine-lidocaine-antacid mouthwash vs placebo. More drowsiness was reported with doxepin mouthwash vs placebo (by 1.5 points [95% CI, 0-4.0]; P = .03), unpleasant taste (by 1.5 points [95% CI, 0-3.0]; P = .002), and stinging or burning (by 4.0 points [95% CI, 2.5-5.0]; P < .001). Maximum grade 3 adverse events for the doxepin mouthwash occurred in 3 patients (4%); diphenhydramine-lidocaine-antacid mouthwash, 3 (4%); and placebo, 2 (2%). Fatigue was reported by 5 patients (6%) in the doxepin mouthwash group and no patients in the diphenhydramine-lidocaine-antacid mouthwash group. Conclusions and Relevance: Among patients undergoing head and neck radiotherapy, the use of doxepin mouthwash or diphenhydramine-lidocaine-antacid mouthwash vs placebo significantly reduced oral mucositis pain during the first 4 hours after administration; however, the effect size was less than the minimal clinically important difference. Further research is needed to assess longer-term efficacy and safety for both mouthwashes. Trial Registration: ClinicalTrials.gov Identifier: NCT02229539.


Assuntos
Antiácidos/uso terapêutico , Difenidramina/uso terapêutico , Doxepina/uso terapêutico , Neoplasias de Cabeça e Pescoço/radioterapia , Lidocaína/uso terapêutico , Antissépticos Bucais , Lesões por Radiação/tratamento farmacológico , Estomatite/tratamento farmacológico , Administração Tópica , Adulto , Idoso , Idoso de 80 Anos ou mais , Difenidramina/efeitos adversos , Método Duplo-Cego , Doxepina/efeitos adversos , Fadiga/induzido quimicamente , Feminino , Humanos , Lidocaína/efeitos adversos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Dor/tratamento farmacológico , Estomatite/etiologia
20.
Int J Mol Sci ; 20(7)2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30934722

RESUMO

Chemotherapy and/or head and neck radiotherapy are frequently associated with oral mucositis. Oral pain, odynophagia and dysphagia, opioid use, weight loss, dehydration, systemic infection, hospitalization and introduction of a feeding tube should be mentioned as the main determinated effect of oral mucositis. Oral mucositis leads to a decreased quality of life and an increase in treatment costs. Moreover, oral mucositis is a life-threatening disease. In addition to its own direct life-threatening consequences, it can also lead to a reduced survival due to the discontinuation or dose reduction of anti-neoplasm therapy. There are numerous strategies for the prevention or treatment of oral mucositis; however, their effectiveness is limited and does not correspond to expectations. This review is focused on the ghrelin and obestatin as potentially useful candidates for the prevention and treatment of chemo- or/and radiotherapy-induced oral mucositis.


Assuntos
Hormônios Gastrointestinais/uso terapêutico , Grelina/uso terapêutico , Estomatite/tratamento farmacológico , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Hormônios Gastrointestinais/farmacologia , Grelina/farmacologia , Humanos , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/patologia , Substâncias Protetoras/farmacologia , Substâncias Protetoras/uso terapêutico , Estomatite/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA