epidermal-growth-factor and Mucositis

The objective of this study was to evaluate the effect of salivary stimulation therapies on the salivary flow, oral mucositis, and salivary cytokine levels in patients receiving allogeneic hematopoietic stem cell transplantation.. Thirty-five eligible patients were randomized into 4 groups: control, mechanical sialogogue, transcutaneous electrical nerve stimulation (TENS) sialogogue, and combined mechanical/electrical sialogogue. Saliva was collected from patients before transplantation and at days 3, 7, and 14 after transplantation. The volume was measured and salivary cytokines were assessed using enzyme-linked immunosorbent assay.. By day 14, resting and stimulated salivary flow levels were diminished. Resting salivary flow rates decreased the most in the control and mechanical groups. In contrast, TENS alone or in combination with mechanical stimulatory therapy benefited the patients. TENS-treated patients showed increase in resting salivary flow. Also, the groups treated with TENS had fewer patients affected by grades 3 and 4 mucositis, and less mucositis was associated with better patient survival (P = .027).. TENS-associated salivary stimulation therapies minimized the reduction of salivary flow and prevented severe chemotherapy-induced oral mucositis.

Topics: Adult; Analysis of Variance; Epidermal Growth Factor; Female; Hematopoietic Stem Cell Transplantation; Humans; Interleukin-10; Male; Matrix Metalloproteinase 2; Matrix Metalloproteinase 9; Middle Aged; Mucositis; Physical Stimulation; Prospective Studies; Saliva; Salivation; Statistics, Nonparametric; Stomatitis; Tissue Inhibitor of Metalloproteinase-1; Tissue Inhibitor of Metalloproteinase-2; Transcutaneous Electric Nerve Stimulation; Transplantation Conditioning; Tumor Necrosis Factor-alpha; Young Adult

Mucositis is a common adverse effect of cytotoxic anticancer treatment with serious implications for the quality of life, morbidity and mortality of cancers patients. Although, evidence supporting the use of certain treatments exists there is no gold standard for preventing or treating mucositis. Current management strategies are scarce with recommendations referring primarily to specific cytotoxic treatment regimens in certain clinical scenarios.. Trophic factors may contribute to preserve epithelial integrity, function, and accelerate regeneration after chemotherapeutic treatment. Accordingly, various growth factors have been evaluated in the prevention or treatment of alimentary tract mucositis. However, in spite of often showing promising results in preclinical testing currently perlifermin is the only trophic factor recommended for the prevention of mucositis.. More knowledge from representative preclinical models, and testing growth factor interventions across different models, may be the key to advance the field from basic science to clinical application of new growth factors. For promising new therapies, subsequent establishment of adequately powered clinical trials and uniform reporting of mucositis, are important elements to help establish new standard interventions that can be included into the continuously updated clinical recommendations for treatment of mucositis.

Topics: Antineoplastic Agents; Epidermal Growth Factor; Fibroblast Growth Factors; Gastrointestinal Diseases; Glucagon-Like Peptides; Humans; Intercellular Signaling Peptides and Proteins; Mucositis; Oligosaccharides; Palliative Care; Quality of Life; Transforming Growth Factor beta

Recombinant human epidermal growth factor (rhEGF) has potential benefit for the mucositis induced by radiation therapy as a therapeutic setting. In this study, we aimed to investigate the effects of rhEGF treatment on the radiation-induced changes in epithelial transport function, before the occurrence of the definitive histological mucosal changes. C3H/He mice received 0, 4, or 8 Gy irradiation and/or EGF treatment (rhEGF 0, 1 and 5mg/kg, i.p., 5 days). At day 7, we recorded short circuit current (I(sc)) of the upper tracheal epithelium using the flow-type Ussing chamber method, with histological analysis. As a result, there was no evident pathological change in the epithelium from the irradiated and/or rhEGF treated mice at day 7. The initial level of I(sc) and amiloride-sensitive I(sc) (ΔI(sc,Amil)) were decreased after 8 Gy irradiation, reflecting suppression of basal Na+ absorption. The decreased ΔI(sc,Amil) was recovered by rhEGF treatment. In conclusion, epithelial Na+ channel-dependent basal Na+ absorption was primarily affected by irradiation, before the pathological changes. The recovery of basal Na+ absorption (ΔI(sc,Amil)) suggested a potentially beneficial effect of early rhEGF treatment for irradiation-induced suppression of the upper aerodigestive epithelial functions.

Topics: Absorption; Animals; Body Weight; Epidermal Growth Factor; Epithelium; Female; Humans; Ion Transport; Mice; Mice, Inbred C3H; Mucositis; Radiation Injuries, Experimental; Radiation-Protective Agents; Recombinant Proteins; Sodium; Trachea