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Idrees M, Kujan O. A Curcumin-Based Oral Gel Has Potential Protective Efficacy against Oral Mucositis: In Vitro Study. J Pers Med 2023; 14:1. [PMID: 38276216 PMCID: PMC10820130 DOI: 10.3390/jpm14010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Oral mucositis is a common distressing complication of cancer therapy, characterised by painful sores within the oral cavity. Current management options offer limited symptomatic relief. Curcumin, a natural polyphenolic compound with recognised anti-inflammatory and antioxidant properties, has emerged as a potential protective agent against oral mucositis. This study explores the therapeutic potential of curcumin in mitigating the impact of oral mucositis by investigating a commercially available curcumin-based oral gel, PerioGold®. Liquid chromatography-tandem mass spectrometry was used to characterise the main constituents of PerioGold®. The cytotoxicity of curcumin constituent was investigated in four cell lines: primary oral keratinocytes (HOKs), immortalised oral keratinocytes (OKF6), dysplastic oral keratinocytes (DOKs), and oral squamous cell carcinoma cells (PE/CA-PJ15). Concentrations of hydrogen peroxide were optimised to develop in vitro models that mimic oral mucositis. The inhibitory effects of PerioGold® against the production of reactive oxygen species were assessed using a designated kit. OKF6 cells were the most sensitive to oxidative stress, while PE/CA-PJ15 cells showed the highest resistance. Pretreatment of the investigated cells for 24 h with PerioGold® demonstrated a significant antioxidative effect in all cells based on a dose-response pattern. PerioGold® exhibits clinical potential for protecting against oxidative stress, warranting further individualised clinical investigations.
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Affiliation(s)
| | - Omar Kujan
- Discipline of Oral Pathology, UWA Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA 6009, Australia;
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Mohammed AI, Sangha S, Nguyen H, Shin DH, Pan M, Park H, McCullough MJ, Celentano A, Cirillo N. Assessment of Oxidative Stress-Induced Oral Epithelial Toxicity. Biomolecules 2023; 13:1239. [PMID: 37627304 PMCID: PMC10452318 DOI: 10.3390/biom13081239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Reactive oxygen species (ROS) are highly reactive molecules generated in living organisms and an excessive production of ROS culminates in oxidative stress and cellular damage. Notably, oxidative stress plays a critical role in the pathogenesis of a number of oral mucosal diseases, including oral mucositis, which remains one of cancer treatments' most common side effects. We have shown previously that oral keratinocytes are remarkably sensitive to oxidative stress, and this may hinder the development and reproducibility of epithelial cell-based models of oral disease. Here, we examined the oxidative stress signatures that parallel oral toxicity by reproducing the initial events taking place during cancer treatment-induced oral mucositis. We used three oral epithelial cell lines (an immortalized normal human oral keratinocyte cell line, OKF6, and malignant oral keratinocytes, H357 and H400), as well as a mouse model of mucositis. The cells were subjected to increasing oxidative stress by incubation with hydrogen peroxide (H2O2) at concentrations of 100 μM up to 1200 μM, for up to 24 h, and ROS production and real-time kinetics of oxidative stress were investigated using fluorescent dye-based probes. Cell viability was assessed using a trypan blue exclusion assay, a fluorescence-based live-dead assay, and a fluorometric cytotoxicity assay (FCA), while morphological changes were analyzed by means of a phase-contrast inverted microscope. Static and dynamic real-time detection of the redox changes in keratinocytes showed a time-dependent increase of ROS production during oxidative stress-induced epithelial injury. The survival rates of oral epithelial cells were significantly affected after exposure to oxidative stress in a dose- and cell line-dependent manner. Values of TC50 of 800 μM, 800 μM, and 400 μM were reported for H400 cells (54.21 ± 9.04, p < 0.01), H357 cells (53.48 ± 4.01, p < 0.01), and OKF6 cells (48.64 ± 3.09, p < 0.01), respectively. Oxidative stress markers (MPO and MDA) were also significantly increased in oral tissues in our dual mouse model of chemotherapy-induced mucositis. In summary, we characterized and validated an oxidative stress model in human oral keratinocytes and identified optimal experimental conditions for the study of oxidative stress-induced oral epithelial toxicity.
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Affiliation(s)
- Ali I. Mohammed
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
- College of Dentistry, The University of Tikrit, Tikrit 34001, Iraq
| | - Simran Sangha
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
| | - Huynh Nguyen
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
| | - Dong Ha Shin
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
| | - Michelle Pan
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
| | - Hayoung Park
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
| | - Michael J. McCullough
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
| | - Antonio Celentano
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (A.I.M.); (H.N.); (M.J.M.); (A.C.)
- College of Dentistry, University of Jordan, Amman 11942, Jordan
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Mohammed AI, Celentano A, Paolini R, Low JT, Silke J, O' Reilly LA, McCullough M, Cirillo N. High molecular weight hyaluronic acid drastically reduces chemotherapy-induced mucositis and apoptotic cell death. Cell Death Dis 2023; 14:453. [PMID: 37479691 PMCID: PMC10362044 DOI: 10.1038/s41419-023-05934-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
Oral and intestinal mucositis (OIM) are debilitating inflammatory diseases initiated by oxidative stress, resulting in epithelial cell death and are frequently observed in cancer patients undergoing chemo-radiotherapy. There are currently few preventative strategies for this debilitating condition. Therefore, the development of a safe and effective mucositis mitigating strategy is an unmet medical need. Hyaluronic acid (HA) preparations have been tentatively used in oral mucositis. However, the protective effects of HA in chemotherapy-induced mucositis and their underlying mechanisms remain to be fully elucidated. This study aimed to assess these mechanisms using multiple formulations of enriched HA (Mucosamin®), cross-linked (xl-), and non-crosslinked high molecular weight HA (H-MW-HA) in an oxidative stress-induced model of human oral mucosal injury in vitro and an in vivo murine model of 5-flurouracil (5-FU)-induced oral/intestinal mucositis. All tested HA formulations protected against oxidative stress-induced damage in vitro without inducing cytotoxicity, with H-MW-HA also significantly reducing ROS production. Daily supplementation with H-MW-HA in vivo drastically reduced the severity of 5-FU-induced OIM, prevented apoptotic damage and reduced COX-2 enzyme activity in both the oral and intestinal epithelium. In 5-FU-injected mice, HA supplementation also significantly reduced serum levels of IL-6 and the chemokine CXCL1/KC, while the serum antioxidant activity of superoxide dismutase was elevated. Our data suggest that H-MW-HA attenuates 5-FU-induced OIM, at least partly, by impeding apoptosis, inhibiting of oxidative stress and suppressing inflammatory cytokines. This study supports the development of H-MW-HA preparations for preventing OIM in patients receiving chemotherapy.
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Affiliation(s)
- Ali I Mohammed
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, 3053, Carlton, VIC, Australia.
- College of Dentistry, The University of Tikrit, Tikrit, Iraq.
| | - Antonio Celentano
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, 3053, Carlton, VIC, Australia
| | - Rita Paolini
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, 3053, Carlton, VIC, Australia
| | - Jun T Low
- The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC, 3052, Australia
| | - John Silke
- The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Lorraine A O' Reilly
- The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Michael McCullough
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, 3053, Carlton, VIC, Australia
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, 3053, Carlton, VIC, Australia.
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Protective Effects of Cannabidiol on Chemotherapy-Induced Oral Mucositis via the Nrf2/Keap1/ARE Signaling Pathways. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4619760. [PMID: 35669853 PMCID: PMC9165619 DOI: 10.1155/2022/4619760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/09/2022] [Indexed: 12/15/2022]
Abstract
Oral mucositis (OM) is a common complication during chemotherapy characterized by ulceration, mucosa atrophy, and necrosis, which seriously interferes with nutritional intake and oncotherapy procedures among patients. However, the efficacy of current treatments for OM remains limited. Cannabidiol (CBD) is a natural cannabinoid with multiple biological activities, including antioxidant and anti-inflammatory potential. In this study, we aimed to investigate the chemopreventive effects and mechanisms of CBD in protecting C57BL/6N mice and human oral keratinocytes (HOK) from 5-fluorouracil- (5-FU-) induced OM. Here, we found that CBD alleviated the severity of 5-FU-induced OM in mice, including improved survival, decreased body weight loss, reduced ulcer sizes, and improved clinical scores. Histologically, CBD restored epithelial thickness and normal structure in tongue tissues. Meanwhile, CBD attenuated reactive oxygen species (ROS) overproduction and improved the antioxidant response, suppressed the inflammatory response, promoted the proliferation of epithelial cells, and inhibited 5-FU-induced apoptosis. In vitro, consistent outcomes showed that CBD suppressed cellular ROS levels, enhanced antioxidant ability, reduced inflammatory response, promoted proliferation, and inhibited apoptosis in 5-FU-treated HOK cells. In particular, CBD upregulated the expression levels of antioxidant enzymes, heme oxygenase-1 (HO-1) and NAD(P)H quinine oxidoreductase 1 (NQO1), by increasing the expression and nuclear translocation of nuclear factor erythroid 2-related factor 2 (Nrf2) and decreasing Kelch-like ECH-associated protein 1 (Keap1). Notably, the Nrf2 inhibitor ML385 reversed the protective effect of CBD. Nrf2-siRNA transfection also significantly blunted the antioxidant effect of CBD in in vitro OM model. Collectively, our findings suggested that CBD protected against 5-FU-induced OM injury at least partially via the Nrf2/Keap1/ARE signaling pathways, highlighting the therapeutic prospects of CBD as a novel strategy for chemotherapy-induced OM.
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Teixeira da Silva T, Braga Martins J, Do Socorro de Brito Lopes M, de Almeida PM, Silva Sá JL, Alline Martins F. Modulating effect of DL-kavain on the mutagenicity and carcinogenicity induced by doxorubicin in Drosophila melanogaster. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2021; 84:769-782. [PMID: 34176449 DOI: 10.1080/15287394.2021.1942354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Kavain, kavalactone, present in Piper methysticum exhibits anticonvulsive, analgesic, anxiolytic, antiepileptic, antithrombotic, anti-inflammatory and antioxidant properties. Given its importance, the aim of the present study was to assess (1) the mutagenic and carcinogenicity of kavain administered alone and (2) the antimutagenic and anticarcinogenic potential when administered simultaneously with the chemotherapeutic drug doxorubicin (DXR) using the Somatic Mutation and Recombination Test (SMART) and Epithelial Tumor Test (ETT) using Drosophila melanogaster as a model system. Third-stage larvae from a standard (ST) and high metabolic bioactivation (HB) crosses were treated with different kavain concentrations (32, 64 or 128 μg/ml), alone or in conjunction with DXR (0.125 mg/ml). In ST descendants, kavain produced no significant mutagenic or recombinogenic effects. In the HB cross, mutagenic activity was observed at kavain concentrations of 64 and 128 μg/ml. In the DXR and kavain co-treatment, a modulating effect of the DXR-mediated mutagenic response dependent upon the concentration was detected in both crosses. In ETT, no marked carcinogenic or anticarcinogenic activity was noted for kavain. However, when kavain was combined with DXR synergistic induction of tumors by the chemotherapeutic drug occurred indicating that kavain enhanced the carcinogenic action of DXR.
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Affiliation(s)
- Thaís Teixeira da Silva
- Department of Chemistry, State Post-Graduation Program in Chemistry, University of Piauí, Teresina, Piauí, Brazil
- Laboratory of Genetics, Center for Natural Sciences, State University of Piauí, Teresina, Piauí, Brazil
| | - Júlia Braga Martins
- Laboratory of Genetics, Center for Natural Sciences, State University of Piauí, Teresina, Piauí, Brazil
| | | | - Pedro Marcos de Almeida
- Laboratory of Genetics, Center for Natural Sciences, State University of Piauí, Teresina, Piauí, Brazil
- Department of Genetics, Health Sciences Center, State University of Piauí, Teresina, Piauí, Brazil
| | - José Luiz Silva Sá
- Department of Chemistry, State Post-Graduation Program in Chemistry, University of Piauí, Teresina, Piauí, Brazil
| | - Francielle Alline Martins
- Department of Chemistry, State Post-Graduation Program in Chemistry, University of Piauí, Teresina, Piauí, Brazil
- Laboratory of Genetics, Center for Natural Sciences, State University of Piauí, Teresina, Piauí, Brazil
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Sanz JL, Soler-Doria A, López-García S, García-Bernal D, Rodríguez-Lozano FJ, Lozano A, Llena C, Forner L, Guerrero-Gironés J, Melo M. Comparative Biological Properties and Mineralization Potential of 3 Endodontic Materials for Vital Pulp Therapy: Theracal PT, Theracal LC, and Biodentine on Human Dental Pulp Stem Cells. J Endod 2021; 47:1896-1906. [PMID: 34425148 DOI: 10.1016/j.joen.2021.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The aim of this study was to assess the biological properties and mineralization potential of the new Theracal PT (Bisco Inc, Schaumburg, IL) compared with its predecessor Theracal LC (Bisco Inc) and the hydraulic silicate-based cement Biodentine (Septodont, Saint-Maur-des-Fossés, France) on human dental pulp stem cells (hDPSCs) in vitro. METHODS Standardized sample discs were obtained for each material (n = 30) together with 1:1, 1:2, and 1:4 material eluates. Previously characterized hDPSCs were cultured with the different materials in standardized conditions, and the following assays were performed: a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, a wound healing assay, Annexin-V-FITC and 7-AAD staining (BD Biosciences, San Jose, CA), reactive oxygen species production analysis, cell adhesion and morphology evaluation via scanning electron microscopy and immunofluorescence, quantification of the expression of osteo/odontogenic markers via real-time quantitative reverse-transcriptase polymerase chain reaction, and alizarin red S staining. Statistical significance was established at P < .05. RESULTS All of the tested dilutions of Theracal LC exhibited a significantly higher cytotoxicity and reactive oxygen species production (P < .001) and a lower cell migration rate than the control group (hDPSCs cultured in growth medium without material extracts) at all of the measured time points (P < .001). Both 1:4 Theracal PT and Biodentine-treated hDPSCs exhibited similar levels of cytocompatibility to that of the control group, a significant up-regulation of at least 1 odontogenic marker (Biodentine: dentin sialophosphoprotein (P < .05); Theracal PT: osteonectin and runt-related transcription factor 2 [P < .001]), and a significantly higher mineralized nodule formation (P < .001). CONCLUSIONS The newly introduced TheraCal PT offers an improved in vitro cytocompatibility and mineralization potential on hDPSCs compared with its predecessor, TheraCal LC, and comparable biological properties to Biodentine.
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Affiliation(s)
- José Luis Sanz
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Anna Soler-Doria
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Sergio López-García
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, IMIB Arrixaca, University of Murcia, Murcia, Spain; Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - David García-Bernal
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, IMIB Arrixaca, University of Murcia, Murcia, Spain
| | - Francisco J Rodríguez-Lozano
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, IMIB Arrixaca, University of Murcia, Murcia, Spain; Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Adrián Lozano
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Carmen Llena
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Leopoldo Forner
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Julia Guerrero-Gironés
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, Spain.
| | - María Melo
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
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