|
1
|
The alterations of microbiota and pathological conditions in the gut of patients with colorectal cancer undergoing chemotherapy. Anaerobe 2021; 68:102361. [PMID: 33781900 DOI: 10.1016/j.anaerobe.2021.102361] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/10/2021] [Accepted: 03/15/2021] [Indexed: 02/08/2023]
Abstract
Colorectal cancer (CRC) has become a serious threat to human life and health. Most patients are diagnosed at the late stage of advanced CRC, resulting in losing their best opportunity for surgical treatment. Chemotherapy plays a crucial role in the control and treatment of advanced CRC. However, the cytotoxicity of chemotherapeutic drugs can easily cause the imbalance of gut flora, damage the barrier of the gastrointestinal mucosa, and mediate mucosal inflammation of the digestive tract, which is called "gastrointestinal mucositis." This mucositis can affect the quality of life of the host and even threaten their lives. Several studies reported the association between chemotherapy-mediated gastrointestinal mucositis in CRC and gut dysbiosis. However, the underlying mechanisms of this association are still unclear. The alternative or complementary treatments to reshape gut microbiota and slow down the side effects of chemotherapy have shown the improvement of gastrointestinal mucositis following chemotherapy in the CRC condition. This review will summarize and discuss the evidence of the association between chemotherapy-mediated gastrointestinal mucositis in CRC and altered gut microbiota from in vivo and clinical studies. The possible mechanisms of gastrointestinal mucositis, including the destruction of the gastrointestinal mucosal barrier, the induction of gut dysbiosis, and histopathological changes in the gut of CRC with chemotherapy will be illustrated. In addition, the nonpharmacological interventions and phytochemical extracts by using the manipulation of the microbial population for therapeutic purposes for relieving side effects of chemotherapy as well as a cancer treatment would be summarized and discussed in this review.
Collapse
|
|
2
|
de Miranda JAL, Martins CDS, Fideles LDS, Barbosa MLL, Barreto JEF, Pimenta HB, Freitas FOR, Pimentel PVDS, Teixeira CS, Scafuri AG, dos Santos Luciano MC, Araújo JL, Rocha JA, Vieira IGP, Ricardo NMPS, da Silva Campelo M, Ribeiro MENP, de Castro Brito GA, Cerqueira GS. Troxerutin Prevents 5-Fluorouracil Induced Morphological Changes in the Intestinal Mucosa: Role of Cyclooxygenase-2 Pathway. Pharmaceuticals (Basel) 2020; 13:E10. [PMID: 31936203 PMCID: PMC7169416 DOI: 10.3390/ph13010010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/29/2019] [Accepted: 01/04/2020] [Indexed: 02/06/2023] Open
Abstract
Intestinal mucositis is a common complication associated with 5-fluorouracil (5-FU), a chemotherapeutic agent used for cancer treatment. Troxerutin (TRX), a semi-synthetic flavonoid extracted from Dimorphandra gardneriana, has been reported as a potent antioxidant and anti-inflammatory agent. In the present study, we aimed to evaluate the effect of TRX on 5-FU-induced intestinal mucositis. Swiss mice were randomly divided into seven groups: Saline, 5-FU, TRX-50, TRX-100, TRX-150, Celecoxib (CLX), and CLX + TRX-100. The weight of mice was measured daily. After treatment, the animals were euthanized and segments of the small intestine were collected to evaluate histopathological alterations (morphometric analysis), levels of malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), mast and goblet cell counts, immunohistochemical analysis, and cyclooxygenase-2 (COX-2) activity. Compared to the saline treatment, the 5-FU treatment induced intense weight loss and reduction in villus height. TRX treatment (100 mg/kg) prevented the 5-FU-induced histopathological changes and decreased oxidative stress by decreasing the MDA levels and increasing GSH concentration. TRX attenuated inflammatory process by decreasing MPO activity, intestinal mastocytosis, and COX-2 expression. TRX also reversed the depletion of goblet cells. Our findings suggest that TRX at a concentration of 100 mg/kg had chemopreventive effects on 5-FU-induced intestinal mucositis via COX-2 pathway.
Collapse
Affiliation(s)
- João Antônio Leal de Miranda
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Conceição da Silva Martins
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Lázaro de Sousa Fideles
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Maria Lucianny Lima Barbosa
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - João Erivan Façanha Barreto
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Helder Bindá Pimenta
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Francisco Orlando Rafael Freitas
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Paulo Vitor de Souza Pimentel
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Claudio Silva Teixeira
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Ariel Gustavo Scafuri
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Maria Claudia dos Santos Luciano
- Nucleus of Research and Development of Medications (NPDM), Federal University of Ceará, Coronel Nunes of Melo Street, 100, Fortaleza 60430-275, Brazil;
| | - Joabe Lima Araújo
- Research Group in Natural Sciences and Biotechnology, Federal University of Maranhão, s/n Avenue Aurila Maria Santos Barros of Sousa, Frei Alberto Beretta, Grajaú-MA 65940-000, Brazil; (J.L.A.); (J.A.R.)
| | - Jefferson Almeida Rocha
- Research Group in Natural Sciences and Biotechnology, Federal University of Maranhão, s/n Avenue Aurila Maria Santos Barros of Sousa, Frei Alberto Beretta, Grajaú-MA 65940-000, Brazil; (J.L.A.); (J.A.R.)
| | - Icaro Gusmão Pinto Vieira
- Technological Development Park, Federal University of Ceará, Humberto Monte Avenue, 2977, Pici Campus, Fortaleza 60440-900, Brazil;
| | - Nágila Maria Pontes Silva Ricardo
- Department of Organic and Inorganic Chemistry, Federal University of Ceará, Pici Campus, Fortaleza 60440-900, Brazil; (N.M.P.S.R.); (M.d.S.C.); (M.E.N.P.R.)
| | - Matheus da Silva Campelo
- Department of Organic and Inorganic Chemistry, Federal University of Ceará, Pici Campus, Fortaleza 60440-900, Brazil; (N.M.P.S.R.); (M.d.S.C.); (M.E.N.P.R.)
| | - Maria Elenir Nobre Pinho Ribeiro
- Department of Organic and Inorganic Chemistry, Federal University of Ceará, Pici Campus, Fortaleza 60440-900, Brazil; (N.M.P.S.R.); (M.d.S.C.); (M.E.N.P.R.)
| | - Gerly Anne de Castro Brito
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| | - Gilberto Santos Cerqueira
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, s/n Delmiro of Farias Street, Porangabuçu Campus, Fortaleza 60416-030, Brazil; (C.d.S.M.); (L.d.S.F.); (M.L.L.B.); (J.E.F.B.); (H.B.P.); (F.O.R.F.); (P.V.d.S.P.); (C.S.T.); (A.G.S.); (G.A.d.C.B.); (G.S.C.)
| |
Collapse
|
|
4
|
Bahramnezhad F, Dehghan Nayeri N, Bassampour SS, Khajeh M, Asgari P. Honey and Radiation-Induced Stomatitis in Patients With Head and Neck Cancer. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e19256. [PMID: 26568850 PMCID: PMC4636750 DOI: 10.5812/ircmj.19256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 12/02/2014] [Accepted: 03/20/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Stomatitis is a common oral complication which affects 100% of patients undergoing head and neck radiotherapy. Acute stomatitis might cause failure and delay radiotherapy. Attention to mouth hygiene, particularly using mouthwash, has a fundamental importance for these patients. OBJECTIVES The current study came to addresses the effects of pure natural honey on radiation-induced stomatitis in patients with a variety of head and neck cancers. PATIENTS AND METHODS The present single-blinded nonrandomized controlled trial was conducted on 105 patients undergoing radiotherapy due to head and neck cancer at the radiation unit of Shafa hospital in Kerman, Iran, from October 2012 to March 2012. The research groups were selected by writing the names of the protocols (the mouthwashes of chamomile, honey and the common caring protocol at ward which uses water) on three cubes. The first extracted cube was related to the chamomile mouthwash (Matrica), the second to the honey mouthwash and the last cube to the water mouthwash. The first experimental group (n = 35) gurgled a solution containing 20 mL diluted honey, the second group gurgled a solution containing German chamomile, and the 35 patients in the control group were advised to gurgle 20 mL water (the ward routine). RESULTS The results showed that severe stomatitis in groups of honey, chamomile and control was 0, 5.7%, and 17.6%, respectively. On the 14th day, it was 0, 0, and 17.6%, respectively. There were significant differences between the three groups regarding the severity of stomatitis in the 14th day (P < 0.001). CONCLUSIONS The application of natural honey is effective in managing and preventing radiation-induced stomatitis in patients with head and neck cancers.
Collapse
Affiliation(s)
- Fatemeh Bahramnezhad
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Shiva Sadat Bassampour
- Department of Medical and Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mahboobeh Khajeh
- Department of Pediatric, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Parvaneh Asgari
- Department of Critical Care Nursing, Nursing and Midwifery Faculty, Arak University of Medical Sciences, Arak, IR Iran
| |
Collapse
|
|
5
|
Amniotic membrane as a biological dressing for 5-fluoruracil-induced oral mucositis in rats. Int J Oral Maxillofac Surg 2015; 44:845-51. [PMID: 25662431 DOI: 10.1016/j.ijom.2015.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 01/08/2015] [Accepted: 01/12/2015] [Indexed: 11/20/2022]
Abstract
Oral mucositis is a reaction to chemoradiation therapy during cancer treatment. The aim of this study was to investigate the use of amniotic membrane as a biological dressing for oral mucositis lesions in rats. Sixty Wistar rats were divided into three groups (n = 20): control, 5-fluoruracil (5-FU), 5-fluoruracil + amniotic membrane (5-FU+AM). Each group was subdivided (n = 5) according to the time interval to sacrifice (3, 7, 14, and 21 days). Histology (haematoxylin-eosin staining) and immunocytochemistry (anti-rat antibodies CD4, CD8, VEGF, and PCNA) were evaluated. Immunocytochemistry results were analyzed using one-way ANOVA and Tukey tests. The amniotic membrane (5FU+AM) played an important role in cell proliferation (PCNA 3 days 27.08 ± 4.65, 7 days 27.90 ± 3.34) and especially in neovascularization (VEGF 3 days 23.00 ± 1.40, 7 days 26.00 ± 0.95) for all time intervals, when compared to 5-FU (PCNA 3 days 23.12 ± 1.61, 7 days 37.21 ± 1.20; VEGF 3 days 17.05 ± 1.51, 7 days 8.45 ± 1.35) and control (PCNA 3 days 29.99 ± 0.92, 7 days 16.33 ± 2.88; VEGF 3 days 13.65 ± 0.55, 7 days 15.70 ± 1.39). It was biocompatible, showing significant differences compared to the other groups in CD4 (F = 40.72; P = 0.001) and CD8 (F = 69.99, P = 0.001) staining together, only during the inflammation phase (7 days). Amniotic membrane presented biocompatibility and stimulated cell proliferation and neovascularization, functioning as a promising biological dressing.
Collapse
|
|
8
|
Boukhettala N, Ibrahim A, Aziz M, Vuichoud J, Saudan KY, Blum S, Déchelotte P, Breuillé D, Coëffier M. A diet containing whey protein, free glutamine, and transforming growth factor-beta ameliorates nutritional outcome and intestinal mucositis during repeated chemotherapeutic challenges in rats. J Nutr 2010; 140:799-805. [PMID: 20181781 DOI: 10.3945/jn.109.119222] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Anticancer chemotherapy often induces side effects such as mucositis. Recent data suggest that a diet, Clinutren Protect (CP), containing whey proteins, glutamine, and transforming growth factor-beta (TGFbeta)-rich casein limits intestinal mucositis and improves recovery after a single methotrexate (MTX) challenge in rats. Chemotherapy consists of alternating periods of treatment and rest. Thus, our study evaluated the effects of CP on nutritional outcome and intestinal mucositis in rats receiving repeated chemotherapeutic challenges. Thirty-six Sprague-Dawley rats received 3 cycles of MTX at 8-d intervals. Rats had free access to CP or control diet (Co) from 7 d before the first MTX injection until the end of the experiment at d 27. In Co, whey proteins and TGFbeta-rich casein were replaced by TGFbeta-free casein. L-Glutamine was replaced by L-alanine. Body composition was assessed by dual energy X-ray absorptiometry. Before MTX challenges, food intake and body weight were similar in both groups but became higher during MTX challenges in CP (P < 0.05). Fat mass decreased similarly in both groups. In contrast, the decrease of fat free mass between d -1 and d 27 was less pronounced in the CP group (-9.5 g) than in the Co group (-57.2 g) (P < 0.05). The intestinal damage score was lower in the CP group (0.6 +/- 0.3 vs. 2.1 +/- 0.6; P < 0.05). Fecal IgA increased over time in the CP group (P < 0.05) but not in the Co group. A diet containing whey proteins, glutamine, and TGFbeta improves nutritional outcome by limiting the reduction of fat free mass and reduces intestinal mucositis during repeated chemotherapeutic challenges in rats.
Collapse
|