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Zhou Y, Li K, Adelson DL. An unmet need for pharmacology: Treatments for radiation-induced gastrointestinal mucositis. Biomed Pharmacother 2024; 175:116767. [PMID: 38781863 DOI: 10.1016/j.biopha.2024.116767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
Gastrointestinal mucositis (GIM) continues to be a significant issue in the management of abdominal cancer radiation treatments and chemotherapy, causing significant patient discomfort and therapy interruption or even cessation. This review will first focus on radiotherapy induced GIM, providing an understanding of its clinical landscape. Subsequently, the aetiology of GIM will be reviewed, highlighting diverse contributing factors. The cellular and tissue damage and associated molecular responses in GIM will be summarised in the context of the underlying complex biological processes. Finally, available drugs and pharmaceutical therapies will be evaluated, underscoring their insufficiency, and highlighting the need for further research and innovation. This review will emphasize the urgent need for improved pharmacologic therapeutics for GIM, which is a key research priority in oncology.
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Affiliation(s)
- Yan Zhou
- Department of Molecular and Biomedical Science, School of Biological Sciences, The University of Adelaide, Adelaide, South Australia 5005, Australia; Zhendong Australia China Centre for Molecular Chinese Medicine, The University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Kun Li
- Beijing Zhendong Guangming Pharmaceutical Research Institute, Beijing 100120, China.
| | - David L Adelson
- Department of Molecular and Biomedical Science, School of Biological Sciences, The University of Adelaide, Adelaide, South Australia 5005, Australia; Zhendong Australia China Centre for Molecular Chinese Medicine, The University of Adelaide, Adelaide, South Australia 5005, Australia.
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2
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Bernardi M, Signore G, Moscardini A, Pugliese LA, Pesce L, Beltram F, Cardarelli F. Fluorescence Lifetime Nanoscopy of Liposomal Irinotecan Onivyde: From Manufacturing to Intracellular Processing. ACS APPLIED BIO MATERIALS 2023; 6:4277-4289. [PMID: 37699572 PMCID: PMC10583229 DOI: 10.1021/acsabm.3c00478] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/27/2023] [Indexed: 09/14/2023]
Abstract
Onivyde was approved by the Food and Drug Administration (FDA) in 2015 for the treatment of solid tumors, including metastatic pancreatic cancer. It is designed to encapsulate irinotecan at high concentration, increase its blood-circulation lifetime, and deliver it to cells where it is enzymatically converted into SN-38, a metabolite with 100- to 1000-fold higher anticancer activity. Despite a rewarding clinical path, little is known about the physical state of encapsulated irinotecan within Onivyde and how this synthetic identity changes throughout the process from manufacturing to intracellular processing. Herein, we exploit irinotecan intrinsic fluorescence and fluorescence lifetime imaging microscopy (FLIM) to selectively probe the supramolecular organization of the drug. FLIM analysis on the manufacturer's formulation reveals the presence of two coexisting physical states within Onivyde liposomes: (i) gelated/precipitated irinotecan and (ii) liposome-membrane-associated irinotecan, the presence of which is not inferable from the manufacturer's indications. FLIM in combination with high-performance liquid chromatography (HPLC) and a membrane-impermeable dynamic quencher of irinotecan reveals rapid (within minutes) and complete chemical dissolution of the gelated/precipitated phase upon Onivyde dilution in standard cell-culturing medium with extensive leakage of the prodrug from liposomes. Indeed, confocal imaging and cell-proliferation assays show that encapsulated and nonencapsulated irinotecan formulations are similar in terms of cell-uptake mechanism and cell-division inhibition. Finally, 2-channel FLIM analysis discriminates the signature of irinotecan from that of its red-shifted SN-38 metabolite, demonstrating the appearance of the latter as a result of Onivyde intracellular processing. The findings presented in this study offer fresh insights into the synthetic identity of Onivyde and its transformation from production to in vitro administration. Moreover, these results serve as another validation of the effectiveness of FLIM analysis in elucidating the supramolecular organization of encapsulated fluorescent drugs. This research underscores the importance of leveraging advanced imaging techniques to deepen our understanding of drug formulations and optimize their performance in delivery applications.
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Affiliation(s)
- Mario Bernardi
- Scuola
Normale Superiore, Laboratorio NEST, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - Giovanni Signore
- Biochemistry
Unit, Department of Biology, University
of Pisa, via San Zeno
51, 56123 Pisa, Italy
- Institute
of Clinical Physiology, National Research
Council, 56124 Pisa, Italy
| | - Aldo Moscardini
- Scuola
Normale Superiore, Laboratorio NEST, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - Licia Anna Pugliese
- Scuola
Normale Superiore, Laboratorio NEST, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - Luca Pesce
- Scuola
Normale Superiore, Laboratorio NEST, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - Fabio Beltram
- Scuola
Normale Superiore, Laboratorio NEST, Piazza San Silvestro 12, 56127 Pisa, Italy
- NEST,
Istituto Nanoscienze-CNR, Piazza S. Silvestro, 12, I-56127 Pisa, Italy
| | - Francesco Cardarelli
- Scuola
Normale Superiore, Laboratorio NEST, Piazza San Silvestro 12, 56127 Pisa, Italy
- NEST,
Istituto Nanoscienze-CNR, Piazza S. Silvestro, 12, I-56127 Pisa, Italy
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3
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Wen X, Ye X, Yang X, Jiang R, Qian C, Wang X. The crosstalk between intestinal bacterial microbiota and immune cells in colorectal cancer progression. Clin Transl Oncol 2023; 25:620-632. [PMID: 36376701 DOI: 10.1007/s12094-022-02995-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022]
Abstract
Different types of cells that are involved in tumor immunity play a significant part in antitumor therapy. The intestinal microbiota consist of the trillions of diverse microorganisms that inhabit the gastrointestinal tract. Recently, much emphasis has been paid to the link between these symbionts and colorectal cancer (CRC). This association might be anything from oncogenesis and cancer development to resistance or susceptibility to chemotherapeutic medicines. Cancer patients have a significantly different microbial composition in their guts compared to healthy persons. The microbiome may play a role in the development and development of cancer through the modulation of tumor immunosurveillance, as shown by these studies; however, the specific processes underlying this role are still poorly understood. This review focuses on the relationship between the intestinal bacterial microbiota and immune cells to determine how the commensal microbiome influences the initiation and development of CRC.
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Affiliation(s)
- Xiaozi Wen
- Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xufang Ye
- Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xuejun Yang
- Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Rujin Jiang
- Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chunyan Qian
- Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xianjun Wang
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Kullenberg F, Peters K, Luna-Marco C, Salomonsson A, Kopsida M, Degerstedt O, Sjöblom M, Hellström PM, Heindryckx F, Dahlgren D, Lennernäs H. The progression of doxorubicin-induced intestinal mucositis in rats. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:247-260. [PMID: 36271936 PMCID: PMC9832110 DOI: 10.1007/s00210-022-02311-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/14/2022] [Indexed: 01/29/2023]
Abstract
Chemotherapy-induced intestinal mucositis is a severe side effect contributing to reduced quality of life and premature death in cancer patients. Despite a high incidence, a thorough mechanistic understanding of its pathophysiology and effective supportive therapies are lacking. The main objective of this rat study was to determine how 10 mg/kg doxorubicin, a common chemotherapeutic, affected jejunal function and morphology over time (6, 24, 72, or 168 h). The secondary objective was to determine if the type of dosing administration (intraperitoneal or intravenous) affected the severity of mucositis or plasma exposure of the doxorubicin. Morphology, proliferation and apoptosis, and jejunal permeability of mannitol were examined using histology, immunohistochemistry, and single-pass intestinal perfusion, respectively. Villus height was reduced by 40% after 72 h, preceded at 24 h by a 75% decrease in proliferation and a sixfold increase in apoptosis. Villus height recovered completely after 168 h. Mucosal permeability of mannitol decreased after 6, 24, and 168 h. There were no differences in intestinal injury or plasma exposure after intraperitoneal or intravenous doxorubicin dosing. This study provides an insight into the progression of chemotherapy-induced intestinal mucositis and associated cellular mucosal processes. Knowledge from this in vivo rat model can facilitate development of preventive and supportive therapies for cancer patients.
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Affiliation(s)
- F Kullenberg
- Department of Pharmaceutical Biosciences, Uppsala University, 752 37, Uppsala, Sweden
| | - K Peters
- Department of Pharmaceutical Biosciences, Uppsala University, 752 37, Uppsala, Sweden
- Department of Medical Cell Biology, Uppsala University, 751 23, Uppsala, Sweden
| | - C Luna-Marco
- Department of Pharmaceutical Biosciences, Uppsala University, 752 37, Uppsala, Sweden
- Department of Medical Cell Biology, Uppsala University, 751 23, Uppsala, Sweden
| | - A Salomonsson
- Department of Pharmaceutical Biosciences, Uppsala University, 752 37, Uppsala, Sweden
| | - M Kopsida
- Department of Medical Cell Biology, Uppsala University, 751 23, Uppsala, Sweden
| | - O Degerstedt
- Department of Pharmaceutical Biosciences, Uppsala University, 752 37, Uppsala, Sweden
| | - M Sjöblom
- Department of Medical Cell Biology, Uppsala University, 751 23, Uppsala, Sweden
| | - P M Hellström
- Department of Medical Sciences, Uppsala University, 751 85, Uppsala, Sweden
| | - F Heindryckx
- Department of Medical Cell Biology, Uppsala University, 751 23, Uppsala, Sweden
| | - D Dahlgren
- Department of Pharmaceutical Biosciences, Uppsala University, 752 37, Uppsala, Sweden
| | - H Lennernäs
- Department of Pharmaceutical Biosciences, Uppsala University, 752 37, Uppsala, Sweden.
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Experimental Chemotherapy-Induced Mucositis: A Scoping Review Guiding the Design of Suitable Preclinical Models. Int J Mol Sci 2022; 23:ijms232315434. [PMID: 36499758 PMCID: PMC9737148 DOI: 10.3390/ijms232315434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
Mucositis is a common and most debilitating complication associated with the cytotoxicity of chemotherapy. The condition affects the entire alimentary canal from the mouth to the anus and has a significant clinical and economic impact. Although oral and intestinal mucositis can occur concurrently in the same individual, these conditions are often studied independently using organ-specific models that do not mimic human disease. Hence, the purpose of this scoping review was to provide a comprehensive yet systematic overview of the animal models that are utilised in the study of chemotherapy-induced mucositis. A search of PubMed/MEDLINE and Scopus databases was conducted to identify all relevant studies. Multiple phases of filtering were conducted, including deduplication, title/abstract screening, full-text screening, and data extraction. Studies were reported according to the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. An inter-rater reliability test was conducted using Cohen's Kappa score. After title, abstract, and full-text screening, 251 articles met the inclusion criteria. Seven articles investigated both chemotherapy-induced intestinal and oral mucositis, 198 articles investigated chemotherapy-induced intestinal mucositis, and 46 studies investigated chemotherapy-induced oral mucositis. Among a total of 205 articles on chemotherapy-induced intestinal mucositis, 103 utilised 5-fluorouracil, 34 irinotecan, 16 platinum-based drugs, 33 methotrexate, and 32 other chemotherapeutic agents. Thirteen articles reported the use of a combination of 5-fluorouracil, irinotecan, platinum-based drugs, or methotrexate to induce intestinal mucositis. Among a total of 53 articles on chemotherapy-induced oral mucositis, 50 utilised 5-fluorouracil, 2 irinotecan, 2 methotrexate, 1 topotecan and 1 with other chemotherapeutic drugs. Three articles used a combination of these drugs to induce oral mucositis. Various animal models such as mice, rats, hamsters, piglets, rabbits, and zebrafish were used. The chemotherapeutic agents were introduced at various dosages via three routes of administration. Animals were mainly mice and rats. Unlike intestinal mucositis, most oral mucositis models combined mechanical or chemical irritation with chemotherapy. In conclusion, this extensive assessment of the literature revealed that there was a large variation among studies that reproduce oral and intestinal mucositis in animals. To assist with the design of a suitable preclinical model of chemotherapy-induced alimentary tract mucositis, animal types, routes of administration, dosages, and types of drugs were reported in this study. Further research is required to define an optimal protocol that improves the translatability of findings to humans.
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Effects of a novel toll-like receptor 4 antagonist IAXO-102 in a murine model of chemotherapy-induced gastrointestinal toxicity. Cancer Chemother Pharmacol 2022; 90:267-278. [PMID: 35962138 PMCID: PMC9402738 DOI: 10.1007/s00280-022-04463-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/03/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Gastrointestinal mucositis (GIM) is a side effect of high-dose irinotecan (CPT-11), causing debilitating symptoms that are often poorly managed. The role of TLR4 in the development of GIM has been clearly demonstrated. We, therefore, aimed to investigate the potential of the TLR4 antagonist, IAXO-102, to attenuate gastrointestinal inflammation as well as supress tumour activity in a colorectal-tumour-bearing mouse model of GIM induced by CPT-11. METHODS 24 C57BL/6 mice received a vehicle, daily i.p. IAXO-102 (3 mg/kg), i.p. CPT-11 (270 mg/kg) or a combination of CPT-11 and IAXO-102. GIM was assessed using validated toxicity markers. At 72 h, colon and tumour tissue were collected and examined for histopathological changes and RT-PCR for genes of interest; TLR4, MD-2, CD-14, MyD88, IL-6, IL-6R, CXCL2, CXCR1, and CXCR2. RESULTS IAXO-102 prevented diarrhoea in mice treated with CPT-11. Tumour volume in IAXO-102-treated mice was lower compared to vehicle at 48 h (P < 0.05). There were no differences observed in colon and tumour weights between the treatment groups. Mice who received the combination treatment had improved tissue injury score (P < 0.05) in the colon but did not show any improvements in cell proliferation or apoptotic rate. Expression of all genes was similar across all treatment groups in the tumour (P > 0.05). In the colon, there was a difference in transcript expression in vehicle vs. IAXO-102 (P < 0.05) and CPT-11 vs. combination (P < 0.01) in MD-2 and IL-6R, respectively. CONCLUSION IAXO-102 was able to attenuate symptomatic parameters of GIM induced by CPT-11 as well as reduce tissue injury in the colon. However, there was no effect on cell proliferation and apoptosis. As such, TLR4 activation plays a partial role in GIM development but further research is required to understand the specific inflammatory signals underpinning tissue-level changes.
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Cardoso LM, Pansani TN, Hebling J, de Souza Costa CA, Basso FG. Chemotherapy drugs and inflammatory cytokines enhance matrix metalloproteinases expression by oral mucosa cells. Arch Oral Biol 2021; 127:105159. [PMID: 34022544 DOI: 10.1016/j.archoralbio.2021.105159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Oral mucositis (OM), the most common side effect of cancer therapy, is associated with pro-inflammatory cytokines and matrix metalloproteinases (MMPs) increased expression. Although there are approaches for OM management, none is infallible, thus, elucidation of molecular events related to OM etiopathogenesis may improve current therapeutic strategies. This study assessed the influence of pro-inflammatory cytokines and chemotherapy drugs on MMPs expression and synthesis by oral mucosa cells. DESIGN Human gingival fibroblasts (HGF) were exposed to different concentrations of methotrexate (MTX) and 5-fluorouracil (5-FU); subsequentially, cell viability, nitric oxide and interleukin(IL)-6 production were evaluated to select the concentration of these drugs that could stimulate inflammatory phenotype without cytotoxic effects. Then, HGF and primary gingival keratinocytes (PGK) were subjected to different stimuli: culture medium (negative control), tumor necrosis factor-alpha (TNF-α - positive control), IL-6, IL-8, MTX, and 5-FU for 3, 6, 12, and 24 h. Next, gene expression and synthesis of MMP-2 and MMP-9 by HGF and MMP-3 by PGK were assessed. RESULTS At 6 h, MMP-2 synthesis increased 60 % after exposure to TNF-α and MTX, 40 % after IL-6, and 15 % after IL-8. At 12 h, MMP-9 synthesis increased 15 % after exposure to TNF-α, while MMP-3 synthesis increased 30 % after TNF-α, and 10 % after IL-8. TNF-α-treated groups presented increased gene expression of all MMPs evaluated. IL-8 and 5-FU increased MMP-2 and MMP-3 expression, while IL-6 and MTX augmented MMP-2 expression. CONCLUSIONS The chemotherapy drugs and cytokines investigated up-regulated MMPs expression by oral mucosa cells, which may lead to OM establishment and severity.
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Affiliation(s)
- Laís Medeiros Cardoso
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry - Araraquara, SP, Brazil
| | - Taisa Nogueira Pansani
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry - Araraquara, SP, Brazil
| | - Josimeri Hebling
- Department of Orthodontics and Pediatric Dentistry, São Paulo State University (UNESP), School of Dentistry - Araraquara, SP, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, São Paulo State University (UNESP), School of Dentistry - Araraquara, SP, Brazil
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Dahlgren D, Sjöblom M, Hellström PM, Lennernäs H. Chemotherapeutics-Induced Intestinal Mucositis: Pathophysiology and Potential Treatment Strategies. Front Pharmacol 2021; 12:681417. [PMID: 34017262 PMCID: PMC8129190 DOI: 10.3389/fphar.2021.681417] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/19/2021] [Indexed: 12/11/2022] Open
Abstract
The gastrointestinal tract is particularly vulnerable to off-target effects of antineoplastic drugs because intestinal epithelial cells proliferate rapidly and have a complex immunological interaction with gut microbiota. As a result, up to 40-100% of all cancer patients dosed with chemotherapeutics experience gut toxicity, called chemotherapeutics-induced intestinal mucositis (CIM). The condition is associated with histological changes and inflammation in the mucosa arising from stem-cell apoptosis and disturbed cellular renewal and maturation processes. In turn, this results in various pathologies, including ulceration, pain, nausea, diarrhea, and bacterial translocation sepsis. In addition to reducing patient quality-of-life, CIM often leads to dose-reduction and subsequent decrease of anticancer effect. Despite decades of experimental and clinical investigations CIM remains an unsolved clinical issue, and there is a strong consensus that effective strategies are needed for preventing and treating CIM. Recent progress in the understanding of the molecular and functional pathology of CIM had provided many new potential targets and opportunities for treatment. This review presents an overview of the functions and physiology of the healthy intestinal barrier followed by a summary of the pathophysiological mechanisms involved in the development of CIM. Finally, we highlight some pharmacological and microbial interventions that have shown potential. Conclusively, one must accept that to date no single treatment has substantially transformed the clinical management of CIM. We therefore believe that the best chance for success is to use combination treatments. An optimal combination treatment will likely include prophylactics (e.g., antibiotics/probiotics) and drugs that impact the acute phase (e.g., anti-oxidants, apoptosis inhibitors, and anti-inflammatory agents) as well as the recovery phase (e.g., stimulation of proliferation and adaptation).
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Affiliation(s)
- David Dahlgren
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Markus Sjöblom
- Department of Neuroscience, Division of Physiology, Uppsala University, Uppsala, Sweden
| | - Per M Hellström
- Department of Medical Sciences, Gastroenterology/Hepatology, Uppsala University, Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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The Macrophages-Microbiota Interplay in Colorectal Cancer (CRC)-Related Inflammation: Prognostic and Therapeutic Significance. Int J Mol Sci 2020; 21:ijms21186866. [PMID: 32962159 PMCID: PMC7558485 DOI: 10.3390/ijms21186866] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023] Open
Abstract
Tumor-associated macrophages (TAMs) are the main population of myeloid cells infiltrating solid tumors and the pivotal orchestrators of cancer-promoting inflammation. However, due to their exceptional plasticity, macrophages can be also key effector cells and powerful activators of adaptive anti-tumor immunity. This functional heterogeneity is emerging in human tumors, colorectal cancer (CRC) in particular, where the dynamic co-existence of different macrophage subtypes influences tumor development, outcome, and response to therapies. Intestinal macrophages are in close interaction with enteric microbiota, which contributes to carcinogenesis and affects treatment outcomes. This interplay may be particularly relevant in CRC, one of the most prevalent and lethal cancer types in the world. Therefore, both macrophages and intestinal microbiota are considered promising prognostic indicators and valuable targets for new therapeutic approaches. Here, we discuss the current understanding of the molecular circuits underlying the interplay between macrophages and microbiota in CRC development, progression, and response to both conventional therapies and immunotherapies.
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10
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Ibrahim MAAH, Elwan WM. Effect of irinotecan on the tongue mucosa of juvenile male albino rat at adulthood. Int J Exp Pathol 2019; 100:244-252. [PMID: 31577062 DOI: 10.1111/iep.12333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/04/2019] [Accepted: 07/05/2019] [Indexed: 12/19/2022] Open
Abstract
Irinotecan is one of the most important anti-tumour drugs against a broad spectrum of malignancies, but is known to be associated with possible oral complications. The aim of the present study was to evaluate the effect of irinotecan on the tongue mucosa of juvenile male albino rat at adulthood using different histological and immunohistochemical methods. Twenty juvenile male albino rats were divided equally into two groups: control and irinotecan-treated group (single injection of 200 mg irinotecan/kg, then kept for four weeks without treatment). The tongue specimens were processed for light microscopy and scanning electron microscopy. The irinotecan-treated group showed statistically significant shortening and thinning of the lingual papillae. There was loss of the normal appearance of the filiform papillae with focal cell loss alternating with areas of hyperkeratosis. Focal separation of the keratin layer, some nuclear changes and vacuolation of some epithelial cells were detected. Dilated congested blood vessels and mild mononuclear cellular infiltration were encountered. Atrophic fungiform papillae with ill-defined taste bud cells were observed. A statistically significant decrease in the pattern of Ki67 immunohistochemical staining reaction was detected in comparision to the control group. Scanning electron microscopy revealed different signs of atrophy of the tongue papillae. Focal areas of desquamation of lingual papillae were observed revealing some filiform papillae with desquamated surface, bisected tips and evident thinning. Some extravasated red blood cells could be detected. Thus irinotecan caused significant morphological and morphometrical alterations of the tongue mucosa in particularly the filiform papillae.
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Affiliation(s)
| | - Walaa M Elwan
- Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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11
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Tibbs TN, Lopez LR, Arthur JC. The influence of the microbiota on immune development, chronic inflammation, and cancer in the context of aging. MICROBIAL CELL (GRAZ, AUSTRIA) 2019; 6:324-334. [PMID: 31403049 PMCID: PMC6685047 DOI: 10.15698/mic2019.08.685] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/23/2018] [Accepted: 11/13/2018] [Indexed: 12/21/2022]
Abstract
From birth, the microbiota plays an essential role in human development by educating host immune responses. Proper maturation of the immune system perturbs chronic inflammation and the pathogenesis of disease by preventing inappropriate immune responses. While many have detailed the roles of specific microbial groups in immune development and human disease, it remains to be elucidated how the microbiota influences the immune system during aging. Furthermore, it is not yet understood how age-related changes to the microbiota and immune system influence the development of age-related diseases. In this review, we outline the role of the microbiota in immune system development as well as functional changes that occur to immune cell populations during immunosenescence. In addition, we highlight how commensal microbes influence the pathogenesis of cancer, a prominent disease of aging. The information provided herein suggests that age-related changes to the microbiota and immune system should be considered in disease treatment and prevention strategies.
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Affiliation(s)
- Taylor N. Tibbs
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Lacey R. Lopez
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Janelle C. Arthur
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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12
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Gibson RJ, van Sebille YZA, Wardill HR, Wignall A, Shirren J, Ball IA, Williams N, Wanner K, Bowen JM. Selective MMP Inhibition, Using AZD3342, to Reduce Gastrointestinal Toxicity and Enhance Chemoefficacy in a Rat Model. Chemotherapy 2019; 63:284-292. [PMID: 30731451 PMCID: PMC6425820 DOI: 10.1159/000495470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND The common cytotoxic mechanisms that underpin chemoefficacy and toxicity have hampered efforts to deliver effective supportive care interventions, particularly for gastrointestinal (GI) toxicity. Matrix metalloproteinases (MMPs) have been implicated in both tumor growth and GI toxicity, and as such MMP inhibitors present as a novel therapeutic avenue to simultaneously enhance treatment efficacy and reduce toxicity. OBJECTIVES The aim of this study was to determine the efficacy of an MMP-9/12 inhibitor, AZD3342, on tumor growth and GI toxicity in a rat model. METHODS Female tumor-bearing Dark Agouti rats (n = 90) were divided into 4 groups: vehicle control; methotrexate (MTX); AZD3342, and MTX + AZD3342. Tumors were measured daily (for 5 days) using digital calipers. GI toxicity was assessed using well-established clinical markers (diarrhea/weight loss), histopathological analysis, and functional assessment of intestinal barrier permeability. RESULTS AZD3342 delayed the onset of severe diarrhea by 1 day (vs. MTX) but was unable to improve the overall severity of diarrhea. No changes were detected in tissue morphology or intestinal barrier function. AZD3342 alone suppressed tumor growth (p = 0.003 vs. vehicle) but did not enhance the efficacy of MTX. CONCLUSIONS This study showed partial efficacy of AZD3342 in reducing tumor growth and delaying the onset of severe diarrhea caused by MTX in rats. We suggest further studies be undertaken targeting appropriate scheduling of AZD3342 as well as investigating different cytotoxic therapies that strongly activate MMP signaling.
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Affiliation(s)
- Rachel J Gibson
- Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Ysabella Z A van Sebille
- Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Hannah R Wardill
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia,
- Centre for Nutrition and Gastrointestinal Disease, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia,
- Beatrix Children's Hospital, University Medical Centre Groningen, Groningen, The Netherlands,
| | - Anthony Wignall
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Joseph Shirren
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Imogen A Ball
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole Williams
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Kiara Wanner
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne M Bowen
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
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13
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Jin H, Kang GY, Jeon S, Kim JM, Park YN, Cho J, Lee YS. Identification of molecular signatures involved in radiation-induced lung fibrosis. J Mol Med (Berl) 2018; 97:37-47. [PMID: 30406363 PMCID: PMC6326977 DOI: 10.1007/s00109-018-1715-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 12/28/2022]
Abstract
In radiotherapy, radiation (IR)-induced lung fibrosis has severe and dose-limiting side effects. To elucidate the molecular effects of IR fibrosis, we examined the fibrosis process in irradiated mouse lung tissues. High focal IR (90 Gy) was exposed to a 3-mm volume of the left lung in C57BL6 mice. In the diffused irradiation, 20 Gy dose delivered with a 7-mm collimator almost covered the entire left lung. Histological examination for lung tissues of both irradiated and neighboring regions was done for 4 weeks after irradiation. Long-term effects (12 months) of 20Gy IR were compared on a diffuse region of the left lung and non-irradiated right lung. Fibrosis was initiated as early as 2 weeks after IR in the irradiated lung region and neighboring region. Upregulation of gtse1 in both 90Gy-irradiated and neighboring regions was observed. Upregulation of fgl1 in both 20Gy diffused irradiated and non-irradiated lungs was identified. When gtse1 or flg1 was knock-downed, TGFβ or IR-induced epithelial-mesenchymal transition was inhibited, accompanied with the inhibition of cellular migration, suggesting fibrosis responsible genes. Immunofluorescence analysis using mouse fibrotic lung tissues suggested that fibrotic regions showed increased expressions of Gtse1 and Fgl1, indicating novel molecular signatures of gtse1and fgl1 for IR-induced lung fibrosis. Even though their molecular mechanisms and IR doses or irradiated volumes for lung fibrosis may be different, these genes may be novel targets for understanding IR-induced lung fibrosis and in treatment strategies. KEY MESSAGES: Upregulation of gtse1 by 90Gy focal irradiation and upregulation of fgl1 by 20Gy diffused irradiation are identified in mouse lung fibrosis model. Gtse1 and Fgl1 are involved in radiation or TGFβ-induced epithelial-mesenchymal transition. Radiation-induced fibrotic regions of mouse lungs showed increased expressions of Gtse1 and Fgl1. Gtse1 and Fgl1 are suggested to be novel targets for radiation-induced lung fibrosis.
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Affiliation(s)
- Hee Jin
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 120-750, South Korea
| | - Ga-Young Kang
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 120-750, South Korea
| | - Seulgi Jeon
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 120-750, South Korea
| | - Jin-Mo Kim
- Department of Radiation Oncology, Yonsei University Health System, Seoul, 120-749, South Korea
| | - You Na Park
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 120-750, South Korea
| | - Jaeho Cho
- Department of Radiation Oncology, Yonsei University Health System, Seoul, 120-749, South Korea
| | - Yun-Sil Lee
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 120-750, South Korea.
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14
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Nagai K, Hayashi Y, Honma K, Sakatani A, Yoshii S, Fujinaga T, Maekawa A, Tsujii Y, Hiyama S, Shinzaki S, Watabe K, Iijima H, Tsujii M, Mizushima T, Morii E, Takehara T. Adenoma of colorectal laterally spreading tumor nongranular type with biological phenotypic features similar to cancer. J Gastroenterol Hepatol 2018; 33:1853-1863. [PMID: 29767452 DOI: 10.1111/jgh.14284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/03/2018] [Accepted: 04/27/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Colorectal laterally spreading tumors (LSTs) are morphologically subdivided into granular (LST-G) and nongranular (LST-NG) categories. We aimed to elucidate the differences in oncogenic characteristics between the two types. METHODS Laterally spreading tumors resected by endoscopic submucosal dissection and surgery from March 2009 to May 2017 were examined for p53 positivity, Ki-67 labeling index (LI), microvessel density, degree of fibrosis, intensities of inducible nitric oxide synthase (iNOS) and nitrotyrosine (NT), and expression of acid mucins. We compared these factors between adenomas, noninvasive cancers, and invasive cancers, both LST-G and LST-NG. RESULTS Ninety-three LST-G (53 adenomas [LST-GA] and 40 cancers [LST-GC]) and 55 LST-NG (24 adenomas [LST-NGA] and 31 cancers [LST-NGC]) were evaluated. Although p53 positivity was lower in LST-GA than in LST-NGA (P < 0.001), there was no difference between LST-GC and LST-NGC. Ki-67 LI was higher in LST-NGA than in LST-GA (P < 0.001) and higher in LST-NGC than in LST-GC of noninvasive cancers (P < 0.001). Microvessel density and degree of fibrosis were higher in LST-NGA than in LST-GA (P < 0.001), and intensities of iNOS and NT were also higher in LST-NGA than in LST-GA (P < 0.001). Expression of acid mucins was lower in LST-NGA than in LST-GA (P < 0.001). Although there were significant differences in p53 positivity, Ki-67 LI, microvessel density, degree of fibrosis, intensities of iNOS and NT, and expression of acid mucins between LST-GA and LST-NGA, these factors were only slightly different between LST-GC and LST-NGC of invasive cancers. CONCLUSIONS Unlike LST-GA, LST-NGA possessed phenotypic features similar to cancer.
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Affiliation(s)
- Kengo Nagai
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshito Hayashi
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keiichiro Honma
- Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akihiko Sakatani
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shunsuke Yoshii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuji Fujinaga
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akira Maekawa
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiki Tsujii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Hiyama
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shinichiro Shinzaki
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenji Watabe
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideki Iijima
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiko Tsujii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuo Takehara
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
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15
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Lucić Vrdoljak A, Fuchs N, Mikolić A, Žunec S, Brčić Karačonji I, Jurič A, Prester L, Micek V, Neuberg M, Čanović S, Mršić G, Kopjar N. Irinotecan and Δ⁸-Tetrahydrocannabinol Interactions in Rat Liver: A Preliminary Evaluation Using Biochemical and Genotoxicity Markers. Molecules 2018; 23:E1332. [PMID: 29865166 PMCID: PMC6100385 DOI: 10.3390/molecules23061332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/23/2018] [Accepted: 05/31/2018] [Indexed: 01/27/2023] Open
Abstract
There is growing interest regarding the use of herbal preparations based on Cannabis sativa for medicinal purposes, despite the poorly understood interactions of their main constituent Δ⁸-tetrahydrocannabinol (THC) with conventional drugs, especially cytostatics. The objective of this pilot study was to prove whether the concomitant intake of THC impaired liver function in male Wistar rats treated with the anticancer drug irinotecan (IRI), and evaluate the toxic effects associated with this exposure. IRI was administered once intraperitoneally (at 100 mg/kg of the body weight (b.w.)), while THC was administered per os repeatedly for 1, 3, and 7 days (at 7 mg/kg b.w.). Functional liver impairments were studied using biochemical markers of liver function (aspartate aminotransferase-AST, alanine aminotransferase-ALP, alkaline phosphatase-AP, and bilirubin) in rats given a combined treatment, single IRI, single THC, and control groups. Using common oxidative stress biomarkers, along with measurement of primary DNA damage in hepatocytes, the degree of impairments caused at the cellular level was also evaluated. THC caused a time-dependent enhancement of acute toxicity in IRI-treated rats, which was confirmed by body and liver weight reduction. Although single THC affected ALP and AP levels more than single IRI, the levels of liver function markers measured after the administration of a combined treatment mostly did not significantly differ from control. Combined exposure led to increased oxidative stress responses in 3- and 7-day treatments, compared to single IRI. Single IRI caused the highest DNA damage at all timepoints. Continuous 7-day oral exposure to single THC caused an increased mean value of comet tail length compared to its shorter treatments. Concomitant intake of THC slightly affected the levels of IRI genotoxicity at all timepoints, but not in a consistent manner. Further studies are needed to prove our preliminary observations, clarify the underlying mechanisms behind IRI and THC interactions, and unambiguously confirm or reject the assumptions made herein.
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Affiliation(s)
- Ana Lucić Vrdoljak
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
| | - Nino Fuchs
- University Hospital Centre Zagreb, HR-10000 Zagreb, Croatia.
| | - Anja Mikolić
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
| | - Suzana Žunec
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
| | | | - Andreja Jurič
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
| | - Ljerka Prester
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
| | - Vedran Micek
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
| | - Marijana Neuberg
- University Centre Varaždin, University North, HR-42000 Varaždin, Croatia.
| | | | - Gordan Mršić
- Forensic Science Centre "Ivan Vučetić", HR-10000 Zagreb, Croatia.
| | - Nevenka Kopjar
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
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16
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Stansborough RL, Bateman EH, Al-Dasooqi N, Bowen JM, Keefe DMK, Yeoh ASJ, Logan RM, Yeoh EEK, Stringer AM, Gibson RJ. Fractionated abdominal irradiation induces intestinal microvascular changes in an in vivo model of radiotherapy-induced gut toxicity. Support Care Cancer 2017; 25:1973-1983. [PMID: 28175996 DOI: 10.1007/s00520-017-3601-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 01/23/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Radiotherapy-induced gut toxicity (RIGT) is associated with diarrhoea, pain and rectal bleeding and can occur as an acute or chronic toxicity. The microvasculature has been shown to be altered in the development of RIGT; however, the features are not yet characterized. We hypothesized that apoptosis of microvascular cells would occur early in the gastrointestinal tract following fractionated irradiation, followed by late microvascular changes, including sclerosis and telangiectasis. METHODS Female Dark Agouti rats were treated with a 6-week fractionated radiation schedule of 3 × 2.5 Gy doses per week localized to the abdomen. At 3, 6 and 15 weeks, the intestines were assessed for markers of acute and chronic injury including morphological changes, collagen deposition, apoptosis and proliferation. RESULTS Apoptosis of microvascular cells significantly increased at 6 and 15 weeks in the jejunum (p = 0.0026 and p = 0.0062, respectively) and at 6 and 15 weeks in the colon (p < 0.0001 and p = 0.0005, respectively) in rats receiving fractionated radiation to the abdomen. Histopathological changes of the colon microvasculature were also seen from week 3, including thickening of the lamina propria and dilated, thickened, telangiectatic vessels. CONCLUSIONS Findings of this study provide evidence of regional and timing-specific changes in the intestinal microvasculature in response to fractionated radiotherapy which may play a role in development of both acute and chronic RIGT.
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Affiliation(s)
- Romany L Stansborough
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia.
| | - Emma H Bateman
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
| | - Noor Al-Dasooqi
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
- Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Joanne M Bowen
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
| | - Dorothy M K Keefe
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
| | - Ann S J Yeoh
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
| | - Richard M Logan
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
| | - Eric E K Yeoh
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
| | - Andrea M Stringer
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
- Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Rachel J Gibson
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia
- Division of Health Sciences, University of South Australia, Adelaide, Australia
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17
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Cell adhesion molecules are altered during irinotecan-induced mucositis: a qualitative histopathological study. Support Care Cancer 2016; 25:391-398. [DOI: 10.1007/s00520-016-3413-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 09/05/2016] [Indexed: 11/26/2022]
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18
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Bastos RW, Pedroso SHSP, Vieira AT, Moreira LMC, França CS, Cartelle CT, Arantes RME, Generoso SV, Cardoso VN, Neves MJ, Nicoli JR, Martins FS. Saccharomyces cerevisiae UFMG A-905 treatment reduces intestinal damage in a murine model of irinotecan-induced mucositis. Benef Microbes 2016; 7:549-57. [PMID: 27133563 DOI: 10.3920/bm2015.0190] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Indigenous microbiota plays a crucial role in the development of several intestinal diseases, including mucositis. Gastrointestinal mucositis is a major and serious side effect of cancer therapy, and there is no effective therapy for this clinical condition. However, some probiotics have been shown to attenuate such conditions. To evaluate the effects of Saccharomyces cerevisiae UFMG A-905 (Sc-905), a potential probiotic yeast, we investigated whether pre- or post-treatment with viable or inactivated Sc-905 could prevent weight loss and intestinal lesions, and maintain integrity of the mucosal barrier in a mucositis model induced by irinotecan in mice. Only post-treatment with viable Sc-905 was able to protect mice against the damage caused by chemotherapy, reducing the weight loss, increase of intestinal permeability and jejunal lesions (villous shortening). Besides, this treatment reduced oxidative stress, prevented the decrease of goblet cells and stimulated the replication of cells in the intestinal crypts of mice with experimental mucositis. In conclusion, Sc-905 protects animals against irinotecan-induced mucositis when administered as a post-treatment with viable cells, and this effect seems to be related with the reduction of oxidative stress and preservation of intestinal mucosa.
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Affiliation(s)
- R W Bastos
- 1 Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - S H S P Pedroso
- 1 Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - A T Vieira
- 1 Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - L M C Moreira
- 1 Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - C S França
- 1 Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - C T Cartelle
- 2 Department of General Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - R M E Arantes
- 2 Department of General Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - S V Generoso
- 3 Department of Basic Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - V N Cardoso
- 4 Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - M J Neves
- 5 Center of Nuclear Technology Development/Brazilian Nuclear Energy Commission (CDTN/CNEN), Belo Horizonte, MG, Brazil
| | - J R Nicoli
- 1 Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - F S Martins
- 1 Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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19
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Stansborough RL, Al-dasooqi N, Bateman EH, Keefe DMK, Gibson RJ. Radiotherapy-induced gut toxicity: Involvement of matrix metalloproteinases and the intestinal microvasculature. Int J Radiat Biol 2016; 92:241-8. [DOI: 10.3109/09553002.2016.1146830] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Tight junction defects are seen in the buccal mucosa of patients receiving standard dose chemotherapy for cancer. Support Care Cancer 2015; 24:1779-88. [DOI: 10.1007/s00520-015-2964-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/21/2015] [Indexed: 02/08/2023]
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21
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Vanhoecke B, Bateman E, Mayo B, Vanlancker E, Stringer A, Thorpe D, Keefe D. Dark Agouti rat model of chemotherapy-induced mucositis: establishment and current state of the art. Exp Biol Med (Maywood) 2015; 240:725-41. [PMID: 25966981 PMCID: PMC4935219 DOI: 10.1177/1535370215581309] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Mucositis is a major oncological problem. The entire gastrointestinal and genitourinary tract and also other mucosal surfaces can be affected in recipients of radiotherapy, and/or chemotherapy. Major progress has been made in recent years in understanding the mechanisms of oral and small intestinal mucositis, which appears to be more prominent than colonic damage. This progress is largely due to the development of representative laboratory animal models of mucositis. This review focuses on the development and establishment of the Dark Agouti rat mammary adenocarcinoma model by the Mucositis Research Group of the University of Adelaide over the past 20 years to characterize the mechanisms underlying methotrexate-, 5-fluorouracil-, and irinotecan-induced mucositis. It also aims to summarize the results from studies using different animal model systems to identify new molecular and cellular markers of mucositis.
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Affiliation(s)
- Barbara Vanhoecke
- Mucositis Research Group, Centre for Personalised Cancer Medicine (CPCM), Centre for Clinical Research Excellence (CCRE) in Oral Health, Faculty of Health Sciences, University of Adelaide, Adelaide, 5005 South Australia, Australia Laboratory of Microbial Ecology and Technology, University of Ghent, 9000 Ghent, Belgium
| | - Emma Bateman
- Mucositis Research Group, Centre for Personalised Cancer Medicine (CPCM), Centre for Clinical Research Excellence (CCRE) in Oral Health, Faculty of Health Sciences, University of Adelaide, Adelaide, 5005 South Australia, Australia
| | - Bronwen Mayo
- Mucositis Research Group, Centre for Personalised Cancer Medicine (CPCM), Centre for Clinical Research Excellence (CCRE) in Oral Health, Faculty of Health Sciences, University of Adelaide, Adelaide, 5005 South Australia, Australia Sansom Institute for Health Research, University of South Australia, Adelaide, 5001 South Australia, Australia
| | - Eline Vanlancker
- Laboratory of Microbial Ecology and Technology, University of Ghent, 9000 Ghent, Belgium
| | - Andrea Stringer
- Sansom Institute for Health Research, University of South Australia, Adelaide, 5001 South Australia, Australia
| | - Daniel Thorpe
- Sansom Institute for Health Research, University of South Australia, Adelaide, 5001 South Australia, Australia
| | - Dorothy Keefe
- Mucositis Research Group, Centre for Personalised Cancer Medicine (CPCM), Centre for Clinical Research Excellence (CCRE) in Oral Health, Faculty of Health Sciences, University of Adelaide, Adelaide, 5005 South Australia, Australia Director, SA Cancer Service, Royal Adelaide Hospital, Adelaide, 5005 South Australia, Australia
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22
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Matrix metalloproteinases and gut toxicity following cytotoxic cancer therapy. Curr Opin Support Palliat Care 2015; 8:164-9. [PMID: 24752198 DOI: 10.1097/spc.0000000000000049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Chemotherapy is an effective anticancer treatment; however, it induces mucositis in a wide range of patients. This condition is characterized by pain and ulceration, vomiting, bloating and diarrhea, depending on the area of the alimentary tract affected. Although treatment is available for a small subset of patients suffering from mucositis, the majority rely on pain relief as their only treatment option. Much progress has been made in recent years into understanding the pathobiology underlying the development of mucositis and matrix metalloproteinases (MMPs) have been implicated as being key mediators. The purpose of this review was to evaluate recent literature implicating MMPs in mucositis. RECENT FINDINGS MMPs are well known for their roles in induction of inflammation and contribution to tissue injury. Recent literature provides a role for MMPs in mucositis development possibly through inflammatory pathways, alterations in extracellular matrix composition, adhesion molecules and tight junctions. SUMMARY Better understanding of the precise roles of MMPs is now required in order to target appropriate treatment strategies.
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23
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Local and systemic pathogenesis and consequences of regimen-induced inflammatory responses in patients with head and neck cancer receiving chemoradiation. Mediators Inflamm 2014; 2014:518261. [PMID: 24757285 PMCID: PMC3976778 DOI: 10.1155/2014/518261] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 01/27/2014] [Indexed: 02/06/2023] Open
Abstract
Treatment-related toxicities are common among patients with head and neck cancer, leading to poor clinical outcomes, reduced quality of life, and increased use of healthcare resources. Over the last decade, much has been learned about the pathogenesis of cancer regimen-related toxicities. Historically, toxicities were separated into those associated with tissue injury and those with behavioural or systemic changes. However, it is now clear that tissue-specific damage such as mucositis, dermatitis, or fibrosis is no longer the sole consequence of direct clonogenic cell death, and a relationship between toxicities that results in their presentation as symptom clusters has been documented and attributed to a common underlying pathobiology. In addition, the finding that patients commonly develop toxicities representing tissue injury outside radiation fields and side effects such as fatigue or cognitive dysfunction suggests the generation of systemic as well as local mediators. As a consequence, it might be appropriate to consider toxicity syndromes, rather than the traditional approach, in which each side effect was considered as an autonomous entity. In this paper, we propose a biologically based explanation which forms the basis for the diverse constellation of toxicities seen in response to current regimens used to treat cancers of the head and neck.
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24
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Al-Dasooqi N, Wardill HR, Gibson RJ. Gastrointestinal mucositis: the role of MMP-tight junction interactions in tissue injury. Pathol Oncol Res 2014; 20:485-91. [PMID: 24424533 DOI: 10.1007/s12253-013-9733-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 12/05/2013] [Indexed: 12/18/2022]
Abstract
Chemotherapy for cancer causes significant gut toxicity known as mucositis. The pathogenesis of mucositis is ill defined. Recent clinical research guidelines have highlighted epithelial junctional complexes as emerging targets within mucositis research. Given the robust biological evidence linking tight junctions and matrix metalloproteinases, key mediators of mucositis, tight junction proteins have received significant attention. Despite this, the link between tight junctions, matrix metalloproteinases and mucositis development is yet to be established. This critical review therefore aims to describe the role of matrix metalloproteinases in mucositis, and how matrix metalloproteinase-dependent tight junction disruption may contribute to the pathobiology of mucositis.
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Affiliation(s)
- Noor Al-Dasooqi
- School of Medicine, University of Adelaide, North Terrace, Adelaide, 5005, Australia,
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25
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Wardill HR, Gibson RJ, Logan RM, Bowen JM. TLR4/PKC-mediated tight junction modulation: a clinical marker of chemotherapy-induced gut toxicity? Int J Cancer 2014; 135:2483-92. [PMID: 24310924 DOI: 10.1002/ijc.28656] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 12/15/2022]
Abstract
Chemotherapy-induced gut toxicity is a major clinical and economic burden to oncology practice. The mechanisms responsible for its development are ill defined, hampering the development of therapeutic interventions. In light of newly published research foci and clinical practice guidelines in supportive care in cancer, there has been renewed interest in the role tight junctions play in the pathobiology of chemotherapy-induced gut toxicity. Several preclinical studies have identified molecular defects in intestinal tight junctions following chemotherapy. Despite these findings, the mechanisms responsible for chemotherapy-induced tight junction disruption remain unclear. Recent research has highlighted roles for toll-like receptor 4 and protein kinase C signalling in the regulation of tight junctions. This critical review therefore aims to provide evidence linking toll-like receptor 4 expression, protein kinase C activation and tight junction disruption and their relationship to clinical toxicity.
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Affiliation(s)
- Hannah R Wardill
- Discipline of Anatomy and Pathology, School of Medical Sciences, University of Adelaide, Adelaide, Australia
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Jensen SB, Peterson DE. Oral mucosal injury caused by cancer therapies: current management and new frontiers in research. J Oral Pathol Med 2013; 43:81-90. [PMID: 24261541 DOI: 10.1111/jop.12135] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2013] [Indexed: 01/17/2023]
Abstract
This invited update is designed to provide a summary of the state-of-the-science regarding oral mucosal injury (oral mucositis) caused by conventional and emerging cancer therapies. Current modeling of oral mucositis pathobiology as well as evidence-based clinical practice guidelines for prevention and treatment of oral mucositis are presented. In addition, studies addressing oral mucositis as published in the Journal of Oral Pathology and Medicine 2008-2013 are specifically highlighted in this context. Key research directions in basic and translational science associated with mucosal toxicity caused by cancer therapies are also delineated as a basis for identifying pathobiologic and pharmacogenomic targets for interventions. This collective portfolio of research and its ongoing incorporation into clinical practice is setting the stage for the clinician in the future to predict mucosal toxicity risk and tailor therapeutic interventions to the individual oncology patient accordingly.
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Affiliation(s)
- Siri B Jensen
- Section of Oral Medicine, Clinical Oral Physiology, Oral Pathology & Anatomy, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Al-Dasooqi N, Sonis ST, Bowen JM, Bateman E, Blijlevens N, Gibson RJ, Logan RM, Nair RG, Stringer AM, Yazbeck R, Elad S, Lalla RV. Emerging evidence on the pathobiology of mucositis. Support Care Cancer 2013; 21:3233-41. [PMID: 23842598 DOI: 10.1007/s00520-013-1900-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 04/04/2013] [Indexed: 01/01/2023]
Abstract
BACKGROUND Considerable progress has been made in our understanding of the biological basis for cancer therapy-induced mucosal barrier injury (mucositis). The last formal review of the subject by MASCC/ISOO was published in 2007; consequently, an update is timely. METHODS Panel members reviewed the biomedical literature on mucositis pathobiology published between January 2005 and December 2011. RESULTS Recent research has provided data on the contribution of tissue structure changes, inflammation and microbiome changes to the development of mucositis. Additional research has focused on targeted therapy-induced toxicity, toxicity clustering and the investigation of genetic polymorphisms in toxicity prediction. This review paper summarizes the recent evidence on these aspects of mucositis pathobiology. CONCLUSION The ultimate goal of mucositis researchers is to identify the most appropriate targets for therapeutic interventions and to be able to predict toxicity risk and personalize interventions to genetically suitable patients. Continuing research efforts are needed to further our understanding of mucositis pathobiology and the pharmacogenomics of toxicity.
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Affiliation(s)
- Noor Al-Dasooqi
- Discipline of Medicine, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia,
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Emerging evidence on the pathobiology of mucositis. Support Care Cancer 2013; 21:2075-83. [PMID: 23604521 DOI: 10.1007/s00520-013-1810-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 04/04/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Considerable progress has been made in our understanding of the biological basis for cancer therapy-induced mucosal barrier injury (mucositis). The last formal review of the subject by MASCC/ISOO was published in 2007; consequently, an update is timely. METHODS Panel members reviewed the biomedical literature on mucositis pathobiology published between January 2005 and December 2011. RESULTS Recent research has provided data on the contribution of tissue structure changes, inflammation and microbiome changes to the development of mucositis. Additional research has focused on targeted therapy-induced toxicity, toxicity clustering and the investigation of genetic polymorphisms in toxicity prediction. This review paper summarizes the recent evidence on these aspects of mucositis pathobiology. CONCLUSION The ultimate goal of mucositis researchers is to identify the most appropriate targets for therapeutic interventions and to be able to predict toxicity risk and personalize interventions to genetically suitable patients. Continuing research efforts are needed to further our understanding of mucositis pathobiology and the pharmacogenomics of toxicity.
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