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2000
Volume 1, Issue 1
  • ISSN: 2666-6499
  • E-ISSN: 2666-6502

Abstract

Radiotherapy for head and neck cancer (HNC) is associated with a dose-limiting side effect known as radiation-induced oral mucositis (RIOM), which severely diminishes the quality of life for patients. The best part is that this adverse effect has identified risk factors, enabling the implementation of preventative medication to delay/mitigate the ill effects, colonization of opportunistic microbes, and infection. Clinically, several effective strategies have been developed to prevent severe RIOM. However, there are limited options for solutions that are both advantageous and practical while also being cost-effective to implement. Results from well-designed and carried-out research have indicated that probiotics have potential benefits in both the management and prevention of RIOM. Research using animal models and clinical studies has affirmatively shown that the utilization of probiotic organisms can successfully modify the intensity of inflammation by modifying the composition, metabolism, and functional characteristics of natural microbiota. Furthermore, the majority (3 of 4) randomized, double-blind, placebo-controlled studies revealed that probiotics were beneficial in decreasing RIOM. This article collates and examines the scientific observations, addresses the underlying mechanisms, and explores the potential benefits of probiotics in mitigating the occurrence and severity of RIOM.

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2024-06-11
2025-01-29
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References

  1. Global Burden of Disease Cancer CollaborationGlobal, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: A systematic analysis for the global burden of disease study.JAMA Oncol.20192019299610.1001/jamaoncol
    [Google Scholar]
  2. SzturzP. VermorkenJ.B. Treatment of elderly patients with squamous cell carcinoma of the head and neck.Front. Oncol.2016619910.3389/fonc.2016.00199
    [Google Scholar]
  3. SonisS.T. A hypothesis for the pathogenesis of radiation-induced oral mucositis: When biological challenges exceed physiologic protective mechanisms. Implications for pharmacological prevention and treatment.Support. Care Cancer20212994939494710.1007/s00520‑021‑06108‑w33712912
    [Google Scholar]
  4. GugnackiP. SierkoE. Is There an Interplay between Oral Microbiome, Head and Neck Carcinoma and Radiation-Induced Oral Mucositis?Cancers20211323590210.3390/cancers1323590234885015
    [Google Scholar]
  5. PetersonD.E. Boers-DoetsC.B. BensadounR.J. HerrstedtJ. Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up.Ann. Oncol.201526Suppl. 5v139v15110.1093/annonc/mdv20226142468
    [Google Scholar]
  6. SonisS.T. The pathobiology of mucositis.Nat. Rev. Cancer20044427728410.1038/nrc131815057287
    [Google Scholar]
  7. SonisS.T. Mucositis: The impact, biology and therapeutic opportunities of oral mucositis.Oral Oncol.200945121015102010.1016/j.oraloncology.2009.08.00619828360
    [Google Scholar]
  8. Rodríguez-CaballeroA. Torres-LagaresD. Robles-GarcíaM. Pachón-IbáñezJ. González-PadillaD. Gutiérrez-PérezJ.L. Cancer treatment-induced oral mucositis: A critical review.Int. J. Oral Maxillofac. Surg.201241222523810.1016/j.ijom.2011.10.01122071451
    [Google Scholar]
  9. VasconcelosR.M. SanfilippoN. PasterB.J. Host-Microbiome Cross-talk in Oral Mucositis.J. Dent. Res.201695772573310.1177/002203451664189027053118
    [Google Scholar]
  10. MontassierE. GastinneT. VangayP. Chemotherapy‐driven dysbiosis in the intestinal microbiome.Aliment. Pharmacol. Ther.201542551552810.1111/apt.1330226147207
    [Google Scholar]
  11. KumpitschC. KoskinenK. SchöpfV. Moissl-EichingerC. The microbiome of the upper respiratory tract in health and disease.BMC Biol.20191718710.1186/s12915‑019‑0703‑z31699101
    [Google Scholar]
  12. KhawA. LoganR. KeefeD. BartoldM. Radiation‐induced oral mucositis and periodontitis – proposal for an inter‐relationship.Oral Dis.2014203e7e1810.1111/odi.1219924147592
    [Google Scholar]
  13. SonisS.T. The pathobiology of oral mucositis.Oral Mucositis20124671310.1007/978‑1‑907673‑46‑7_2
    [Google Scholar]
  14. BelaziM. VelegrakiA. Koussidou-EremondiT. Oral Candida isolates in patients undergoing radiotherapy for head and neck cancer: Prevalence, azole susceptibility profiles and response to antifungal treatment.Oral Microbiol. Immunol.200419634735110.1111/j.1399‑302x.2004.00165.x15491459
    [Google Scholar]
  15. NapeñasJ.J. BrennanM.T. Bahrani-MougeotF.K. FoxP.C. LockhartP.B. Relationship between mucositis and changes in oral microflora during cancer chemotherapy.Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod.20071031485910.1016/j.tripleo.2005.12.01617178494
    [Google Scholar]
  16. RolstonK.V.I. The Infectious Diseases Society of America 2002 guidelines for the use of antimicrobial agents in patients with cancer and neutropenia: Salient features and comments.Clin. Infect. Dis.200439s1Suppl. 1S44S4810.1086/38305315250020
    [Google Scholar]
  17. Abu SharaK.A. GhareebM.A. ZaherS. MobacherA. KhalifaM.C. SalehS.Z. Radiotherapeutic effect on oropharyngeal flora in patients with head and neck cancer.J. Laryngol. Otol.1993107322222710.1017/S00222151001226868509700
    [Google Scholar]
  18. SoniP. PariharR.S. SoniL.K. Opportunistic microorganisms in oral cavity according to treatment status in head and neck cancer patients.J. Clin. Diagn. Res.2017119DC14DC17
    [Google Scholar]
  19. Zagury-OrlyI. KhaouamN. NoujaimJ. DesrosiersM.Y. ManiakasA. The Effect of Radiation and Chemoradiation Therapy on the Head and Neck Mucosal Microbiome: A Review.Front. Oncol.20211178445710.3389/fonc.2021.78445734926301
    [Google Scholar]
  20. da CunhaS.R.B. RamosP.A.M. NesrallahA.C.A. ParahybaC.J. FregnaniE.R. AranhaA.C.C. The Effects of Ionizing Radiation on the Oral Cavity.J. Contemp. Dent. Pract.201516867968710.5005/jp‑journals‑10024‑174026423505
    [Google Scholar]
  21. VestyA. GearK. BiswasK. MackenzieB.W. TaylorM.W. DouglasR.G. Oral microbial influences on oral mucositis during radiotherapy treatment of head and neck cancer.Support. Care Cancer20202862683269110.1007/s00520‑019‑05084‑631650293
    [Google Scholar]
  22. Reyes-GibbyC.C. WangJ. ZhangL. Oral microbiome and onset of oral mucositis in patients with squamous cell carcinoma of the head and neck.Cancer2020126235124513610.1002/cncr.3316132888342
    [Google Scholar]
  23. ChungA. ChungY.T. LiangY.W. ChungY.L. Waldeyer ring microbiome in relation to chemoradiation‐induced oral mucositis in patients with nasopharyngeal carcinoma.Head Neck20234582047205710.1002/hed.2743137337976
    [Google Scholar]
  24. IngrossoG. SaldiS. MaraniS. Breakdown of Symbiosis in Radiation-Induced Oral Mucositis.J. Fungi20217429010.3390/jof704029033921294
    [Google Scholar]
  25. ShettyS.S. MaruthiM. DharaV. Oral mucositis: Current knowledge and future directions.Dis. Mon.202268510130010.1016/j.disamonth.2021.10130034758917
    [Google Scholar]
  26. Galeana-PatiñoC.E. OrtizM.I. Cariño-CortésR. Probiotics, as Adjuvant Therapy and Preventive Measure on Progression, and Complications of Head and Neck Cancer.Curr. Pharm. Biotechnol.202324121504151410.2174/138920102466623021309495336788699
    [Google Scholar]
  27. HuY. ShaoZ. WangQ. Exploring the dynamic core microbiome of plaque microbiota during head-and-neck radiotherapy using pyrosequencing.PLoS One201382e5634310.1371/journal.pone.005634323437114
    [Google Scholar]
  28. HuY.J. WangQ. JiangY.T. Characterization of oral bacterial diversity of irradiated patients by high-throughput sequencing.Int. J. Oral Sci.201351212510.1038/ijos.2013.1523538641
    [Google Scholar]
  29. HouJ. ZhengH. LiP. LiuH. ZhouH. YangX. Distinct shifts in the oral microbiota are associated with the progression and aggravation of mucositis during radiotherapy.Radiother. Oncol.20181291445110.1016/j.radonc.2018.04.02329735410
    [Google Scholar]
  30. GuobisŽ. KareivienėV. BasevičienėN. Microflora of the oral cavity in patients with xerostomia.Medicina2011471264665122370462
    [Google Scholar]
  31. Boñar-ÁlvarezP. Padin-IruegasE. Chamorro-PetronacciC. Assessment of saliva and oral candidiasis levels 12, 24 and 36 months after radiotherapy in patients with head and neck cancer.J. Stomatol. Oral Maxillofac. Surg.2021122656657210.1016/j.jormas.2020.09.01633031953
    [Google Scholar]
  32. TarapanS. MatangkasombutO. TrachoothamD. Oral Candida colonization in xerostomic postradiotherapy head and neck cancer patients.Oral Dis.20192571798180810.1111/odi.1315131257663
    [Google Scholar]
  33. BensadounR.J. PattonL.L. LallaR.V. EpsteinJ.B. Oropharyngeal candidiasis in head and neck cancer patients treated with radiation: Update 2011.Support. Care Cancer201119673774410.1007/s00520‑011‑1154‑421479787
    [Google Scholar]
  34. PereiraI.F. FirminoR.T. MeiraH.C. Do Egito VasconcelosB.C. De Souza NoronhaV.R.A. SantosV.R. Radiation-induced oral mucositis in brazilian patients: Prevalence and associated factors.In vivo201933260560910.21873/invivo.1151730804148
    [Google Scholar]
  35. JiL. HaoS. WangJ. ZouJ. WangY. Roles of Toll-Like Receptors in Radiotherapy- and Chemotherapy-Induced Oral Mucositis: A Concise Review.Front. Cell. Infect. Microbiol.202212831387
    [Google Scholar]
  36. ChenC. ZhangQ. YuW. ChangB. LeA.D. Oral Mucositis: An Update on Innate Immunity and New Interventional Targets.J. Dent. Res.202099101122113010.1177/002203452092542132479139
    [Google Scholar]
  37. PrisciandaroL.D. GeierM.S. ButlerR.N. CumminsA.G. HowarthG.S. Evidence supporting the use of probiotics for the prevention and treatment of chemotherapy-induced intestinal mucositis.Crit. Rev. Food Sci. Nutr.201151323924710.1080/1040839090355174721390944
    [Google Scholar]
  38. ThomsenM. VitettaL. Adjunctive treatments for the prevention of chemotherapy-and radiotherapy-induced mucositis.Integr. Cancer Ther.20181741027104710.1177/153473541879488530136590
    [Google Scholar]
  39. WangY. LiJ. ZhangH. Probiotic Streptococcus salivarius K12 Alleviates Radiation-Induced Oral Mucositis in Mice.Front. Immunol.20211268482410.3389/fimmu.2021.68482434149727
    [Google Scholar]
  40. XiaC. JiangC. LiW. A Phase II Randomized Clinical Trial and Mechanistic Studies Using Improved Probiotics to Prevent Oral Mucositis Induced by Concurrent Radiotherapy and Chemotherapy in Nasopharyngeal Carcinoma.Front. Immunol.20211261815010.3389/fimmu.2021.61815033841399
    [Google Scholar]
  41. JiangC. WangH. XiaC. A randomized, double‐blind, placebo‐controlled trial of probiotics to reduce the severity of oral mucositis induced by chemoradiotherapy for patients with nasopharyngeal carcinoma.Cancer201912571081109010.1002/cncr.3190730521105
    [Google Scholar]
  42. De SanctisV. BelgioiaL. CanteD. Lactobacillus brevis CD2 for Prevention of Oral Mucositis in Patients With Head and Neck Tumors: A Multicentric Randomized Study.Anticancer Res.20193941935194210.21873/anticanres.1330330952736
    [Google Scholar]
  43. MirzaM.A. ArunaD. IrukullaM. Efficacy of Bacillus clausii UBBC - 07 spores in the amelioration of oral mucositis in head and neck cancer patients undergoing radiation therapy.Cancer Treat. Res. Commun.20223110052310.1016/j.ctarc.2022.10052335101832
    [Google Scholar]
  44. LiuY.C. WuC.R. HuangT.W. Preventive Effect of Probiotics on Oral Mucositis Induced by Cancer Treatment: A Systematic Review and Meta-Analysis.Int. J. Mol. Sci.202223211326810.3390/ijms23211326836362057
    [Google Scholar]
  45. Plomer M III, III Perez M, Greifenberg DM. Effect of Bacillus clausii capsules in reducing adverse effects associated with Helicobacter pylori eradication therapy: A randomized, double-blind, controlled trial.Infect. Dis. Ther.20209486787810.1007/s40121‑020‑00333‑232897519
    [Google Scholar]
  46. Jeżewska-FrąckowiakJ. SeroczyńskaK. BanaszczykJ. WoźniakD. Żylicz-StachulaA. SkowronP.M. The promises and risks of probiotic Bacillus species.Acta Biochim. Pol.201865450951910.18388/abp.2018_265230521647
    [Google Scholar]
  47. NistaE.C. CandelliM. CremoniniF. Bacillus clausii therapy to reduce side‐effects of anti‐Helicobacter pylori treatment: Randomized, double‐blind, placebo controlled trial.Aliment. Pharmacol. Ther.200420101181118810.1111/j.1365‑2036.2004.02274.x15569121
    [Google Scholar]
  48. SudhaM.R. BhonagiriS. KumarM.A. Efficacy of Bacillus clausii strain UBBC-07 in the treatment of patients suffering from acute diarrhoea.Benef. Microbes20134221121610.3920/BM2012.003423443952
    [Google Scholar]
  49. SmiyanO.I. Smiian-HorbunovaK.O. ByndaT.P. Optimization of the treatment of rotavirus infection in children by using bacillus clausii.Wiad. Lek.20197271320132310.36740/WLek20190711731398163
    [Google Scholar]
  50. KaiserJ. Gut microbes shape response to cancer immunotherapy.Science2017358636357310.1126/science.358.6363.57329097525
    [Google Scholar]
  51. MaynardC.L. ElsonC.O. HattonR.D. WeaverC.T. Reciprocal interactions of the intestinal microbiota and immune system.Nature2012489741523124110.1038/nature1155122972296
    [Google Scholar]
  52. SharmaA. RathG.K. ChaudharyS.P. ThakarA. MohantiB.K. BahadurS. Lactobacillus brevis CD2 lozenges reduce radiation- and chemotherapy-induced mucositis in patients with head and neck cancer: A randomized double-blind placebo-controlled study.Eur. J. Cancer201248687588110.1016/j.ejca.2011.06.01021741230
    [Google Scholar]
  53. ThomasS. IzardJ. WalshE. The Host Microbiome Regulates and Maintains Human Health: A Primer and Perspective for Non-Microbiologists.Cancer Res.20177781783181210.1158/0008‑5472.CAN‑16‑292928292977
    [Google Scholar]
  54. SivanA. CorralesL. HubertN. Commensal Bifidobacterium promotes antitumor immunity and facilitates anti-PD-L1 efficacy.Science201535062641084108910.1126/science.aac425526541606
    [Google Scholar]
  55. VétizouM. PittJ.M. DaillèreR. Anticancer immunotherapy by CTLA-4 blockade relies on the gut microbiota.Science201535062641079108410.1126/science.aad132926541610
    [Google Scholar]
  56. TouchefeuY. MontassierE. NiemanK. Systematic review: The role of the gut microbiota in chemotherapy‐ or radiation‐induced gastrointestinal mucositis – current evidence and potential clinical applications.Aliment. Pharmacol. Ther.201440540942110.1111/apt.1287825040088
    [Google Scholar]
  57. ChangC.W. LiuC.Y. LeeH.C. Lactobacillus caseivariety rhamnosus probiotic preventively attenuates 5-fluorouracil/oxaliplatin-induced intestinal injury in a syngeneic colorectal cancer model.Front. Microbiol.2018998310.3389/fmicb.2018.0098329867884
    [Google Scholar]
  58. ZelanteT. IannittiR.G. CunhaC. Tryptophan catabolites from microbiota engage aryl hydrocarbon receptor and balance mucosal reactivity via interleukin-22.Immunity201339237238510.1016/j.immuni.2013.08.00323973224
    [Google Scholar]
  59. GuptaN. FerreiraJ. HongC.H.L. TanK.S. Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 ameliorates chemotherapy-induced oral mucositis.Sci. Rep.20201011618910.1038/s41598‑020‑73292‑w31913322
    [Google Scholar]
  60. DicaroS. TaoH. GrilloA. Effects of on genes expression pattern in small bowel mucosa.Dig. Liver Dis.200537532032910.1016/j.dld.2004.12.00815843081
    [Google Scholar]
  61. FengJ. GaoM. ZhaoC. Oral administration of probiotics reduces chemotherapy-induced diarrhea and oral mucositis: A systematic review and meta-analysis.Front. Nutr.2022982328810.3389/fnut.2022.82328835299763
    [Google Scholar]
  62. MinerviniG. FrancoR. MarrapodiM.M. Probiotics in the treatment of radiotherapy-induced oral mucositis: Systematic review with meta-analysis.Pharmaceuticals202316565410.3390/ph1605065437242437
    [Google Scholar]
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