Calcitriol for Oral Mucositis Prevention in Patients With Fanconi Anemia Undergoing Hematopoietic SCT: A Double-Blind, Randomized, Placebo-Controlled Trial

Hamidieh, Amir Ali; Sherafatmand, Mona; Mansouri, Ava; Hadjibabaie, Molouk; Ashouri, Asieh; Jahangard‐Rafsanjani, Zahra; Gholami, Kheirollah; Javadi, Mohammad Reza; Ghavamzadeh, Ardeshir; Radfar, Mohammad Hadi

doi:10.1097/mjt.0000000000000269

Cited by 15 publications

(10 citation statements)

References 33 publications

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“…Calcitriol, also called 1,25-dihydroxycholecalciferol, is the active metabolite of vitamin D. Vitamin D is a group of fatsoluble hormones responsible for increasing intestinal absorption of calcium, magnesium, and phosphate [73]. Vitamin D is speculated to have anti-inflammatory properties related to its ability to diminish the release of TNF-α and to increase the synthesis of interleukin10 [71]. Table 5 summarizes the details of studies reviewed on calcitriol.…”

Section: Calcitriolmentioning

confidence: 99%

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Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines—part 1: vitamins, minerals, and nutritional supplements

Yarom

Hovan²,

Bossi

et al. 2019

Support Care Cancer

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Purpose To update the clinical practice guidelines for the use of natural and miscellaneous agents for the prevention and/or treatment of oral mucositis (OM). Methods A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: Recommendation, Suggestion, and No Guideline Possible. Results A total of 78 papers were identified within the scope of this section, out of which 29 were included in this part, and were analyzed with 27 previously reviewed studies. A new Suggestion was made for oral glutamine for the prevention of OM in head and neck (H&N) cancer patients receiving radiotherapy with concomitant chemotherapy. The previous Recommendation against the use of parenteral glutamine for the prevention of OM in hematopoietic stem cell transplantation (HSCT) patients was reestablished. A previous Suggestion for zinc to prevent OM in H&N cancer patients treated with radiotherapy or chemoradiotherapy was reversed to No Guideline Possible. No guideline was possible for other interventions. Conclusions Of the vitamins, minerals, and nutritional supplements studied for the management of OM, the evidence supports a Recommendation against parenteral glutamine in HSCT patients and a Suggestion in favor of oral glutamine in H&N cancer patients for the management of OM.

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Section: Calcitriolmentioning

confidence: 99%

“…The use of calcitriol for prevention of OM in patients undergoing HSCT was evaluated in a single RCT [71]. Twentyeight patients with Fanconi anemia undergoing HSCT were treated with either oral calcitriol or placebo.…”

Section: Gcalcitriol (Po): Hsct-prevention Guideline: No Guideline Pomentioning

confidence: 99%

Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines—part 1: vitamins, minerals, and nutritional supplements

Yarom

Hovan²,

Bossi

et al. 2019

Support Care Cancer

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“…Another study with smaller patient cohort size (n=14) found no significant benefit. 24 Therefore collectively, these data argue for a beneficial role for Vit D in improving treatment-associated mucositis in cancers and perhaps hematopoietic stem cell transplantation. 25 IL-22 is an important cytokine in gut homeostasis.…”

Section: Discussionmentioning

confidence: 98%

Therapeutic effects of Vitamin D and IL-22 on methotrexate-induced mucositis in mice

lmaz

Azizoğlu

Aslan

et al. 2020

Preprint

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Background: Mucositis is a common side effect of cancer therapies and transplant conditioning regimens. Management of mucositis involves multiple approaches from oral hygiene, anti-inflammatory, anti-apoptotic, cytoprotective and antioxidant agents, to cryo-, physical therapy, and growth factors. There is room for novel, affordable treatment options or improvement of currently available therapies. Vitamin D (Vit D) has been shown to regulate mucosa-resident cell populations such as Th17 or innate lymphoid cells and critical mucosal cytokine IL-22, however their therapeutic potential has not been put to test in preclinical mouse models. In this study, we aimed to test the therapeutic potential of Vit D injections and IL-22 overexpression in a murine model of chemotherapy-induced mucositis. Methods: Balb/c mice were given daily intraperitoneal injections of Vit D. Another group received IL-22 plasmid via hydrodynamic gene delivery. Mucositis was induced by methotrexate. Weight loss, intestinal histopathology and IL-22, IL-17A and GM-CSF protein levels in intestinal tissue were measured. Intestinal Il23, Ifng, Tnfa and Il10 gene expression were analyzed by real-time qPCR. Intestinal lamina propria B cell, neutrophil and total innate lymphoid cells were quantified. Results: Daily Vit D injections significantly ameliorated intestinal inflammation and elevated intestinal IL-22 levels compared with control groups. Temporal overexpression of IL-22 by hydrodynamic gene delivery slightly increased intestinal IL-22 but failed to confer significant protection from mucositis. Conclusion: To our knowledge, this is the first experimental demonstration in animal model of mucositis that Vit D and IL-22 supplementation may be beneficial and warrants further trials in human patients.

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“…Data from a study by Anand et al (2017) with adult oral cancer patients revealed that vitamin D supplementation significantly improved treatment-associated mucositis [23]. Another study with smaller patient cohort size (n = 14) found no significant benefit [24]. Therefore collectively, these data argue for a beneficial role for vitamin D in improving treatment-associated mucositis in cancers and perhaps hematopoietic stem cell transplantation [25].…”

Section: Discussionmentioning

confidence: 99%

Therapeutic effects of vitamin D and IL-22 on methotrexate-induced mucositis in mice

et al. 2021

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Mucositis is a common side effect of cancer therapies and transplant conditioning regimens. Management of mucositis involves multiple approaches from oral hygiene, antiinflammatory, anti-apoptotic, cytoprotective, and antioxidant agents, to cryo-therapy, physical therapy, and growth factors. There is room for novel, affordable treatment options, or improvement of currently available therapies. Vitamin D has been shown to regulate mucosa-resident cell populations such as Th17 or innate lymphoid cells and critical mucosal cytokine IL-22; however, their therapeutic potential has not been put to test in preclinical mouse models. In this study, we aimed to test the therapeutic potential of vitamin D injections and IL-22 overexpression in a murine model of chemotherapy-induced mucositis. Balb/c mice were given daily intraperitoneal injections of vitamin D. Mucositis was induced by methotrexate. Another group received IL-22 plasmid via hydrodynamic gene delivery. Weight loss and intestinal histopathology, intestinal levels of cytokines IL-22, IL-17A, GM-CSF, IL-23, IFN-γ, TNF-α, and IL-10, and number of intestinal lamina propria B cell, neutrophil, and total innate lymphoid cells were quantified. Daily vitamin D injections ameliorated intestinal inflammation and elevated intestinal IL-22 levels compared with control groups. Temporal overexpression of IL-22 by hydrodynamic gene delivery slightly increased intestinal IL-22 but failed to confer significant protection from mucositis. To our knowledge, this is the first experimental demonstration in an animal model of mucositis of therapeutic use of vitamin D and IL-22 supplementation and our results with vitamin D suggest it may have merit in further trials in human mucositis patients.

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Calcitriol for Oral Mucositis Prevention in Patients With Fanconi Anemia Undergoing Hematopoietic SCT: A Double-Blind, Randomized, Placebo-Controlled Trial

Cited by 15 publications

References 33 publications

Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines—part 1: vitamins, minerals, and nutritional supplements

Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines—part 1: vitamins, minerals, and nutritional supplements

Therapeutic effects of Vitamin D and IL-22 on methotrexate-induced mucositis in mice

Therapeutic effects of vitamin D and IL-22 on methotrexate-induced mucositis in mice

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