Determination of cytokine protein levels in oral secretions in patients undergoing radiotherapy for head and neck malignancies

Abstract

BackgroundCytokines may be elevated in tumor and normal tissues following irradiation. Cytokine expression in these tissues may predict for toxicity or tumor control. The purpose of this pilot study was to determine the feasibility of measuring local salivary cytokine levels using buccal sponges in patients receiving chemo-radiation for head and neck malignancies.Patients and methods11 patients with epithelial malignancies of the head and neck were recruiting to this study. All patients received radiotherapy to the head and neck region with doses ranging between 60 – 67.5 Gy. Chemotherapy was delivered concurrently with radiation in all patients. Salivary samples were obtained from high dose and low dose regions prior to treatment and at three intervals during treatment for assessment of cytokine levels (IL-4, IL-6, IL-8, IL-10, EGF, MCP-1, TNF-α, and VEGF).ResultsCytokine levels were detectable in the salivary samples. Salivary cytokine levels of IL-4, IL-6, IL-8, EGF, MCP-1, TNF- α , and VEGF were higher in the high dose region compared to the low dose region at all time points (p < 0.05). A trend toward an increase in cytokine levels as radiation dose increased was observed for IL-6, IL-8, MCP-1, and TNF-α.ConclusionAssessment of salivary cytokine levels may provide a novel method to follow local cytokine levels during radiotherapy and may provide a mechanism to study cytokine levels in a regional manner.

Inflammatory Biomarker C-Reactive Protein and Radiotherapy-Induced Early Adverse Skin Reactions in Patients with Breast Cancer

“…Previous studies suggest that RT-induced changes in pro-inflammatory cytokines and growth factors may contribute to normal tissue toxicities (11, 12). Our current data provide new evidence that the inflammatory biomarker, plasma CRP levels are associated with RT-induced EASRs in breast cancer patients undergoing RT.…”

“…Inflammation may play critical roles in RT-induced EASRs and previous studies showed that RT induces changes in pro-inflammatory (IL-1α, IL-4, IL-2, IL-6, IL-8, IL-10, TNF-α, IFN-γ), pro-fibrotic (TGF-β1), pro-angiogenic (VEGF) and stem cell mobilizing (GM-CSF) cytokines and growth factors that may contribute to normal tissue toxicities or tumor control (11, 12). In addition, an inflammatory biomarker, C-reactive protein (CRP) has been associated with elevated risk for vascular atherosclerosis, insulin resistance, type 2 diabetes mellitus, and cancer (13–15).…”

Mechanisms of Normal Tissue Injury From Irradiation

“…Deficiency of TNF-α in a lung injury model was sufficient to prevent symptoms of radiation pneumonitis 70 . TNF-α has also been implicated in radiation mucositis, enteritis, and dermatitis 71–75 . The clinical availability of agents targeting TNF-α to treat rheumatologic disorders provides a unique opportunity for clinical translation, and will likely enhance investigation into this molecule and its pathway.…”

Immunopathogenesis of Oral Mucositis Induced by Chemotherapy and/or Radiotherapy: State of Art

“…Cytokines are prevalent within the affected tissue and are also detected in peripheral blood 5 . Studies have shown a significant increase in the levels of pro-inflammatory cytokines during chemotherapy and / or radiotherapy of head and neck, such as TNF-α 19,20 and IL-6 12,19,21 .…”