Mucositis and salivary antioxidants in patients undergoing bone marrow transplantation (BMT)

Bachmeier, Evelin; Mazzeo, M; López, María Marcela; Linares, J.A.; Jarchum, Gustavo; Wietz, Fernando Martín; Finkelberg, A.

doi:10.4317/medoral.19062

Cited by 22 publications

(30 citation statements)

References 27 publications

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“…Changes in the salivary composition after HSCT were also found. In the first 2 weeks after HSCT, a decreased salivary antioxidant capacity was reported [19,36]. The chemotherapeutic agents induce epithelial cell damage and consequently induce the generation of reactive oxygen species (ROS) [48].…”

Section: Discussionmentioning

confidence: 99%

“…The chemotherapeutic agents induce epithelial cell damage and consequently induce the generation of reactive oxygen species (ROS) [48]. One of the protective components in saliva is superoxide dismutase (SOD), which inhibits the production of free radicals [36]. In the first 2 weeks after HSCT, salivary SOD levels were Supplementary Table S3.…”

Section: Discussionmentioning

confidence: 99%

“…In stimulated SM/SL saliva, increased levels of lactoferrin, secretory leukocyte protease inhibitor (SLPI), and b 2 -microglobulin were seen 6 months after allogeneic HSCT [10] (Figure 3; Supplementary Table S3). At several days after autologous HSCT, several components of the salivary antioxidant system were decreased in UWS, leading to decreased salivary antioxidative capacities [17,19,36]. In addition, a decrease in secretory IgA was found at day +7 in UWS of adult autologous HSCT recipients and at 1 month after allogeneic HSCT in stimulated SM/SL saliva of adult patients [10,19] (Figure 3; Supplementary Table S3).…”

Section: Saliva Compositionmentioning

confidence: 99%

See 2 more Smart Citations

Salivary Changes before and after Hematopoietic Stem Cell Transplantation: A Systematic Review

Leeuwen

Potting

Huysmans

et al. 2019

Biology of Blood and Marrow Transplantation

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A B S T R A C T Severe oral problems, including oral mucositis (OM) and xerostomia, often occur after conditioning therapy for hematopoietic stem cell transplantation (HSCT). Saliva plays a major role in protecting the oral mucosa and teeth. Alterations in salivary flow rate or salivary components resulting in decreased salivary defence mechanisms may affect oral/mucosal health and may influence the severity of OM. A systematic review was conducted to assess the current scientific knowledge on changes in salivary function and composition before and after HSCT. All English or Dutch articles examining salivary flow rate or salivary components before and after HSCT were included after title/abstract selection by 2 independent reviewers (weighted k = .91). After quality assessment and exclusion of all research groups with both children age <14 years and adults, 33 articles were included for data analysis. Overall, the salivary flow rate was decreased at several days and months after HSCT. Although several salivary components were studied, most components were examined in only 1 or 2 studies with different patient populations or at different time points after HSCT. At 7 days after HSCT, albumin and proinflammatory cytokines were increased, whereas secretory IgA and components of the salivary antioxidant system were decreased. Secretory IgA levels were still reduced at 1 month after HSCT but returned to pre-HSCT values at 6 months after HSCT. Lactoferrin, secretory leukocyte protease inhibitor, and b 2 -microglobulin levels were increased at 6 months after HSCT. Our findings show that changes in saliva reflect an inflammatory response occurring immediately after HSCT, followed by evidence of increased salivary antimicrobial defense mechanisms by 6 months after HSCT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Saliva Compositionmentioning

confidence: 99%

See 1 more Smart Citation

Salivary Changes before and after Hematopoietic Stem Cell Transplantation: A Systematic Review

Leeuwen

Potting

Huysmans

et al. 2019

Biology of Blood and Marrow Transplantation

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“…Durante el período de quimioterapia, la aparición de toxicidades sistémicas graves es uno de los principales problemas clínicos, entre los que se encuentran los relacionados con el sistema estomatognático 1,2 . Las complicaciones orales más frecuentes son: mucositis, disgeusia, inflamación, hemorragia gingival y disminución del flujo salival o hiposalivación, un factor que predispone a la xerostomía y otras complicaciones locales 3 . Ciclofosfamida es una droga ampliamente utilizada asociada a otras drogas oncológicas para el tratamiento de tumores sólidos o en esquemas de acondicionamiento para trasplante de médula ósea.…”

Section: Introductionunclassified

Efecto de ciclofosfamida sobre el metabolismo de los hidratos de carbono en glándula submandibular de ratas

Mazzeo¹,

Bachmeier²,

López³

et al. 2018

RevFacOdont

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Efecto de ciclofosfamida sobre el metabolismo de los hidratos de carbono en glándula submandibular de ratasEffect of cyclophosphamide on the metabolism of carbohydrates in the submandibular gland of rats AbstractObjective: During the period of chemotherapy, the appearance of serious systemic toxicities is one of the main clinical problems, among which are those related to the stomatognathic system. Cyclophosphamide is a drug widely used in solid tumors and bone marrow transplantation. The objective of this work was to evaluate the toxicity of cyclophosphamide on the functional activity of the submandibular glands of Wistar rats in an experimental model. Methods: We used 42 male Wistar rats aged 3 months, housed in individual cages, with temperature and controlled lighting and free diet. They were divided into three experimental groups: 1) Control (C), 2) treated with cyclophosphamide (Cf,) applying an i.p. of 50 mg / Kg of body weight during two consecutive days and 3) rats with paired feeding (AA): during two days the amount administered resulted from the average of the ingested food of group 2 .Both submandibular glands were removed. The submandibular glycogen concentration was analyzed in initial time (t0) and after 60 minutes of mechanical stimulation (t60). Results: The average variations changed significantly between time 0 and 60 in groups C and AA (p-value = 0.0001), Cf had a lower average concentration in time 0 with respect to C and AA, without significant consumption in time 60. Conclusion: Cf would affect the metabolism of carbohydrates, decreasing the use of glycogen as a metabolic substrate. In the present experimental model the toxicity of this drug reduces the functional activity of the submandibular gland.

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“…). Além disso, observam-se alterações dos constituintes salivares durante o TCTH, tais como aumento de superóxido dismutase(Bachmeier et al, 2014), diminuição da atividade antioxidante, redução da IgAs e aumento de albumina(Avivi et al, 2009).A disgeusia pode ocorrer por mudanças na expressão gênica das papilas gustativas na mucosa lingual e ser exacerbada com a apresentação de mucosite oral. Em pacientes com mucosite severa, há diminuição na expressão de mRNA na mucosa lingual até 2 semanas após o início do tratamento quimioterápico.…”

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Análise das alterações de paladar durante o transplante de célulastronco hematopoiéticas

Ferreira¹

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Ferreira MH. Analysis of taste alterations during hematopoietic cell transplantation [dissertation]. São Paulo: Universidade de São Paulo, Faculdade de Odontologia; 2018. Versão Corrigida.Taste changes during hematopoietic cell transplantation (HCT) are often described after the end of transplantation, however little is known about which flavors and what type of perception changes are experienced by patients during transplantation. The aim of this study was to characterize the taste alterations and taste buds atrophy present in the period of neutropenia of HCT, as well as to verify if there is association between these alterations and clinical variables related to transplant and oral mucosal toxicity. The impact of taste and oral mucosal changes on patients' quality of life was also evaluated. We selected 52 patients undergoing autologous and allogenic HCT, who underwent taste acuity tests prior to conditioning and during neutropenia. Patients were also submitted to oroscopy for evaluation of oral mucositis and taste buds atrophy. An investigation was also conducted on xerostomia and taste changes. It was carried out an acuity test in the perception of sweet, bitter, sour and salty flavors, offered in solutions containing low and high concentrations of substances stimulating these flavors. Quality of life was assessed by the EORTC questionnaire QLQ-C30 and QLQ-H & N35. It was found that 46.1% of the patients exhibited taste alterations before the conditioning of the HCT, but that this frequency increased to 90.5% during neutropenia (c2 test, p = 0.042). The most common alteration was the hypogeusia of the strongest concentrations, especially bitter. High frequency of patients (72.0%) were detected with taste buds atrophy in the period of neutropenia, but this taste buds atrophy was not associated with alterations in the perception of each type of taste. There was no association between changes in taste and type of transplant, type of conditioning, and variables related to toxicity in the oral cavity and in the gastrointestinal tract. There was a significant association between taste buds atrophy and oral mucositis duration ≥8 days (OR = 5.62, 95% CI = 0.98-60.30, p = 0.039). Salivary and taste changes significantly reduced quality of life during neutropenia compared to the pre-condition period. It was concluded that taste alterations are already present before HCT, but there is an increase in the frequency of these alterations, mainly hypogeusia. The tongue taste buds atrophy occurred after conditioning, and was associated with a longer duration of oral mucositis. The impact of salivary and taste changes on patient quality of life during neutropenia is high and should be minimized through the adoption of more comprehensive strategies that include maintenance of oral mucosal integrity.

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Mucositis and salivary antioxidants in patients undergoing bone marrow transplantation (BMT)

Cited by 22 publications

References 27 publications

Salivary Changes before and after Hematopoietic Stem Cell Transplantation: A Systematic Review

Salivary Changes before and after Hematopoietic Stem Cell Transplantation: A Systematic Review

Efecto de ciclofosfamida sobre el metabolismo de los hidratos de carbono en glándula submandibular de ratas

Análise das alterações de paladar durante o transplante de célulastronco hematopoiéticas

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