Oral mucositis: Current knowledge and future directions

Phytochemical-rich vegetable and fruit juice alleviates oral mucositis during concurrent chemoradiotherapy in patients with locally advanced head and neck cancer

“… 26 The initiation phase happens immediately after administering the cytotoxic agents, which induce primary tissue damage possibly mediated by elevated intracellular ROS. 11 The message generation stage involves activation of nuclear factor-κB (NF-κB), which subsequently upregulates pro-inflammatory cytokine (TNF-α, IL-1β, and IL-6) production, as well as induces stress-responsive genes such as cyclooxygenase-2 (COX-2) and inducible nitric oxide synthases (iNOS). The pro-inflammatory cytokines amplify the primary signal and further activate NF-κB, leading to transcription of genes responsible for mitogen-activated protein kinase (MAPK) and tyrosine kinase signaling molecules.…”

“…The pro-inflammatory cytokines amplify the primary signal and further activate NF-κB, leading to transcription of genes responsible for mitogen-activated protein kinase (MAPK) and tyrosine kinase signaling molecules. 11 , 26 These signaling pathways collectively cause mucosal injuries. In the ulcerative stage, the basement membrane protective barrier is lost, oral bacteria colonize the ulcer and stimulate surrounding cells to release cytokines and chemokines.…”

“…Oxidative stress has thus been suggested as one of the major causative factors of OM. 11 A systematic review also indicated that several natural agents containing phytochemicals, such as polyphenols, carotenoids, triterpenes, and essential oils, which exert antioxidant, anti-inflammatory, and antimicrobial properties, are effective alternatives to synergistic therapy for OM lesions after RT, CT, or both. 12 …”

Association of anxiety and depression with oral mucositis: A systematic review

“…Oral mucositis (OM) is a side effect associated with regimens of chemotherapy (CT), radiotherapy (RT) and chemoradiotherapy (CCRT) (Elad et al, 2020; Elad et al, 2022; Shetty et al, 2022). OM is characterized by erythematous and/or ulcerated lesions in the oral mucosa and oropharynx (Shetty et al, 2022; Villa & Sonis, 2020).…”

“…Oral mucositis (OM) is a side effect associated with regimens of chemotherapy (CT), radiotherapy (RT) and chemoradiotherapy (CCRT) (Elad et al, 2020; Elad et al, 2022; Shetty et al, 2022). OM is characterized by erythematous and/or ulcerated lesions in the oral mucosa and oropharynx (Shetty et al, 2022; Villa & Sonis, 2020). The pathogenesis of OM comprises epithelial and submucosal injury, activation of pro‐inflammatory pathways, and subsequent oral microbiota changes (Bowen et al, 2019; Elad et al, 2022; Villa & Sonis, 2015).…”