The pathogenesis of mucositis: updated perspectives and emerging targets

Abstract

Mucositis research and treatment are a rapidly evolving field providing constant new avenues of research and potential therapies. The MASCC/ISOO Mucositis Study Group regularly assesses available literature relating to pathogenesis, mechanisms, and novel therapeutic approaches and distils this to summary perspectives and recommendations. Reviewers assessed 164 articles published between January 2011 and June 2016 to identify progress made since the last review and highlight new targets for further investigation. Findings were organized into sections including established and emerging mediators of toxicity, potential insights from technological advances in mucositis research, and perspective. Research momentum is accelerating for mucositis pathogenesis, and with this has come utilization of new models and interventions that target specific mechanisms of injury. Technological advances have the potential to revolutionize the field of mucositis research, although focused effort is needed to move rationally targeted interventions to the clinical setting.

MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy

“…Our knowledge on the pathogenesis of OM has also improved. 32 Although we reviewed a large body of evidence, there are still clinical settings for which there is no recommended intervention. Until more research is available, pain relief, dietary support, and secondary infection prevention are key elements in patient management.…”

Preventive use of gabapentin to decrease pain and systemic symptoms in patients with head and neck cancer undergoing chemoradiation

“…Studies capitalizing on this hypothesis have been ongoing. 9 Radiation mucositis is also associated with increased systemic levels of inflammatory mediators. 10 In addition to their critical role in the local response to tissue damage, systemic inflammatory mediators serve as peripheral to central communication molecules helping to coordinate the response of the endocrine, immune, and nervous systems.…”

The MASCC/ISOO mucositis guidelines 2019: the second set of articles and future directions

“…The July 2019 articles described the methods used [1] and results related to gastrointestinal mucositis [2], as well as other classes of interventions for oral mucositis including anti-inflammatory agents [3], photobiomodulation [4], vitamins, minerals, and nutritional supplements [5], and protocols categorized as basic oral care [6]. Furthermore, an entire paper was dedicated to advances in the understanding of the pathogenesis of mucositis [7]. This issue includes another set of articles that are part of the update for the MASCC/ISOO clinical practice guidelines for the management of mucositis.…”