Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (8): 567-571.doi: 10.12016/j.issn.2096-1456.2021.08.011

• Review Articles • Previous Articles     Next Articles

Research progress on probiotics for the prevention and treatment of oral and gastrointestinal chemoradiotherapy mucositis

ZHANG Lin1(),TANG Yawen1,WANG Jiantao2,WANG Yan1()   

  1. 1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2. State key Laboratory of Biotherapy & Department of Lung Cancer Center and Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2020-12-26 Revised:2021-02-04 Online:2021-08-20 Published:2021-05-13
  • Contact: Yan WANG E-mail:1776911068@qq.com;wangyan1458@scu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(81600864)

Abstract:

Mucositis is the most common side effect of radiotherapy and chemotherapy. It is an inflammatory disease with an unclear pathogenesis, diverse clinical manifestations and no effective treatment. It often manifests as local mucosal burning and stinging pain in the oral cavity and nausea, vomiting and diarrhea in the gastrointestinal tract. At present, it has been found that local microflora imbalance promotes the occurrence and development of chemoradiotherapy mucositis, and probiotics can be used as an emerging approach to prevent and treat mucositis. This paper reviews the research progress of probiotics in the prevention and treatment of oral and gastrointestinal chemoradiotherapy mucositis, focusing on the influence of microorganisms on the pathogenesis and treatment of gastrointestinal mucositis. Literature review results showed that the occurrence and development of mucositis may be related to changes in the composition and function of local microflora, and probiotics can play a preventive role by regulating local microecology and host immunity. At present, the main probiotics used in the prevention and treatment of mucositis are Lactobacillus and Bifidobacterium. Most clinical trials have confirmed that probiotics have a positive effect in the prevention and treatment of mucositis. However, due to the variety of probiotics and different tumor treatment regimens, prevention and treatment effects may not be observed in some studies. Therefore, the selection of probiotics with high efficacy and safety and the design of the best combination of probiotics and intervention programs are current research hotspots.

Key words: probiotics, Lactobacillus, Bifidobacterium, oral mucositis, gastrointestinal mucositis, tumor, chemotherapy, radiotherapy, local microecology, host immunity

CLC Number: 

  • R78
[1] Mccullough RW. US oncology-wide incidence, duration, costs and deaths from chemoradiation mucositis and antimucositis therapy benefits[J]. Future Oncol, 2017,13(30):2823-2852. doi: 10.2217/fon-2017-0418.
doi: 10.2217/fon-2017-0418
[2] Thomsen M, Vitetta L. Adjunctive treatments for the prevention of chemotherapy- and Radiotherapy-Induced mucositis[J]. Integr Cancer Ther, 2018,17(4):1027-1047. doi: 10.1177/1534735418794 885.
doi: 10.1177/1534735418794 885
[3] Sonis ST. Oral mucositis[J]. Anticancer Drugs, 2011,22(7):607-612. doi: 10.1097/CAD.0b013e3283462086.
doi: 10.1097/CAD.0b013e3283462086
[4] Alexander JL, Wilson ID, Teare J, et al. Gut microbiota modulation of chemotherapy efficacy and toxicity[J]. Nat Rev Gastroenterol Hepatol, 2017,14(6):356-365. doi: 10.1038/nrgastro.2017.20.
doi: 10.1038/nrgastro.2017.20 pmid: 28270698
[5] Hong BY, Sobue T, Choquette L, et al. Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis[J]. Microbiome, 2019,7(1):66. doi: 10.1186/s40168-019-0679-5.
doi: 10.1186/s40168-019-0679-5
[6] Hou J, Zheng H, Li P, et al. Distinct shifts in the oral microbiota are associated with the progression and aggravation of mucositis during radiotherapy[J]. Radiother Oncol, 2018,129(1):44-51. doi: 10.1016/j.radonc.2018.04.023.
doi: 10.1016/j.radonc.2018.04.023
[7] Zhu XX, Yang XJ, Chao YL, et al. The potential effect of oral microbiota in the prediction of mucositis during radiotherapy for nasopharyngeal carcinoma[J]. EBioMedicine, 2017,18(18):23-31. doi: 10.1016/j.ebiom.2017.02.002.
doi: 10.1016/j.ebiom.2017.02.002
[8] Vesty A, Gear K, Biswas K, et al. Oral microbial influences on oral mucositis during radiotherapy treatment of head and neck cancer[J]. Support Care Cancer, 2020,28(6):2683-2691. doi: 10.1007/s00520-019-05084-6.
doi: 10.1007/s00520-019-05084-6 pmid: 31650293
[9] Vasconcelos RM, Sanfilippo N, Paster BJ, et al. Host-Microbiome cross-talk in oral mucositis[J]. J Dent Res, 2016,95(7):725-733. doi: 10.1177/0022034516641890.
doi: 10.1177/0022034516641890
[10] Vanlancker E, Vanhoecke B, Sieprath T, et al. Oral microbiota reduce wound healing capacity of epithelial monolayers, irrespective of the presence of 5-fluorouracil[J]. Exp Biol Med (Maywood), 2018,243(4):350-360. doi: 10.1177/1535370217753842.
doi: 10.1177/1535370217753842
[11] Vanhoecke BW, De Ryck TR, De BK, et al. Low-dose irradiation affects the functional behavior of oral microbiota in the context of mucositis[J]. Exp Biol Med (Maywood), 2016,241(1):60-70. doi: 10.1177/1535370215595467.
doi: 10.1177/1535370215595467
[12] Li HL, Lu L, Wang XS, et al. Alteration of gut microbiota and inflammatory cytokine/chemokine profiles in 5-fluorouracil induced intestinal mucositis[J]. Front Cell Infect Microbiol, 2017,7:455. doi: 10.3389/fcimb.2017.00455.
doi: 10.3389/fcimb.2017.00455
[13] Gerassy-Vainberg S, Blatt A, Danin-Poleg Y, et al. Radiation induces proinflammatory dysbiosis: transmission of inflammatory susceptibility by host cytokine induction[J]. Gut, 2018,67(1):97-107. doi: 10.1136/gutjnl-2017-313789.
doi: 10.1136/gutjnl-2017-313789 pmid: 28438965
[14] Markowiak P, Slizewska K. Effects of probiotics, prebiotics, and synbiotics on human health[J]. Nutrients, 2017,9(9):1021. doi: 10.3390/nu9091021.
doi: 10.3390/nu9091021
[15] Seminario-Amez M, López-López J, Estrugo-Devesa A, et al. Probiotics and oral health: a systematic review[J]. Med Oral Patol Oral Cir Bucal, 2017,22(3):e282-e288. doi: 10.4317/medoral.21494.
doi: 10.4317/medoral.21494
[16] Batista VL, da Silva TF, de Jesus LCL, et al. Probiotics, prebiotics, synbiotics, and paraprobiotics as a therapeutic alternative for intestinal mucositis[J]. Front Microbiol, 2020,11:544490. doi: 10.3389/fmicb.2020.544490.
doi: 10.3389/fmicb.2020.544490
[17] Gerhard D, Sousa F, Andraus RAC, et al. Probiotic therapy reduces inflammation and improves intestinal morphology in rats with induced oral mucositis[J]. Braz Oral Res, 2017,31:e71. doi: 10.1590/1807-3107BOR-2017.vol31.0071.
doi: 10.1590/1807-3107BOR-2017.vol31.0071
[18] Gupta N, Ferreira J, Hong CHL, et al. Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 ameliorates chemotherapy-induced oral mucositis[J]. Sci Rep, 2020,10(1):16189. doi: 10.1038/s41598-020-73292-w.
doi: 10.1038/s41598-020-73292-w
[19] Sharma A, Rath GK, Chaudhary SP, et al. Lactobacillus brevis CD2 lozenges reduce radiation- and chemotherapy-induced mucositis in patients with head and neck cancer: a randomized double-blind placebo-controlled study[J]. Eur J Cancer, 2012,48(6):875-881. doi: 10.1016/j.ejca.2011.06.010.
doi: 10.1016/j.ejca.2011.06.010
[20] Sharma A, Tilak T, Bakhshi S, et al. Lactobacillus brevis CD2 lozenges prevent oral mucositis in patients undergoing high dose chemotherapy followed by haematopoietic stem cell transplantation[J]. ESMO Open, 2016,1(6):e000138. doi: 10.1136/esmoopen-2016-000138.
doi: 10.1136/esmoopen-2016-000138
[21] De Sanctis V, Belgioia L, Cante D, et al. Lactobacillus brevis CD2 for prevention of oral mucositis in patients with head and neck tumors: a multicentric randomized study[J]. Anticancer Res, 2019,39(4):1935-1942. doi: 10.21873/anticanres.13303.
doi: 10.21873/anticanres.13303
[22] Limaye SA, Haddad RI, Cilli F, et al. Phase 1b, multicenter, single blinded, placebo-controlled, sequential dose escalation study to assess the safety and tolerability of topically applied AG013 in subjects with locally advanced head and neck cancer receiving induction chemotherapy[J]. Cancer, 2013,119(24):4268-4276. doi: 10.1002/cncr.28365.
doi: 10.1002/cncr.28365
[23] Jiang C, Wang H, Xia C, et al. A randomized, double-blind, placebo-controlled trial of probiotics to reduce the severity of oral mucositis induced by chemoradiotherapy for patients with nasopharyngeal carcinoma[J]. Cancer, 2019,125(7):1081-1090. doi: 10.1002/cncr.31907.
doi: 10.1002/cncr.31907
[24] Oh NS, Jy L, Lee JM, et al. Mulberry leaf extract fermented with Lactobacillus acidophilus A4 ameliorates 5-fluorouracil-induced intestinal mucositis in rats[J]. Lett Appl Microbiol, 2017,64(6):459-468. doi: 10.1111/lam.12741.
doi: 10.1111/lam.12741
[25] Kato S, Hamouda N, Kano Y, et al. Probiotic bifidobacterium bifidum G9-1 attenuates 5-fluorouracil-induced intestinal mucositis in mice via suppression of dysbiosis-related secondary inflammatory responses[J]. Clin Exp Pharmacol Physiol, 2017,44(10):1017-1025. doi: 10.1111/1440-1681.12792.
doi: 10.1111/1440-1681.12792
[26] Chang CW, Liu CY, Lee HC, et al. Lactobacillus casei variety rhamnosus probiotic preventively attenuates 5-fluorouracil/oxaliplatin-induced intestinal injury in a syngeneic colorectal cancer model[J]. Front Microbiol, 2018,9:983. doi: 10.3389/fmicb.2018. 00983.
doi: 10.3389/fmicb.2018. 00983
[27] Huang L, Chiang CJ, Cheng ML, et al. SCID/NOD mice model for 5-FU induced intestinal mucositis: Safety and effects of probiotics as therapy[J]. Pediatr Neonatol, 2019,60(3):252-260. doi: 10.1016/j.pedneo.2018.07.007.
doi: 10.1016/j.pedneo.2018.07.007
[28] Mi H, Dong Y, Zhang B, et al. Bifidobacterium infantis ameliorates chemotherapy-induced intestinal mucositis via regulating T cell immunity in colorectal cancer rats[J]. Cell Physiol Biochem, 2017,42(6):2330-2341. doi: 10.1159/000480005.
doi: 10.1159/000480005
[29] Maioli TU, de Melo Silva B, Dias MN, et al. Pretreatment with Saccharomyces boulardii does not prevent the experimental mucositis in Swiss mice[J]. J Negat Results Biomed, 2014,13(1):6. doi: 10.1186/1477-5751-13-6.
doi: 10.1186/1477-5751-13-6
[30] Tang Y, Wu Y, Huang Z, et al. Administration of probiotic mixture DM#1 ameliorated 5-fluorouracil-induced intestinal mucositis and dysbiosis in rats[J]. Nutrition, 2017,33:96-104. doi: 10.1016/j.nut.2016.05.003.
doi: S0899-9007(16)30074-0 pmid: 27427511
[31] Quaresma M, Damasceno S, Monteiro C, et al. Probiotic mixture containing Lactobacillus spp. and Bifidobacterium spp. attenuates 5-fluorouracil-induced intestinal mucositis in mice[J]. Nutr Cancer, 2020,72(8):1355-1365. doi: 10.1080/01635581.2019.1675719.
doi: 10.1080/01635581.2019.1675719
[32] Lalla RV, Bowen J, Barasch A, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy[J]. Cancer, 2014,120(10):1453-1461. doi: 10.1002/cncr.28592.
doi: 10.1002/cncr.28592
[33] Osterlund P, Ruotsalainen T, Korpela R, et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study[J]. Br J Cancer, 2007,97(8):1028-1034. doi: 10.1038/sj.bjc.6603990.
doi: 10.1038/sj.bjc.6603990
[34] Motoori M, Yano M, Miyata H, et al. Randomized study of the effect of synbiotics during neoadjuvant chemotherapy on adverse events in esophageal cancer patients[J]. Clin Nutr, 2017,36(1):93-99. doi: 10.1016/j.clnu.2015.11.008.
doi: 10.1016/j.clnu.2015.11.008
[35] Wardill HR, Van Sebille YZA, Ciorba MA, et al. Prophylactic probiotics for cancer therapy-induced diarrhoea: a meta-analysis[J]. Curr Opin Support Palliat Care, 2018,12(2):187-197. doi: 10.1097/SPC.0000000000000338.
doi: 10.1097/SPC.0000000000000338 pmid: 29547491
[36] Ladas EJ, Bhatia M, Chen L, et al. The safety and feasibility of probiotics in children and adolescents undergoing hematopoietic cell transplantation[J]. Bone Marrow Transplant, 2016,51(2):262-266. doi: 10.1038/bmt.2015.275.
doi: 10.1038/bmt.2015.275
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