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Updated Perspectives on the Contribution of the Microbiome to the Pathogenesis of Mucositis Using the Mascc/Isoo Framework Publisher Pubmed



Stringer AM1 ; Hargreaves BM1 ; Mendes RA2, 3 ; Blijlevens NMA4 ; Bruno JS5 ; Joyce P6 ; Kamath S6 ; Laheij AMGA7, 8 ; Ottaviani G9 ; Secombe KR10 ; Tonkaboni A11 ; Zadik Y12, 13 ; Bossi P14, 15 ; Wardill HR10, 16
Authors
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Authors Affiliations
  1. 1. Clinical and Health Sciences, University of South Australia, Adelaide, 5000, Australia
  2. 2. Faculty of Medicine, University of Porto/CINTESIS@RISE, Porto, Portugal
  3. 3. Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, Case Western Reserve University, Cleveland, 44106-7401, OH, United States
  4. 4. Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
  5. 5. Molecular Oncology Center, Hospital Sirio-Libanes, Sao Paulo, Brazil
  6. 6. Centre for Pharmaceutical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, 5000, Australia
  7. 7. Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
  8. 8. Department of Oral and Maxillofacial Surgery, UMC, University of Amsterdam, Amsterdam, Netherlands
  9. 9. Department of Surgical, Medical and Health Sciences, University of Trieste, Trieste, Italy
  10. 10. The School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, 5005, Australia
  11. 11. Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  12. 12. Department of Military Medicine and “Tzameret”, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
  13. 13. Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
  14. 14. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, 20072, Italy
  15. 15. IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, 20089, Italy
  16. 16. Supportive Oncology Research Group, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute, Level 5S, Adelaide, 5000, Australia

Source: Supportive Care in Cancer Published:2024


Abstract

Advances in the treatment of cancer have significantly improved mortality rates; however, this has come at a cost, with many treatments still limited by their toxic side effects. Mucositis in both the mouth and gastrointestinal tract is common following many anti-cancer agents, manifesting as ulcerative lesions and associated symptoms throughout the alimentary tract. The pathogenesis of mucositis was first defined in 2004 by Sonis, and almost 20 years on, the model continues to be updated reflecting ongoing research initiatives and more sophisticated analytical techniques. The most recent update, published by the Multinational Association for Supportive Care in Cancer and the International Society for Oral Oncology (MASCC/ISOO), highlights the numerous co-occurring events that underpin mucositis development. Most notably, a role for the ecosystem of microorganisms that reside throughout the alimentary tract (the oral and gut microbiota) was explored, building on initial concepts proposed by Sonis. However, many questions remain regarding the true causal contribution of the microbiota and associated metabolome. This review aims to provide an overview of this rapidly evolving area, synthesizing current evidence on the microbiota’s contribution to mucositis development and progression, highlighting (i) components of the 5-phase model where the microbiome may be involved, (ii) methodological challenges that have hindered advances in this area, and (iii) opportunities for intervention. © The Author(s) 2024.
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