Effect of low-level laser therapy on inflammatory mediator release during chemotherapy-induced oral mucositis: a randomized preliminary study
Effect of low-level laser therapy on inflammatory mediator release during chemotherapy-induced oral mucositis: a randomized preliminary study
复制标题
DOI：
10.1007/s10103-014-1624-2
复制
发表时间：
2015-01-01
影响因子：
2.1
通讯作者：
Batista, Aline Carvalho
中科院分区：
文献类型：
--
作者：
Lauria Silva, Geisa Badauy;Sacono, Nancy Tomoko;Batista, Aline Carvalho
接受造血干细胞移植（HSCT）的患者接受高剂量化疗的调理方案，有或没有放射治疗，这通常会导致口腔溃疡和粘膜屏障破坏。口腔粘膜炎 (OM) 是自体和同种异体 HSCT 的常见且使人衰弱的毒副作用。本研究的目的是评估低强度激光治疗（LLLT）对 HSCT 患者唾液和血液中 OM 严重程度和炎症介质（TNF-α、IL-6、IL-1β、IL-10、TGF-β、金属蛋白酶和生长因子）水平的影响。 30 名患者被随机分配到两组：对照组（n = 15）和激光组（n = 15）。从预处理方案的第一天到 HSCT 后第 7 天（D + 7）应用 LLLT。在入院 (AD)、D-1、D+3、D+7 和骨髓移植日 (ME) 时收集患者的唾液和血液。临床结果显示激光组 OM 较轻 (p < 0.05)。 LLLT 组在 D + 7 时唾液中基质金属蛋白酶 2 (MMP-2) 水平升高 (p = 0.04)。与对照组相比，D+7 时和 ME 时血浆中的 IL-10 也存在显着差异 (p < 0.05)。对于所研究的其他炎症介质，在唾液或血液中没有发现显着差异。 LLLT 在临床上可有效降低 HSCT 患者化疗引起的 OM 的严重程度，其作用机制似乎与促炎或抗炎细胞因子、生长因子或基质金属蛋白酶的调节并不完全相关。
Patients undergoing hematopoietic stem cell transplantation (HSCT) are submitted to a conditioning regimen of high-dose chemotherapy, with or without radiation therapy, which usually results in oral ulcerations and mucosal barrier breakdown. Oral mucositis (OM) is a common and debilitating toxicity side effect of autologous and allogeneic HSCT. The aim of this study was to evaluate the effect of low-level laser therapy (LLLT) on the severity of OM and inflammatory mediator (TNF-alpha, IL-6, IL-1 beta, IL-10, TGF-beta, metalloproteinases, and growth factors) levels in saliva and blood of HSCT patients. Thirty patients were randomly assigned to two groups: control (n = 15) and laser (n = 15). LLLT was applied from the first day of the conditioning regimen until day 7 post-HSCT (D + 7). Saliva and blood were collected from patients on admission (AD), D-1, D + 3, D + 7, and on marrow engraftment day (ME). Clinical results showed less severe OM in the laser group (p < 0.05). The LLLT group showed increased matrix metalloproteinase 2 (MMP-2) levels in saliva on D + 7 (p = 0.04). Significant differences were also observed for IL-10 on D + 7 and on ME in blood plasma, when compared to the control group (p < 0.05). No significant differences were seen in saliva or blood for the other inflammatory mediators investigated. LLLT was clinically effective in reducing the severity of chemotherapy-induced OM in HSCT patients, and its mechanism of action does not seem to be completely linked to the modulation of pro- or anti-inflammatory cytokines, growth factors or matrix metalloproteinases.