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The pathogenesis of mucositis: updated perspectives and emerging targets

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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.

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Acknowledgements

We would like to acknowledge the expert assistance of our research librarians during the development of the database search terms and paper retrieval; Lorraine Porcello (Bibby Dental Library, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA) and Daniel A. Castillo (Edward G. Miner Library, University of Rochester Medical Center, Rochester, NY, USA). Additionally, we would like to thank Vinisha Ranna, DDS, and Anusha Vaddi, BDS, for their assistance with retrieving the papers.

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Authors and Affiliations

  1. Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia

    J. Bowen, N. Al-Dasooqi, H. Wardill & E. Bateman

  2. Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy

    P. Bossi

  3. Division of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia

    Y. Van Sebille, B. Mayo, A. Stringer & D. Thorpe

  4. Dental and OMFS Department, Oral Pathology and Medicine, Al-Nahdha Hospital, Ministry of Health, Muscat, Oman

    A. Al-Azri

  5. Hematology and Blood Transfusion Center, University of Campinas, Campinas, Brazil

    M. E. Correa

  6. Department of Oral and Maxillofacial Surgery, Amsterdam UMC, and Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands

    J. Raber-Durlacher

  7. Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayn University, Dehradun, Uttarakhand, India

    A. Kandwal

  8. Oral Medicine, Oral Oncology, Oral Pathology and Human Diseases, Griffith University, Hematology and Oncology, Gold Coast University Hospital, Southport, Queensland, Australia

    R. G. Nair

  9. Oral medicine, Academic Centre Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, Netherlands

    K. ten Bohmer

  10. Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA

    R. V. Lalla

  11. Harvard School of Dental Medicine, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA

    S. Sonis

  12. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    K. Cheng

  13. Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA

    S. Elad

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  1. J. Bowen
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  2. N. Al-Dasooqi
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  3. P. Bossi
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  17. S. Sonis
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  19. S. Elad
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Consortia

On behalf of The Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)

Corresponding author

Correspondence to J. Bowen.

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Conflict of interest

Authors that report no conflict of interest: JB, NA, HW, YVS, AA, JRD, EB, MEC, JRD, AK, BM, RN, AS, KTB, DT, KC, SE.

PB has served an advisory role for AstraZeneca, Helsinn, and Kyowa Kyrin and received grants from Merck, Kyowa Kyrin, and Roche. RVL has served as a consultant for Colgate Oral Pharmaceuticals, Galera Therapeutics, Ingalfarma SA, Monopar Therapeutics, Mundipharma, and Sucampo Pharma; has received research support to his institution from Galera Therapeutics, Novartis, Oragenics, and Sucampo Pharma, and has received stock in Logic Biosciences. SS is an employee at Biomodels LLC and a partner at Primary Endpoint Solutions.

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Bowen, J., Al-Dasooqi, N., Bossi, P. et al. The pathogenesis of mucositis: updated perspectives and emerging targets. Support Care Cancer 27, 4023–4033 (2019). https://doi.org/10.1007/s00520-019-04893-z

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