Abstract
Purpose
Intestinal mucositis is an important adverse effect of antineoplastic therapy, which remains without adequate treatment. The present study aimed to carry out a complete evaluation of the histopathological changes during irinotecan-induced intestinal mucositis, using the protocol most found in the pharmacological reports nowadays to better understand irinotecan toxicity and support future studies on drug discovery.
Methods
Intestinal mucositis was induced by treating swiss mice for 4 days with irinotecan (75 mg/kg, i.p.). After 72 h post irinotecan, the mice were sacrificed and the small intestine and colon were excised to performed histological analysis by stained tissue with hematoxylin/eosin (H&E).
Results
Histoarchitecture loss, villus/crypt ratio reduction, atrophy of the muscular layer, hypertrophy in the submucosal and mucous layers, ruptures in the epithelium, as well as extent cellular infiltrate and presence of micro abscesses and the fusion of the crypts were observed in the histological analysis. Moreover, duodenum and colon had increased intraepithelial lymphocytes and mitotic figures. However, submucosal ganglia were decreased in the duodenum and increased in the colon.
Conclusions
The data obtained in the present study provides new evidence that irinotecan-induced intestinal mucositis highly affects small intestine and colon, further contributing to establish criteria in light of the histopathological changes induced by irinotecan during intestinal mucositis and facilitating inter-study comparisons.
Similar content being viewed by others
Code availability
Not applicable.
References
Sangild PT, Shen RL, Pontoppidan P, Rathe M (2018) Animal models of chemotherapy-induced mucositis: translational relevance and challenges. Am J Physiol Liver Physiol 314:G231–G246. https://doi.org/10.1152/ajpgi.00204.2017
Rothenberg ML (1997) Topoisomerase I inhibitors: review and update. Ann Oncol Off J Eur Soc Med Oncol 8:837–855
Fujita KI, Kubota Y, Ishida H, Sasaki Y (2015) Irinotecan, a key chemotherapeutic drug for metastatic colorectal cancer. World J Gastroenterol 21:12234–12248. https://doi.org/10.3748/wjg.v21.i43.12234
Bajic JE, Johnston IN, Howarth GS, Hutchinson MR (2018) From the bottom-up: chemotherapy and gut-brain axis dysregulation. Front BehavNeurosci 12:104. https://doi.org/10.3389/fnbeh.2018.00104
Potten CS, Wilson JW, Booth C (1997) Regulation and significance of apoptosis in the stem cells of the gastrointestinal epithelium. Stem Cells 15:82–93. https://doi.org/10.1002/stem.150082
Vanhoecke B, Bateman E, Mayo B et al (2015) Dark Agouti rat model of chemotherapy-induced mucositis: establishment and current state of the art. Exp Biol Med 240:725–741. https://doi.org/10.1177/1535370215581309
Wardill HR, Gibson RJ, Van Sebille YZA et al (2016) Irinotecan-induced gastrointestinal dysfunction and pain are mediated by common TLR4-dependent mechanisms. Mol Cancer Ther 15:1376–1386. https://doi.org/10.1158/1535-7163.MCT-15-0990
Andreyev J, Ross P, Donnellan C et al (2014) Guidance on the management of diarrhoea during cancer chemotherapy. Lancet Oncol 15:e447–e460. https://doi.org/10.1016/S1470-2045(14)70006-3
Boeing T, de Souza P, Speca S et al (2020) Luteolin prevents irinotecan-induced intestinal mucositis in mice through antioxidant and anti-inflammatory properties. Br J Pharmacol 177:2393–2408. https://doi.org/10.1111/bph.14987
Alvarenga EM, Sousa NA, de Araújo S et al (2017) Carvacryl acetate, a novel semisynthetic monoterpene ester, binds to the TRPA1 receptor and is effective in attenuating irinotecan-induced intestinal mucositis in mice. J Pharm Pharmacol 69:1773–1785. https://doi.org/10.1111/jphp.12818
Cechinel-Zanchett CC, Boeing T, Somensi LB et al (2019) Flavonoid-rich fraction of Bauhinia forficata Link leaves prevents the intestinal toxic effects of irinotecan chemotherapy in IEC-6 cells and in mice. Phyther Res 33:90–106. https://doi.org/10.1002/ptr.6202
Arifa RDN, De PTP, Madeira MFM et al (2016) The reduction of oxidative stress by nanocomposite Fullerol decreases mucositis severity and reverts leukopenia induced by Irinotecan. Pharmacol Res 107:102–110. https://doi.org/10.1016/j.phrs.2016.03.004
Guo S, Gillingham T, Guo Y et al (2016) Secretions of bifiodobacteriuminfantis and lactobacillus acidophilus protect intestinal epithelial barrier function. J PediatGastroenterolNutr 64(3):404–412
Gibson RJ, Bowen JM, Inglis MRB et al (2003) Irinotecan causes severe small intestinal damage, as well as colonic damage, in the rat with implanted breast cancer. J Gastroenterol Hepatol 18:1095–1100. https://doi.org/10.1046/j.1440-1746.2003.03136.x
Logan RM, Gibson RJ, Bowen JM et al (2008) Characterisation of mucosal changes in the alimentary tract following administration of irinotecan: implications for the pathobiology of mucositis. Cancer Chemother Pharmacol 62:33–41. https://doi.org/10.1007/s00280-007-0570-0
Ikuno N, Soda H, Watanabe M, Oka M (1995) Irinotecan (CPT-11) and characteristic mucosal changes in the mouse Ileum and Cecum. JNCI 87:1876–1883
Taha AS, Dahill S, Nakshabendi I et al (1993) Duodenal histology, ulceration, and Helicobacter pylori in the presence or absence of non-steroidal anti-inflammatory drugs. Gut 34:1162–1166. https://doi.org/10.1136/gut.34.9.1162
Erben U, Loddenkemper C, Doerfel K et al (2014) A guide to histomorphological evaluation of intestinal inflammation in mouse models. Int J Clin Exp Pathol 7:4557–4576
Cherny NI (2008) Evaluation and management of treatment-related Diarrhea in patients with advanced cancer: a review. J Pain Symptom Manage 36:413–423. https://doi.org/10.1016/J.JPAINSYMMAN.2007.10.007
Cheroutre H, Lambolez F, Mucida D (2011) The light and dark sides of intestinal intraepithelial lymphocytes. Nat Rev Immunol 11:445–456
Hoytema van Konijnenburg DP, Reis BS, Pedicord VA et al (2017) Intestinal epithelial and intraepithelial T cell crosstalk mediates a dynamic response to infection. Cell 171:783-794.e13. https://doi.org/10.1016/j.cell.2017.08.046
Fang ZZ, Zhang D, Cao YF et al (2016) Irinotecan (CPT-11)-induced elevation of bile acids potentiates suppression of IL-10 expression. Toxicol Appl Pharmacol 291:21–27. https://doi.org/10.1016/j.taap.2015.12.003
Fernandes C, Wanderley CWS, Silva CMS et al (2018) Role of regulatory T cells in irinotecan-induced intestinal mucositis. Eur J Pharm Sci 115:158–166. https://doi.org/10.1016/j.ejps.2018.01.006
Stringer AM, Gibson RJ, Bowen JM et al (2009) Irinotecan-induced mucositis manifesting as diarrhoea corresponds with an amended intestinal flora and mucin profile. Int J Exp Pathol 90:489–499. https://doi.org/10.1111/j.1365-2613.2009.00671.x
Sonis ST (2004) The pathobiology of mucositis. J NeuropatholExpNeurol 4:277–284. https://doi.org/10.1038/nrc1318
Goyal R, Guo Y, Mashimo H (2019) Advances in the physiology of gastric emptying. Neurogastroenterol Motil 31:e13546
Thorpe D, Butler R, Sultani M et al (2019) Irinotecan-Induced mucositis is associated with goblet cell dysregulation and neural cell damage in a tumour bearing da rat model. PatholOncol Res. https://doi.org/10.1007/s12253-019-00644-x
Acknowledgements
We are grateful to the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES—Finance Code 001) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) for financial support, and to the University of Vale do Itajaí (UNIVALI) and State University of Maringá, where the study was carried out.
Funding
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES—Finance Code 001) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Dr. Thaise Boeing received a Postdoctoral scholarship from CNPQ.
Author information
Authors and Affiliations
Contributions
TB, PS, and LBS performed the experimental work; MB and DMGSA performed the histological analysis; TB wrote the manuscript; LMS designed the study. All authors contributed to manuscript revision, read and approved the submitted version.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare.
Ethical approval
License number (021/16p).
Consent to participate
Not applicable.
Consent for publication
All authors approved the submitted version of the manuscript and agree to publication of the material.
Availability of data and material
Data is not publicly available, but can be provided on request.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Boeing, T., Gois, M.B., de Souza, P. et al. Irinotecan-induced intestinal mucositis in mice: a histopathological study. Cancer Chemother Pharmacol 87, 327–336 (2021). https://doi.org/10.1007/s00280-020-04186-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00280-020-04186-x