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Место и роль микрофлоры полости рта в патогенезе орального мукозита при злокачественных новообразованиях (обзор литературы)
Место и роль микрофлоры полости рта в патогенезе орального мукозита при злокачественных новообразованиях (обзор литературы)
Завьялов А. А., Тырышкин А. И., Олесова В. Н., Пащенко Н. А., Гуркова М. М. Место и роль микрофлоры полости рта в патогенезе орального мукозита при злокачественных новообразованиях (обзор литературы). Современная Онкология. 2023;25(4):525–530. DOI: 10.26442/18151434.2023.4.202544
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
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Аннотация
Обоснование. Оральный мукозит (ОМ) является одним из наиболее частых осложнений системной лекарственной терапии онкологических заболеваний. Клинически заболевание проявляется в виде эритемы и изъязвления неороговевающей слизистой оболочки. Хотя это состояние является самоизлечивающимся, оно может повлиять на проведение комплексного противоопухолевого лечения. В настоящее время патофизиологическая модель развития ОМ дополняется новыми данными, полученными в ходе исследований микрофлоры полости рта. Противоопухолевое лечение может приводить к изменениям в составе резидентной оральной микрофлоры, и вполне возможно, что происходящие изменения влияют на развитие повреждений слизистой оболочки полости рта. Расширение знаний в данной сфере позволяет исследователям искать новые способы включения оральной микробиоты в стратегии менеджмента ОМ.
Цель. Обобщить и актуализировать накопленные данные относительно роли микробиоты полости рта в патогенезе ОМ у пациентов со злокачественными новообразованиями.
Материалы и методы. Поиск литературы производился в системах Medline, Cochrane Library, Elibrary и Pubmed, включались публикации, демонстрирующие современные возможности оценки влияния орального микробиома на развитие ОМ, а также разработки в данной сфере, касающиеся менеджмента ОМ.
Результаты. В обзоре освещены современные представления о положении орального микробиома в патогенезе ОМ, акцентируется внимание на перспективных направлениях использования средств, влияющих на состояние микробиоты полости рта, в различных стратегиях контроля данного заболевания.
Заключение. Более глубокое понимание патогенеза ОМ с учетом новых факторов, таких как оральный микробиом, вероятно, позволит в будущем сформировать более эффективные стратегии менеджмента этого заболевания. Данное направление представляется весьма перспективным, а разработки в этой области демонстрируют многообещающие результаты.
Ключевые слова: патогенез, оральный мукозит, злокачественные новообразования, микробиота полости рта, пробиотики
Aim. To summarize and update the accumulated data regarding the role of the oral microbiota in the pathogenesis of OM in patients with malignant neoplasms.
Materials and methods. Literature search was performed in Medline, Cochrane Library, Elibrary and Pubmed, including publications demonstrating the current ability to assess the impact of the oral microbiome on OM, as well as developments in this area relating to OM management.
Results. In the review the current views on the position of the oral microbiome in the pathogenesis of OM were highlighted and the promising directions for the use of agents influencing the state of the oral microbiota in various strategies to control this disease were emphasised.
Conclusion. A better understanding of the pathogenesis of OM and the inclusion of new factors, such as the oral microbiome, into the picture of pathogenesis is likely to enable the formation of more effective management strategies for this disease in the future. This direction seems very promising, and developments in this area show promising results.
Keywords: pathogenesis, oral mucositis, malignant tumors, oral microbiota, probiotics
Цель. Обобщить и актуализировать накопленные данные относительно роли микробиоты полости рта в патогенезе ОМ у пациентов со злокачественными новообразованиями.
Материалы и методы. Поиск литературы производился в системах Medline, Cochrane Library, Elibrary и Pubmed, включались публикации, демонстрирующие современные возможности оценки влияния орального микробиома на развитие ОМ, а также разработки в данной сфере, касающиеся менеджмента ОМ.
Результаты. В обзоре освещены современные представления о положении орального микробиома в патогенезе ОМ, акцентируется внимание на перспективных направлениях использования средств, влияющих на состояние микробиоты полости рта, в различных стратегиях контроля данного заболевания.
Заключение. Более глубокое понимание патогенеза ОМ с учетом новых факторов, таких как оральный микробиом, вероятно, позволит в будущем сформировать более эффективные стратегии менеджмента этого заболевания. Данное направление представляется весьма перспективным, а разработки в этой области демонстрируют многообещающие результаты.
Ключевые слова: патогенез, оральный мукозит, злокачественные новообразования, микробиота полости рта, пробиотики
________________________________________________
Aim. To summarize and update the accumulated data regarding the role of the oral microbiota in the pathogenesis of OM in patients with malignant neoplasms.
Materials and methods. Literature search was performed in Medline, Cochrane Library, Elibrary and Pubmed, including publications demonstrating the current ability to assess the impact of the oral microbiome on OM, as well as developments in this area relating to OM management.
Results. In the review the current views on the position of the oral microbiome in the pathogenesis of OM were highlighted and the promising directions for the use of agents influencing the state of the oral microbiota in various strategies to control this disease were emphasised.
Conclusion. A better understanding of the pathogenesis of OM and the inclusion of new factors, such as the oral microbiome, into the picture of pathogenesis is likely to enable the formation of more effective management strategies for this disease in the future. This direction seems very promising, and developments in this area show promising results.
Keywords: pathogenesis, oral mucositis, malignant tumors, oral microbiota, probiotics
Полный текст
Список литературы
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18. Sonis ST. The Chicken or the Egg? Changes in Oral Microbiota as Cause or Consequence of Mucositis During Radiation Therapy. EBioMedicine. 2017;18:7‑8. DOI:10.1016/j.ebiom.2017.03.017
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24. Panebianco C, Latiano T, Pazienza V. Microbiota Manipulation by Probiotics Administration as Emerging Tool in Cancer Prevention and Therapy. Front Oncol. 2020;10:679. DOI:10.3389/fonc.2020.00679
25. Perales-Puchalt A, Perez-Sanz J, Payne KK, et al. Frontline Science: Microbiota reconstitution restores intestinal integrity after cisplatin therapy. J Leukoc Biol. 2018;103(5):799‑805. DOI:10.1002/JLB.5HI1117‑446RR
26. 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. Clin Exp Pharmacol Physiol. 2017;44(10):1017‑25. DOI:10.1111/1440‑1681.12792
27. Suez J, Zmora N, Zilberman-Schapira G, et al. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell. 2018;174(6):1406‑23.e16. DOI:10.1016/j.cell.2018.08.047
28. Cosseau C, Devine DA, Dullaghan E, et al. The commensal Streptococcus salivarius K12 downregulates the innate immune responses of human epithelial cells and promotes host-microbe homeostasis. Infect Immun. 2008;76(9):4163‑75. DOI:10.1128/IAI.00188‑08
29. Wescombe PA, Hale JD, Heng NC, Tagg JR. Developing oral probiotics from Streptococcus salivarius. Future Microbiol. 2012;7(12):1355‑71. DOI:10.2217/fmb.12.113
30. Burton JP, Chilcott CN, Moore CJ, et al. A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters. J Appl Microbiol. 2006;100(4):754‑64. DOI:10.1111/j.1365‑2672.2006.02837.x
31. Wang Y, Li J, Zhang H, et al. Probiotic Streptococcus salivarius K12 Alleviates Radiation-Induced Oral Mucositis in Mice. Front Immunol. 2021;12:684824. DOI:10.3389/fimmu.2021.684824
32. Barr JJ, Auro R, Furlan M, et al. Bacteriophage adhering to mucus provide a non-host-derived immunity. Proc Natl Acad Sci U S A. 2013;110(26):10771‑6. DOI:10.1073/pnas.1305923110
2. Murphy BA, Beaumont JL, Isitt J, et al. Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy. J Pain Symptom Manage. 2009;38(4):522‑32. DOI:10.1016/j.jpainsymman.2008.12.004
3. Peterson DE, Srivastava R, Lalla RV. Oral mucosal injury in oncology patients: perspectives on maturation of a field. Oral Dis. 2015;21(2):133‑41. DOI:10.1111/odi.12167
4. Hong BY, Sobue T, Choquette L, et al. Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis. Microbiome. 2019;7(1):66. DOI:10.1186/s40168‑019‑0679‑5
5. Sonis ST. New thoughts on the initiation of mucositis. Oral Dis. 2010;16(7): 597‑600.
6. Rice DH, Gill G. The effect of irradiation upon the bacterial flora in patients with head and neck cancer. Laryngoscope. 1979;89(11):1839‑41. DOI:10.1288/00005537‑197911000‑00018
7. Vanhoecke B, De Ryck T, Stringer A, et al. Microbiota and their role in the pathogenesis of oral mucositis. Oral Dis. 2015;21(1):17‑30. DOI:10.1111/odi.12224
8. Groeger S, Meyle J. Oral Mucosal Epithelial Cells. Front Immunol. 2019;10:208. DOI:10.3389/fimmu.2019.00208
9. Li Y, Deng SL, Lian ZX, Yu K. Roles of Toll-Like Receptors in Nitroxidative Stress in Mammals Cells. 2019;8(6):576. DOI:10.3390/cells8060576
10. Rauta PR, Samanta M, Dash HR, et al. Toll-like receptors (TLRs) in aquatic animals: signaling pathways, expressions and immune responses. Immunol Lett. 2014;158(1‑2):14‑24. DOI:10.1016/j.imlet.2013.11.013
11. McClure R, Massari P. TLR-Dependent Human Mucosal Epithelial Cell Responses to Microbial Pathogens. Front Immunol. 2014;5. DOI:10.3389/fimmu.2014.00386
12. Ji L, Hao S, Wang J, et al. Roles of Toll-Like Receptors in Radiotherapy- and Chemotherapy-Induced Oral Mucositis: A Concise Review. Front Cell Infect Microbiol. 2022;12:831387. DOI:10.3389/fcimb.2022.831387
13. Nguyen S, Baker K, Padman BS, et al. Bacteriophage Transcytosis Provides a Mechanism To Cross Epithelial Cell Layers. mBio. 2017;8(6):e01874‑17. DOI:10.1128/mBio.01874‑17
14. Vasconcelos RM, Sanfilippo N, Paster BJ, et al. Host-Microbiome Cross-talk in Oral Mucositis. J Dent Res. 2016;95(7):725‑33. DOI:10.1177/0022034516641890
15. Saunders DP, Epstein JB, Elad S, et al; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(11):3191‑207. DOI:10.1007/s00520‑013‑1871‑y
16. Laheij AM, van Loveren C, Deng D, de Soet JJ. The impact of virulence factors of Porphyromonas gingivalis on wound healing in vitro. J Oral Microbiol. 2015;7:27543.
17. Laheij AM, de Soet JJ, von dem Borne PA, et al. Oral bacteria and yeasts in relationship to oral ulcerations in hematopoietic stem cell transplant recipients. Support Care Cancer. 2012;20(12):3231‑40. DOI:10.1007/s00520‑012‑1463‑2
18. Sonis ST. The Chicken or the Egg? Changes in Oral Microbiota as Cause or Consequence of Mucositis During Radiation Therapy. EBioMedicine. 2017;18:7‑8. DOI:10.1016/j.ebiom.2017.03.017
19. Zhu XX, Yang XJ, Chao YL, et al. The Potential Effect of Oral Microbiota in the Prediction of Mucositis During Radiotherapy for Nasopharyngeal Carcinoma. EBioMedicine. 2017;18:23‑31. DOI:10.1016/j.ebiom.2017.02.002
20. De Ryck T, Vanlancker E, Grootaert C, et al. Microbial inhibition of oral epithelial wound recovery: potential role for quorum sensing molecules? AMB Express. 2015;5:27. DOI:10.1186/s13568‑015‑0116‑5
21. Hong CHL, Gueiros LA, Fulton JS, et al. Systematic Review of Basic Oral Care for the Management of Oral Mucositis in Cancer Patients and Clinical Practice Guidelines. Support Care Cancer. 2019;27(10):3949‑67. DOI:10.1007/s00520‑019‑04848‑4
22. Cinausero M, Aprile G, Ermacora P, et al. New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury. Front Pharmacol. 2017;8:354. DOI:10.3389/fphar.2017.00354
23. Clarkson JE. Interventions for treating oral mucositis for patients with cancer receiving treatment. The Cochrane Collaboration, 2010.
24. Panebianco C, Latiano T, Pazienza V. Microbiota Manipulation by Probiotics Administration as Emerging Tool in Cancer Prevention and Therapy. Front Oncol. 2020;10:679. DOI:10.3389/fonc.2020.00679
25. Perales-Puchalt A, Perez-Sanz J, Payne KK, et al. Frontline Science: Microbiota reconstitution restores intestinal integrity after cisplatin therapy. J Leukoc Biol. 2018;103(5):799‑805. DOI:10.1002/JLB.5HI1117‑446RR
26. 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. Clin Exp Pharmacol Physiol. 2017;44(10):1017‑25. DOI:10.1111/1440‑1681.12792
27. Suez J, Zmora N, Zilberman-Schapira G, et al. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell. 2018;174(6):1406‑23.e16. DOI:10.1016/j.cell.2018.08.047
28. Cosseau C, Devine DA, Dullaghan E, et al. The commensal Streptococcus salivarius K12 downregulates the innate immune responses of human epithelial cells and promotes host-microbe homeostasis. Infect Immun. 2008;76(9):4163‑75. DOI:10.1128/IAI.00188‑08
29. Wescombe PA, Hale JD, Heng NC, Tagg JR. Developing oral probiotics from Streptococcus salivarius. Future Microbiol. 2012;7(12):1355‑71. DOI:10.2217/fmb.12.113
30. Burton JP, Chilcott CN, Moore CJ, et al. A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters. J Appl Microbiol. 2006;100(4):754‑64. DOI:10.1111/j.1365‑2672.2006.02837.x
31. Wang Y, Li J, Zhang H, et al. Probiotic Streptococcus salivarius K12 Alleviates Radiation-Induced Oral Mucositis in Mice. Front Immunol. 2021;12:684824. DOI:10.3389/fimmu.2021.684824
32. Barr JJ, Auro R, Furlan M, et al. Bacteriophage adhering to mucus provide a non-host-derived immunity. Proc Natl Acad Sci U S A. 2013;110(26):10771‑6. DOI:10.1073/pnas.1305923110
2. Murphy BA, Beaumont JL, Isitt J, et al. Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy. J Pain Symptom Manage. 2009;38(4):522‑32. DOI:10.1016/j.jpainsymman.2008.12.004
3. Peterson DE, Srivastava R, Lalla RV. Oral mucosal injury in oncology patients: perspectives on maturation of a field. Oral Dis. 2015;21(2):133‑41. DOI:10.1111/odi.12167
4. Hong BY, Sobue T, Choquette L, et al. Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis. Microbiome. 2019;7(1):66. DOI:10.1186/s40168‑019‑0679‑5
5. Sonis ST. New thoughts on the initiation of mucositis. Oral Dis. 2010;16(7): 597‑600.
6. Rice DH, Gill G. The effect of irradiation upon the bacterial flora in patients with head and neck cancer. Laryngoscope. 1979;89(11):1839‑41. DOI:10.1288/00005537‑197911000‑00018
7. Vanhoecke B, De Ryck T, Stringer A, et al. Microbiota and their role in the pathogenesis of oral mucositis. Oral Dis. 2015;21(1):17‑30. DOI:10.1111/odi.12224
8. Groeger S, Meyle J. Oral Mucosal Epithelial Cells. Front Immunol. 2019;10:208. DOI:10.3389/fimmu.2019.00208
9. Li Y, Deng SL, Lian ZX, Yu K. Roles of Toll-Like Receptors in Nitroxidative Stress in Mammals Cells. 2019;8(6):576. DOI:10.3390/cells8060576
10. Rauta PR, Samanta M, Dash HR, et al. Toll-like receptors (TLRs) in aquatic animals: signaling pathways, expressions and immune responses. Immunol Lett. 2014;158(1‑2):14‑24. DOI:10.1016/j.imlet.2013.11.013
11. McClure R, Massari P. TLR-Dependent Human Mucosal Epithelial Cell Responses to Microbial Pathogens. Front Immunol. 2014;5. DOI:10.3389/fimmu.2014.00386
12. Ji L, Hao S, Wang J, et al. Roles of Toll-Like Receptors in Radiotherapy- and Chemotherapy-Induced Oral Mucositis: A Concise Review. Front Cell Infect Microbiol. 2022;12:831387. DOI:10.3389/fcimb.2022.831387
13. Nguyen S, Baker K, Padman BS, et al. Bacteriophage Transcytosis Provides a Mechanism To Cross Epithelial Cell Layers. mBio. 2017;8(6):e01874‑17. DOI:10.1128/mBio.01874‑17
14. Vasconcelos RM, Sanfilippo N, Paster BJ, et al. Host-Microbiome Cross-talk in Oral Mucositis. J Dent Res. 2016;95(7):725‑33. DOI:10.1177/0022034516641890
15. Saunders DP, Epstein JB, Elad S, et al; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(11):3191‑207. DOI:10.1007/s00520‑013‑1871‑y
16. Laheij AM, van Loveren C, Deng D, de Soet JJ. The impact of virulence factors of Porphyromonas gingivalis on wound healing in vitro. J Oral Microbiol. 2015;7:27543.
17. Laheij AM, de Soet JJ, von dem Borne PA, et al. Oral bacteria and yeasts in relationship to oral ulcerations in hematopoietic stem cell transplant recipients. Support Care Cancer. 2012;20(12):3231‑40. DOI:10.1007/s00520‑012‑1463‑2
18. Sonis ST. The Chicken or the Egg? Changes in Oral Microbiota as Cause or Consequence of Mucositis During Radiation Therapy. EBioMedicine. 2017;18:7‑8. DOI:10.1016/j.ebiom.2017.03.017
19. Zhu XX, Yang XJ, Chao YL, et al. The Potential Effect of Oral Microbiota in the Prediction of Mucositis During Radiotherapy for Nasopharyngeal Carcinoma. EBioMedicine. 2017;18:23‑31. DOI:10.1016/j.ebiom.2017.02.002
20. De Ryck T, Vanlancker E, Grootaert C, et al. Microbial inhibition of oral epithelial wound recovery: potential role for quorum sensing molecules? AMB Express. 2015;5:27. DOI:10.1186/s13568‑015‑0116‑5
21. Hong CHL, Gueiros LA, Fulton JS, et al. Systematic Review of Basic Oral Care for the Management of Oral Mucositis in Cancer Patients and Clinical Practice Guidelines. Support Care Cancer. 2019;27(10):3949‑67. DOI:10.1007/s00520‑019‑04848‑4
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23. Clarkson JE. Interventions for treating oral mucositis for patients with cancer receiving treatment. The Cochrane Collaboration, 2010.
24. Panebianco C, Latiano T, Pazienza V. Microbiota Manipulation by Probiotics Administration as Emerging Tool in Cancer Prevention and Therapy. Front Oncol. 2020;10:679. DOI:10.3389/fonc.2020.00679
25. Perales-Puchalt A, Perez-Sanz J, Payne KK, et al. Frontline Science: Microbiota reconstitution restores intestinal integrity after cisplatin therapy. J Leukoc Biol. 2018;103(5):799‑805. DOI:10.1002/JLB.5HI1117‑446RR
26. 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. Clin Exp Pharmacol Physiol. 2017;44(10):1017‑25. DOI:10.1111/1440‑1681.12792
27. Suez J, Zmora N, Zilberman-Schapira G, et al. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell. 2018;174(6):1406‑23.e16. DOI:10.1016/j.cell.2018.08.047
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30. Burton JP, Chilcott CN, Moore CJ, et al. A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters. J Appl Microbiol. 2006;100(4):754‑64. DOI:10.1111/j.1365‑2672.2006.02837.x
31. Wang Y, Li J, Zhang H, et al. Probiotic Streptococcus salivarius K12 Alleviates Radiation-Induced Oral Mucositis in Mice. Front Immunol. 2021;12:684824. DOI:10.3389/fimmu.2021.684824
32. Barr JJ, Auro R, Furlan M, et al. Bacteriophage adhering to mucus provide a non-host-derived immunity. Proc Natl Acad Sci U S A. 2013;110(26):10771‑6. DOI:10.1073/pnas.1305923110
Авторы
А. А. Завьялов*1, А. И. Тырышкин1, В. Н. Олесова1, Н. А. Пащенко1, М. М. Гуркова2,3
1ФГБУ «Государственный научный центр Российской Федерации – Федеральный медицинский биофизический центр им. А. И. Бурназяна» ФМБА России, Москва, Россия;
2ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
3Научно-производственный центр «Микромир», Москва, Россия
*azav06@mail.ru
1State Research Center – Burnasyan Federal Medical Biophysical Center, Moscow, Russia;
2Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
3Research and Production Center «Micromir», Moscow, Russia
*azav06@mail.ru
1ФГБУ «Государственный научный центр Российской Федерации – Федеральный медицинский биофизический центр им. А. И. Бурназяна» ФМБА России, Москва, Россия;
2ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
3Научно-производственный центр «Микромир», Москва, Россия
*azav06@mail.ru
________________________________________________
1State Research Center – Burnasyan Federal Medical Biophysical Center, Moscow, Russia;
2Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
3Research and Production Center «Micromir», Moscow, Russia
*azav06@mail.ru
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