Implications of treatment-induced mucosal barrier injury.
OBJECTIVE
This review highlights recent developments in the pathophysiology of treatment-induced mucosal barrier injury, outlines the application of new diagnostic tools, focuses on risk factors and complications, and offers an up-to-date overview on treatment options.


RESULTS
Treatment-induced mucosal damage is now thought to occur in five phases: initiation, up-regulation and message generation, amplification and signaling, ulceration, and healing. It is now possible to assess gut mucosal damage both by sugar permeability tests and serum citrulline. Amifostine reduces the oral mucositis of stem cell transplantation recipients after radiotherapy and high-dose chemotherapy. Palifermin (recombinant human keratinocyte growth factor 1), a trophic growth factor, has been shown to reduce significantly both the incidence and duration of severe mucositis after myeloablative therapy and may have the potential to reduce gut mucosal damage.


CONCLUSIONS
Treatment-induced mucosal barrier injury is a complex, dynamic pathobiological process manifested not only in the oral cavity but throughout the entire digestive tract, diminishing the quality of life and predisposing the patient to serious clinical complications. Therefore, it is important to detect mucosal damage induced by cytotoxic therapy adequately to be able to test the efficacy of new therapeutic options for preventing or ameliorating this complication.
Blijlevens
Nicole M A
NM
Department of Haematology, University Medical Centre St Radboud, Nijmegen, The Netherlands. N.Blijlevens@hemat.umcn.nl
D000970:Antineoplastic Agents / Q000009:adverse effects*; D006801:Humans; D052016:Mucositis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009092:Mucous Membrane / Q000473:pathology*; D009369:Neoplasms / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors
D000970:Antineoplastic Agents