Apoptotic and inflammation markers in oral mucositis in head and neck cancer patients receiving radiotherapy: preliminary report.
OBJECTIVE
The aim of this study was to investigate the expression of pro-apoptotic protein p53 and anti-apoptotic proteins BCl-2 and MCl-1, as well as the expression of pro-inflammatory cytokines tumor necrosis factor (TNF) and interleukin-1beta (IL-1beta) in patients developing mucositis during radiotherapy for head and neck cancer.


METHODS
Thirty-five patients receiving radiotherapy for head/neck cancer were included in this study. Patients were examined before radiotherapy. Oral mucositis was recorded weekly during radiotherapy. Cytologic smears from the oral cavity were taken with a brush. Immunocytochemical staining was performed by the use of p53, BCl-2, MCl-1 TNF and IL-1beta monoclonal antibodies.


RESULTS
P53 was expressed in 1 of 15 smears before the initiation of radiotherapy (6.5%) compared to 3 of 7 smears from patients with grade III mucositis (43%) during radiotherapy. BCl-2 was expressed in 15 of 15 smears before radiotherapy (100%) and in three of seven patients with grade III mucositis (43%) during radiotherapy. MCl-1 was expressed in 10 of 14 samples before radiotherapy (71.5%) and in two of seven patients with grade III (28.5%) mucositis during radiotherapy. TNF was expressed in 9 of 14 patients before radiotherapy (64%) and in six of seven patients with grade III mucositis during radiotherapy (86%). IL-1beta was detected in 7 of 14 patients before radiotherapy (50%) compared to 6 of 7 patients with grade III mucositis during radiotherapy (86%).


CONCLUSIONS
Our preliminary results indicate an induction of apoptosis and inflammation in the oral mucosa in patients developing mucositis during radiotherapy for head/neck cancer.
Xanthinaki
Arsinoi
A
Dental Oncology Unit, Clinic of Hospital Dentistry, School of Dentistry, University of Athens, Athens, Greece. xanthinaki@yahoo.gr
Nicolatou-Galitis
Ourania
O
Athanassiadou
Pavlina
P
Gonidi
Maria
M
Kouloulias
Vassilis
V
Sotiropoulou-Lontou
Anastasia
A
Pissakas
George
G
Kyprianou
Konstantinos
K
Kouvaris
John
J
Patsouris
Efstratios
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006258:Head and Neck Neoplasms / Q000737:chemistry* / Q000532:radiotherapy*; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000503:physiopathology*; D053583:Interleukin-1beta / Q000032:analysis; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D064549:Myeloid Cell Leukemia Sequence 1 Protein; D010865:Pilot Projects; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D012720:Severity of Illness Index; D013280:Stomatitis / Q000209:etiology* / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D014408:Biomarkers, Tumor; D053583:Interleukin-1beta; D064549:Myeloid Cell Leukemia Sequence 1 Protein; D019253:Proto-Oncogene Proteins c-bcl-2; D014409:Tumor Necrosis Factor-alpha