title: Amelioration of radiation-induced acute inflammation and mucosal atrophy by beta-hydroxy-beta-methylbutyrate, L-glutamıne, and L-argınıne: results of an experimental study.
abstract: OBJECTIVE
  We aimed to evaluate the effects of β-hydroxy-β-methylbutyrate, L-glutamine, and L-arginine (HMB/Glu/Arg) on radiation-induced acute inflammation and mucosal atrophy in the oral mucosa.
  
  
  METHODS
  Twenty-eight rats were divided into four groups. group (G) 1 was defined as control group, and G2 was the radiation therapy (RT) group. G3 and G4 were HMB/Glu/Arg control and 17 Gy RT plus HMB/Glu/Arg groups, respectively. A single dose of 17 Gy RT was given to the head and neck area, and the active supplement consisting of 5.2 g of HMB, 29.6 g arginine, and 29.6 g of glutamine which was equivalent to 60 kg adult dose was calculated for each rat and administrated orally. HMB/Glu/Arg started from the day of RT and continued until the animals were sacrificed 7 days after the RT. The extent of acute inflammation and mucosal atrophy for each rat was quantified with image analysis of histological sections of the oral mucosa.
  
  
  RESULTS
  There were significant differences in terms of epithelial thickness, subepithelial edema, inflammation, and congestion between all groups (p values were <0.001, 0.003, <0.001, and 0.001 for each parameter, respectively). Using HMB/Glu/Arg alone led to hypertrophic changes in the epithelial layer. Moreover, when used with RT, HMB/Glu/Arg reversed radiation-induced epithelial atrophy (p, 0.006) and decreased radiation-induced inflammation at a significant level (p, 0.007).
  
  
  CONCLUSIONS
  Concomitant use of HMB/Glu/Arg appears to ameliorate the radiation-induced acute inflammation and mucosal atrophy which represent the early phase of acute oral mucositis; however, this finding should be clarified with further clinical studies.
authors.affiliation: Department of Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey.
authors.forename: Cagdas
authors.initials: C
authors.lastname: Yavas
authors.forename: Guler
authors.initials: G
authors.lastname: Yavas
authors.forename: Hilal
authors.initials: H
authors.lastname: Acar
authors.forename: Hatice
authors.initials: H
authors.lastname: Toy
authors.forename: Deniz
authors.initials: D
authors.lastname: Yuce
authors.forename: Serap
authors.initials: S
authors.lastname: Akyurek
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ata
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000818:Animals; D001120:Arginine / Q000008:administration & dosage / Q000494:pharmacology*; D001284:Atrophy; D004338:Drug Combinations; D005260:Female; D005973:Glutamine / Q000008:administration & dosage / Q000494:pharmacology*; D007249:Inflammation / Q000188:drug therapy* / Q000209:etiology; D009061:Mouth Mucosa / Q000187:drug effects / Q000473:pathology; D011833:Radiation Injuries, Experimental / Q000188:drug therapy* / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar; D014631:Valerates / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D004338:Drug Combinations; D014631:Valerates; D005973:Glutamine; C004961:beta-hydroxyisovaleric acid; D001120:Arginine