title: Effect of low-level laser therapy on inflammatory mediator release during chemotherapy-induced oral mucositis: a randomized preliminary study.
abstract: Patients undergoing hematopoietic stem cell transplantation (HSCT) are submitted to a conditioning regimen of high-dose chemotherapy, with or without radiation therapy, which usually results in oral ulcerations and mucosal barrier breakdown. Oral mucositis (OM) is a common and debilitating toxicity side effect of autologous and allogeneic HSCT. The aim of this study was to evaluate the effect of low-level laser therapy (LLLT) on the severity of OM and inflammatory mediator (TNF-α, IL-6, IL-1β, IL-10, TGF-β, metalloproteinases, and growth factors) levels in saliva and blood of HSCT patients. Thirty patients were randomly assigned to two groups: control (n = 15) and laser (n = 15). LLLT was applied from the first day of the conditioning regimen until day 7 post-HSCT (D + 7). Saliva and blood were collected from patients on admission (AD), D-1, D + 3, D + 7, and on marrow engraftment day (ME). Clinical results showed less severe OM in the laser group (p < 0.05). The LLLT group showed increased matrix metalloproteinase 2 (MMP-2) levels in saliva on D + 7 (p = 0.04). Significant differences were also observed for IL-10 on D + 7 and on ME in blood plasma, when compared to the control group (p < 0.05). No significant differences were seen in saliva or blood for the other inflammatory mediators investigated. LLLT was clinically effective in reducing the severity of chemotherapy-induced OM in HSCT patients, and its mechanism of action does not seem to be completely linked to the modulation of pro- or anti-inflammatory cytokines, growth factors or matrix metalloproteinases.
authors.affiliation: Hematopoietic Stem Cell Transplant Unit, Araújo Jorge Hospital, Associação de Combate ao Câncer de Goiás, Goiânia, Goiás, Brazil.
authors.forename: Geisa Badauy Lauria
authors.initials: GB
authors.lastname: Silva
authors.forename: Nancy Tomoko
authors.initials: NT
authors.lastname: Sacono
authors.forename: Angélica Ferreira
authors.initials: AF
authors.lastname: Othon-Leite
authors.forename: Elismauro Francisco
authors.initials: EF
authors.lastname: Mendonça
authors.forename: Adriano Moraes
authors.initials: AM
authors.lastname: Arantes
authors.forename: César
authors.initials: C
authors.lastname: Bariani
authors.forename: Luciana Garcia Lobo
authors.initials: LG
authors.lastname: Duarte
authors.forename: Mauro Henrique Nogueira
authors.initials: MH
authors.lastname: Abreu
authors.forename: Celso Martins
authors.initials: CM
authors.lastname: Queiroz-Júnior
authors.forename: Tarcília Aparecida
authors.initials: TA
authors.lastname: Silva
authors.forename: Aline Carvalho
authors.initials: AC
authors.lastname: Batista
mesh_terms: D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D007938:Leukemia / Q000628:therapy; D028022:Low-Level Light Therapy; D008223:Lymphoma / Q000628:therapy; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000009:adverse effects; D012463:Saliva / Q000201:enzymology; D013280:Stomatitis / Q000139:chemically induced / Q000378:metabolism / Q000532:radiotherapy*; D016212:Transforming Growth Factor beta / Q000378:metabolism; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D055815:Young Adult
chemical_list: C508609:IL10 protein, human; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D019653:Myeloablative Agonists; C439524:TNF protein, human; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2