Regular PaperEvaluation of GM-CSF mouthwash for prevention of chemotherapy-induced mucositis: a randomized, double-blind, dose-ranging study
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Challenges in the local delivery of peptides and proteins for oral mucositis management
2018, European Journal of Pharmaceutics and BiopharmaceuticsCitation Excerpt :Both factors can improve the activity of peripheral neutrophils in the mucosal tissue, whereas GM-CSF can still stimulate the proliferation of keratinocytes [104,105]. A pro-healing wound effect has been observed and extensively studied [106-111], which led to the study of these glycoproteins or their PEGylated recombinant versions (e.g., filgrastim and pegfilgrastim) via systemic (parenteral or subcutaneous injections) [52,112–120] or topical (mouthwash or gel) [121–125] administration in OM prevention and healing. Results tend to be very conflicting, with studies indicating some promising results in OM prevention or regression, while others not showing any clinical benefits [9,24,55].
A Review of Clinical Radioprotection and Chemoprotection for Oral Mucositis
2018, Translational OncologyCitation Excerpt :Methotrexate and etoposide, in particular, are secreted in saliva, which leads to an increased risk of direct mucositis [13]. While evidence of a direct causal link between mucositis and neutropenia is not definitive, the possibility that it is a contributory factor is suggested by a) reduced duration and severity of the OM with topical and systemic GM-CSF treatment (although this data is contradictory [14]) b) predisposition to mucositis with low neutrophil counts (<400 cells/μL) c) high incidence of microbial infections during neutropenia since perturbation of the mucosal barrier results in a portal of entry for pathogens and neutrophil-depleted patients are less able to clear these pathogens d) recovery of the mucosa in tandem with white cell recovery, all of which implies that depletion of neutrophils leads to impaired wound healing and that neutrophil repopulation particularly during the recovery phase accelerates repair [15]. Like macrophages, neutrophils are highly plastic cells, capable of dynamically switching between two main states, N1, inflammatory, and N2, pro-repair, in a context- and time-dependent manner.
Topical use of systemic drugs in dermatology: A comprehensive review
2011, Journal of the American Academy of DermatologyCitation Excerpt :A recent study also revealed the beneficial effects of topical granulocyte-CSF in the treatment of oral and genital ulcers in Behçet disease.28 No cutaneous or systemic adverse effects were detected after the use of topical GM-CSF or granulocyte-CSF except for a burning sensation and allergic reaction in a minority of patients.28,29 Topical phenytoin has been shown to be effective in the treatment of ulcers in many RDBPCTs.
Phase II double-blind randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-and-neck neoplasms
2004, International Journal of Radiation Oncology Biology PhysicsComparative efficacy and safety of interventions for preventing chemotherapy-induced oral mucositis in adult cancer patients: A systematic review and network meta-analysis
2020, European Journal of Hospital Pharmacy