Updated perspectives on the contribution of the microbiome to the pathogenesis of mucositis using the MASCC/ISOO framework
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Date
2024
Authors
Stringer, A.M.
Hargreaves, B.M.
Mendes, R.A.
Blijlevens, N.M.A.
Bruno, J.S.
Joyce, P.
Kamath, S.
Laheij, A.M.G.A.
Ottaviani, G.
Secombe, K.R.
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Supportive Care in Cancer, 2024; 32(8):558-1-558-15
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Andrea M. Stringer, Benjamin M. Hargreaves, Rui Amaral Mendes, Nicole M. A. Blijlevens, Julia S. Bruno, Paul Joyce, Srinivas Kamath, Alexa M. G. A. Laheij, Giulia Ottaviani, Kate R. Secombe, Arghavan Tonkaboni, Yehuda Zadik, Paolo Bossi, Hannah R. Wardill
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Abstract
Advances in the treatment of cancer have significantly improved mortality rates; however, this has come at a cost, with many treatments still limited by their toxic side effects. Mucositis in both the mouth and gastrointestinal tract is common following many anti-cancer agents, manifesting as ulcerative lesions and associated symptoms throughout the alimentary tract. The pathogenesis of mucositis was first defined in 2004 by Sonis, and almost 20 years on, the model continues to be updated reflecting ongoing research initiatives and more sophisticated analytical techniques. The most recent update, published by the Multinational Association for Supportive Care in Cancer and the International Society for Oral Oncology (MASCC/ISOO), highlights the numerous co-occurring events that underpin mucositis development. Most notably, a role for the ecosystem of microorganisms that reside throughout the alimentary tract (the oral and gut microbiota) was explored, building on initial concepts proposed by Sonis. However, many questions remain regarding the true causal contribution of the microbiota and associated metabolome. This review aims to provide an overview of this rapidly evolving area, synthesizing current evidence on the microbiota's contribution to mucositis development and progression, highlighting (i) components of the 5-phase model where the microbiome may be involved, (ii) methodological challenges that have hindered advances in this area, and (iii) opportunities for intervention.
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© The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.