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Review
. 2014:2014:378281.
doi: 10.1155/2014/378281. Epub 2014 Apr 10.

Oral complications in hematopoietic stem cell recipients: the role of inflammation

T M Haverman  1 , J E Raber-Durlacher  2 , W M H Rademacher  1 , S Vokurka  3 , J B Epstein  4 , C Huisman  5 , M D Hazenberg  5 , J J de Soet  6 , J de Lange  7 , F R Rozema  8
Affiliations
Review

Oral complications in hematopoietic stem cell recipients: the role of inflammation

T M Haverman et al. Mediators Inflamm. 2014.

Abstract

Hematopoietic stem cell transplantation (HSCT) is widely used as a potentially curative treatment for patients with various hematological malignancies, bone marrow failure syndromes, and congenital immune deficiencies. The prevalence of oral complications in both autologous and allogeneic HSCT recipients remains high, despite advances in transplant medicine and in supportive care. Frequently encountered oral complications include mucositis, infections, oral dryness, taste changes, and graft versus host disease in allogeneic HSCT. Oral complications are associated with substantial morbidity and in some cases with increased mortality and may significantly affect quality of life, even many years after HSCT. Inflammatory processes are key in the pathobiology of most oral complications in HSCT recipients. This review article will discuss frequently encountered oral complications associated with HSCT focusing on the inflammatory pathways and inflammatory mediators involved in their pathogenesis.

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Figures

Figure 1
Figure 1
An overview of the pathogenesis of oral mucositis. RT: radiotherapy, ROS: reactive oxygen species, CT: chemotherapy, NF-κB: nuclear factor-kappa B, IL: interleukin, TNF-α: tumor necrosis factor-alpha, COX-2: cyclooxygenase-2, and MMP: matrix metalloproteinase. Courtesy of Professor ST Sonis and the Multinational Association of Supportive Care in Cancer (MASCC).
Figure 2
Figure 2
Chronic mucosal GvHD characterized by lichenoid inflammation and pseudomembranous mucositis. Courtesy of Dr. Maria Elvira Correa.
Figure 3
Figure 3
Typical histopathological changes of salivary gland in chronic GvHD. Periductal lymphocytic infiltrate and lymphocyte exocytosis can be noted implying high inflammatory activity. (a) Hematoxylin and eosin stained histological section (original magnification ×400); (b) immunostained section targeting for CD45 (original magnification ×100); (c) immunostained section targeting for CD8. Lymphocytes are shown within ductal epithelium and acinar unit (original magnification ×400). Courtesy of Drs. Tânia C Benetti Soares and Maria Elvira Correa.
See this image and copyright information in PMC

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