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Effect of photobiomodulation therapy on reducing the chemo-induced oral mucositis severity and on salivary levels of CXCL8/interleukin 8, nitrite, and myeloperoxidase in patients undergoing hematopoietic stem cell transplantation: a randomized clinical trial

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Abstract

Oral mucositis (OM) is the most common debilitating complication among patients undergoing hematopoietic stem cell transplantation (HSCT). Photobiomodulation therapy (PBM) has shown beneficial effects in the treatment of OM, but few studies have evaluated its biological effects. This study evaluated the effect of PBM on the reduction of OM severity in patients undergoing HSCT and its relation to the modulation of the inflammatory response. Fifty-one patients were randomly assigned to two groups: PBM [submitted to PBM from admission (AD) to D+7] (n = 27) and control (n = 24) [received oral hygiene]. OM severity was assessed daily using the WHO scale. Saliva samples were collected on AD, D+7, and hospital discharge (HD) to measure CXCL8/interleukin 8, using cytometric bead array analysis and nitrite (NO) and myeloperoxidase (MPO) using colorimetric methods. PBM significantly reduced the severity of OM from D+7 to D+11 (p < 0.05). All non-interventional patients (controls) who developed grade 2 or higher OM induced an increase of CXCL8 in saliva (n = 14) on D+7. PBM led to a decrease in CXCL8 on D+7 in 85% of patients, while 70.8% of patients in the control group presented an increase in this chemokine (p = 0.007). NO decreased from AD to D+7 in the PBM group (p > 0.05). MPO significantly decreased on D+7 in both groups (p < 0.05). PBM brought about a reduction in the severity of OM in patients undergoing HSCT, and this reduction was associated with a decrease in CXCL8 salivary levels.

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Acknowledgements

We wish to thank the Foundation for Research Support in the State of Goiás and the National Council for Scientific and Technological Development (CNPq) for financial support. The authors wish to thank the Hematopoietic Stem Cell Transplantation Unit (HSCTU) at Hospital Araújo Jorge/Goiás Combat Cancer Association (HAJ/ACCG), Goiânia-GO, Brazil.

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Authors and Affiliations

  1. Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Goiás, Brazil

    Daniella Ribeiro Naves Salvador, Danilo Figueiredo Soave, Eduardo Fernandes de Castro, Elismauro Francisco Mendonça & Aline Carvalho Batista

  2. Department of Pediatric Dentistry, Paulista University (UNIP), Goiânia, Goiás, Brazil

    Nancy Tomoko Sacono

  3. Hematopoietic Stem Cell Transplant Unit, Araújo Jorge Hospital, Associação de Combate ao Câncer de Goiás, Goiânia, Goiás, Brazil

    Geisa Badauy Lauria Silva & Larissa Pereira e Silva

  4. Department of Oral Surgery and Pathology, Dental School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

    Tarcília Aparecida Silva

  5. Laboratory of Cellular Pharmacology and Toxicology, FarmaTec, Faculty of Pharmacy, Federal University of Goiás, Goiânia, Brazil

    Marize Campos Valadares

  6. Disciplina de Patologia Geral e Bucal, Faculdade de Odontologia, Universidade Federal de Goiás (Federal University of Goiás), Praça Universitária S/N, Setor Universitário, Goiânia, 74605-220, Brazil

    Aline Carvalho Batista

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  1. Daniella Ribeiro Naves Salvador
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  2. Danilo Figueiredo Soave
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Correspondence to Aline Carvalho Batista.

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This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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This study was approved by the Research Ethics Committees of both institutions (Federal University of Goiás and Hospital Araújo Jorge/Goiás Combat Cancer Association).

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All research subjects read and signed the informed consent form before the beginning of the clinical procedures.

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Salvador, D.R.N., Soave, D.F., Sacono, N.T. et al. Effect of photobiomodulation therapy on reducing the chemo-induced oral mucositis severity and on salivary levels of CXCL8/interleukin 8, nitrite, and myeloperoxidase in patients undergoing hematopoietic stem cell transplantation: a randomized clinical trial. Lasers Med Sci 32, 1801–1810 (2017). https://doi.org/10.1007/s10103-017-2263-1

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