Study on effectiveness of salivary inflammation markers as an indicator of perioperative oral mucositis.

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K09889
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 57080:Social dentistry-related
• Research Institution: Iwate Medical University
• Principal Investigator: Kishi Mtsuo 岩手医科大学, 歯学部, 教授 (60295988)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 口腔粘膜炎 / 唾液 / 骨髄抑制 / 白血球 / 血液 / 化学療法

Outline of Final Research Achievements

We tested the hypothesis that the onset of oral mucositis in cancer chemotherapy patients can be predicted from changes in the inflammatory components in saliva. Saliva samples were collected from 26 patients before and after starting chemotherapy. Lactate dehydrogenase (LDH), hemoglobin (Hb) and leukocytes in the saliva were quantified. Leukocytes and CRP in peripheral blood on the same day as saliva collection were obtained from medical records. As the results, severe oral mucositis developed in only 5 patients, and association with salivary inflammatory components was not found. Leukocytes in saliva decreased according with decrement of leukocytes in blood. A strong correlation was found between leukocyte amounts between saliva and blood only during chemotherapy. From the above, chemotherapy decreased leukocytes number in blood and saliva simultaneously, suggesting that this is one of the mechanisms of the decrease in oral immunity due to myelosuppression.

Free Research Field

歯科医学

Academic Significance and Societal Importance of the Research Achievements

がん化学療法による口腔粘膜炎は一次性粘膜炎と二次性粘膜炎に分類される。一次性は抗がん剤の直接作用であり、二次性のものは骨髄抑制による白血球減少により、口腔内が易感染状態になることによると考えられている。しかし、血液中の白血球低下がなぜ口腔の易感染性につながるのかを研究した例はほとんどない。今回の研究で、化学療法による血液中の白血球低下には症例差が大きいこと、血液中の白血球低下率が高い者は唾液中でも同様に低下率が高いことが観察され、化学療法の白血球減少への影響は血液と同様に唾液にも現れることが観察された。このことは二次性口腔粘膜炎の発症機序の解明と予防法の開発に大きく寄与するものと考えられる。