Tissue reactions to ionizing radiation —oral mucosa

Publication date: Available online 25 July 2016 Source:Mutation Research/Reviews in Mutation Research Author(s): Sylvia Gruber, Wolfgang Dörr Radiotherapy is one of the most effective treatment strategies for solid malignancies, including head-and-neck tumors (HNT). Oral mucositis is the most frequent, often dose-limiting early adverse event of radio(chemo)therapy for HNT. The oral mucosal response is − like that of typical turnover tissues − based on radiation-induced impairment of epithelial proliferation and cell production, in face of ongoing physiological cell differentiation and cell loss, consequently resulting in hypoplasia and eventually mucosal ulceration. The regenerative epithelial response, i.e. repopulation, and hence the impact of overall treatment time, besides intrinsic radiosensitivity, is the dominant parameter of the radiation tolerance of oral mucosa in fractionated radiotherapy protocols. The epithelial changes are accompanied, at the molecular and cellular level, by various changes in non-epithelial cell populations, i.e. vascular endothelial cells, macrophages, and fibroblasts. An inflammatory response precedes and parallels the epithelial changes; this includes vasodilation associated with rheological consequences and the manifestation of local hypoxia, activation of macrophages and endothelial cells. During these processes, a variety of intra- and intercellular communication pathways are modulated; NF-kB associated signaling is one promi...

Source: Mutation Research Reviews in Mutation Research - July 25, 2016 Category: Genetics & Stem Cells Source Type: research