Master's Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, México.
Biochemical Unit, Department of Genomic Medicine and Environmental Toxicology, Biomedical Research Institute, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Universidad Nacional Autónoma de México, Mexico City, México.
Oral Dis. 2017 Oct;23(7):941-948. doi: 10.1111/odi.12677. Epub 2017 May 16.
To assess changes in the salivary expression of IL-1α, IL-1β, IL-2, IL-6, IL-10, IL-17, and TNF in acute leukemia (AL) patients before and during chemotherapy, and its association with HSV infection, oral candidiasis (OC), and oral mucositis (OM) onset.
Cohort study in AL patients >15 years starting induction chemotherapy at a Mexican oncological center (2013-2014). Onset of oral lesions (OLs) was assessed during follow-up, and saliva was obtained at baseline, at visit 2 (days 4-12), and at visit 3 (days 13-21) after chemotherapy, treated with a protease inhibitor and stored at -70°C. An enzyme-linked immunosorbent assay was performed. Cox proportional hazards regression models were constructed to estimate hazard ratios and its 95% CI (HR, 95% CI) for OL development.
Forty-one patients were followed up, and 17 (41.5%) developed OLs. OL patients had higher baseline salivary IL-1α than those without lesions (p = 0.040). During visit 2, OL patients had higher levels of IL-1α (p = 0.033), IL-1β (p = 0.016), IL-6 (p = 0.035), and TNF (p = 0.019) than those who did not develop OLs. Patients with HSV infection, OC, and OM showed higher salivary TNF levels during follow-up (HR: 3.52, 95% CI: 1.35-9.14, p = 0.010).
AL patients undergoing chemotherapy with high salivary TNF levels were more likely to develop HSV infection, OC, and OM.
评估急性白血病（AL）患者在化疗前后唾液中白细胞介素 1α（IL-1α）、白细胞介素 1β（IL-1β）、白细胞介素 2（IL-2）、白细胞介素 6（IL-6）、白细胞介素 10（IL-10）、白细胞介素 17（IL-17）和肿瘤坏死因子（TNF）表达的变化，及其与单纯疱疹病毒（HSV）感染、口腔念珠菌病（OC）和口腔黏膜炎（OM）发病的关系。
这是一项在墨西哥肿瘤中心进行的 15 岁以上 AL 患者队列研究，于 2013-2014 年开始诱导化疗。在随访期间评估口腔病变（OLs）的发病情况，并在化疗后第 2 天（第 4-12 天）和第 3 天（第 13-21 天）采集基线唾液，用蛋白酶抑制剂处理并储存在-70°C。采用酶联免疫吸附试验（ELISA）检测。构建 Cox 比例风险回归模型来估计 OL 发病的危险比及其 95%置信区间（HR，95%CI）。
共 41 例患者进行了随访，其中 17 例（41.5%）发生 OLs。OL 患者的基线唾液 IL-1α 水平高于无病变患者（p=0.040）。在第 2 次就诊时，OL 患者的 IL-1α（p=0.033）、IL-1β（p=0.016）、IL-6（p=0.035）和 TNF（p=0.019）水平均高于未发生 OLs 的患者。HSV 感染、OC 和 OM 患者在随访期间的 TNF 水平较高（HR：3.52，95%CI：1.35-9.14，p=0.010）。
化疗后唾液 TNF 水平较高的 AL 患者更易发生 HSV 感染、OC 和 OM。
