Mucositis: The impact, biology and therapeutic opportunities of oral mucositis

The pathobiology of mucositis as a five stage process. The key biological processes associated with the pathogenesis of oral mucositis can be arbitrarily divided into five stages: initiation, the primary damage response (messaging and signaling), amplification, ulceration, and healing. Reprinted with permission (J Support Oncol 2007;5(Suppl. 4):3–11).

The relationship between mucositis severity and bacterial colonization. The relationship between quantitative increases in bacteria and the course of mucositis was studied in a hamster model in which an acute dose of radiation was given on day 0. Bacterial sampling and clinical mucositis scoring was performed at weekly intervals. Mucositis development (a score of three indicates ulcerative OM) preceded increases in bacterial numbers suggesting that, at least quantitatively, bacteria do not drive the development of mucosal ulceration. Bacterial colonization of ulcerative lesions is suggested by the synchronous peak of mean bacterial count and mucositis score on day 21.