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Abstract
Although cycloooxygenase-2 (COX-2) is upregulated by factors associated with oral
mucositis, its role in the pathogenesis of mucositis has not been studied. We investigated
the kinetics of mucosal COX-2 expression following radiation exposure, and assessed
its relationship to the development of oral mucositis in an established animal model
using immunohistochemical endpoints. While little or no COX-2 expression was observed
in unirradiated mucosa or in tissue taken 2 days after radiation, COX-2 expression
was dramatic on days 10 and 16, especially in submucosal fibroblasts and endothelium.
The kinetics of COX-2 expression paralleled mucositis severity. A burst of angiogenic
activity was seen on day 21 following peak COX-2 expression. The kinetics of COX-2
expression relative to mucositis progression suggests that COX-2 is not a primary
driver of radiation injury, but instead plays an amplifying role.