Protective Effects of Aqueous Extract of Solanum nigrum Linn. Leaves in Rat Models of Oral Mucositis

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Abstract

Oral mucositis is one of the most debilitating side effects in patient undergoing chemotherapy or chemoradiotherapy. Leaves of the plant Solanum nigrum are used in folklore medicine to treat oral ulcers in India. However, no pharmacological investigation has been carried out till date. Aqueous extract of Solanum nigrum leaves (AESN) was prepared and subjected to various phytochemical screening. HPLC analysis of the ethyl acetate fraction was carried out. The aqueous extract (100 and 200 mg/kg) was further evaluated for its protective effect on two rat models: (a) busulfan plus infrared radiation (chemoradiotherapy) induced oral mucositis and (b) methotrexate (chemotherapy) induced oral mucositis. Various parameters including body weight change, food intake, and mortality were measured. AESN showed protective effect in both models of oral mucositis; however, the higher dose was more effective in chemotherapy induced oral mucositis. A reduction in oral mucositis score ( P < 0.05) was observed in the treatment groups. Significant ( P < 0.05) improvement in food intake was also observed in AESN treated groups. Aqueous extract of Solanum nigrum leaves has protective effect on chemotherapy and chemoradiotherapy induced oral mucositis in rats.

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Chemotherapy-induced and/or radiation therapy-induced oral mucositis--complicating the treatment of cancer.

Maddireddy Umameshwar Rao Naidu, Gogula Venkat Ramana, Pingali Usha Rani … (2015)

The term mucositis is coined to describe the adverse effects of radiation and chemotherapy treatments. Mucositis is one of the most common adverse reactions encountered in radiation therapy for head and neck cancers, as well as in chemotherapy, in particular with drugs affecting DNA synthesis (S-phase-specific agents such as fluorouracil, methotrexate, and cytarabine). Mucositis may limit the patient's ability to tolerate chemotherapy or radiation therapy, and nutritional status is compromised. It may drastically affect cancer treatment as well as the patient's quality of life. The incidence and severity of mucositis will vary from patient to patient. It will also vary from treatment to treatment. It is estimated that there is 40% incidence of mucositis in patients treated with standard chemotherapy and this will not only increase with the number of treatment cycles but also with previous episodes. Similarly, patients who undergo bone marrow transplantation and who receive high doses of chemotherapy have a 76% chance of getting mucositis. Patients receiving radiation, in particular to head and neck cancers, have a 30% to 60% chance. The exact pathophysiology of development is not known, but it is thought to be divided into direct and indirect mucositis. Chemotherapy and/or radiation therapy will interfere with the normal turnover of epithelial, cells leading to mucosal injury; subsequently, it can also occur due to indirect invasion of Gram-negative bacteria and fungal species because most of the cancer drugs will cause changes in blood counts. With the advancement in cytology, a more precise mechanism has been established. With this understanding, we can select and target particular mediators responsible for the mucositis. Risk factors such as age, nutritional status, type of malignancy, and oral care during treatment will play important roles in the development of mucositis. Many treatment options are available to prevent and treat this condition, but none of them can completely prevent or treat mucositis. More and more pathological methods are being developed to understand this condition so that better therapeutic regimens can be selected. Emphasis also should be made in assessing the patient's psychologic condition, particular depressive disorders. This is important because treatment with antidepressants will not only contribute in lifting depression but also reduces pain somatization. Although mucositis is rarely life-threatening, it will interfere with treatment of cancer to a great extent.

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Fred R Burlage, F Spijkervet, R Coppes … (2002)

In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e.g., salivary glands, oral mucosa, bone, dentition, masticatory musculature, and temporomandibular joints. The clinical consequences of radiotherapy include mucositis, hyposalivation, taste loss, osteoradionecrosis, radiation caries, and trismus. Mucositis and taste loss are reversible consequences that usually subside early post-irradiation, while hyposalivation is normally irreversible. Furthermore, the risk of developing radiation caries and osteoradionecrosis is a life-long threat. All these consequences form a heavy burden for the patients and have a tremendous impact on their quality of life during and after radiotherapy. In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed.

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New thoughts on the initiation of mucositis.

S T Sonis (2010)

It has been slightly more than a decade since the classic mechanistic paradigm that defined the pathogenesis of mucositis was revised. A five-stage sequence of linked biological events forms the basis for our current understanding of how regimen-related mucosal injury occurs. The first stage is the initiation phase, although the gateway to toxicity has been the least studied. This essay proposes new thoughts on the phase's components, how they might interact, and how they present new opportunities for treatment interventions and mucositis risk prediction. © 2010 John Wiley & Sons A/S.

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Author and article information

Journal

Journal ID (nlm-ta): ScientificWorldJournal

Journal ID (iso-abbrev): ScientificWorldJournal

Journal ID (publisher-id): TSWJ

Title: The Scientific World Journal

Publisher: Hindawi Publishing Corporation

ISSN (Print): 2356-6140

ISSN (Electronic): 1537-744X

Publication date (Print): 2014

Publication date (Electronic): 20 November 2014

Volume: 2014

Electronic Location Identifier: 345939

Affiliations

Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, Karnataka 576104, India

Author notes

*K. Nandakumar: mailnandakumar77@ 123456gmail.com

Academic Editor: Thomas Efferth

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Alkesh Patel http://orcid.org/0000-0001-7036-5011

Subhankar Biswas http://orcid.org/0000-0003-4709-5839

Muhammed Haneefa Shoja http://orcid.org/0000-0002-8111-1946

Grandhi Venkata Ramalingayya http://orcid.org/0000-0002-9347-375X

K. Nandakumar http://orcid.org/0000-0001-6653-4660

Article

DOI: 10.1155/2014/345939

PMC ID: 4258331

PubMed ID: 25506066

SO-VID: dedddc8f-9332-4513-b286-22aa4d072f7d

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This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 3 July 2014

Date revision received : 30 October 2014

Date accepted : 30 October 2014

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Protective Effects of Aqueous Extract of Solanum nigrum Linn. Leaves in Rat Models of Oral Mucositis

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Animal models of intrauterine growth restriction (IUGR)

Most cited references 26

Chemotherapy-induced and/or radiation therapy-induced oral mucositis--complicating the treatment of cancer.

Oral sequelae of head and neck radiotherapy.

New thoughts on the initiation of mucositis.

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