| DB ID | MyCo_2354 |
| Title | TNF as marker of oral candidiasis, HSV infection, and mucositis onset during chemotherapy in leukemia patients |
| Year | 2017 |
| PMID | 28403570 |
| Fungal Diseases involved | Oral mucositis (OM) |
| Associated Medical Condition | acute leukemia (AL) |
| Genus | None |
| Species | None |
| Organism | None |
| Ethical Statement | The design of the trial has been described and registered in Clinical ClinicalTrials.gov (No. NCT01087476), available at: https://clinicaltrials.gov/ct2/show/NCT01087476?term=NCT01087476&rank=1. Both protocols, the RCT and the specific protocol of the present study, were approved by the Scientific and Bioethical Committee of the National Cancer Institute of Mexico (INCAN/CC/025/10 and C007/CB/584/19, respectively). All patients signed an informed consent form. |
| Site of Infection | Mouth |
| Opportunistic invasive | Opportunistic |
| Sample type | Body fluid |
| Sample source | Saliva |
| Host Group | Human |
| Host Common name | Human |
| Host Scientific name | Homo sapiens |
| Biomarker Name | TNF |
| Biomarker Full Name | Tumour necrosis factor |
| Biomarker Type | Diagnostic |
| Biomolecule | Protein |
| Geographical Location | Mexico |
| Cohort | A randomized controlled trial (RCT) to evaluate the efficacy of sub-antimicrobial doses of doxycycline for OM prevention in 147 adult AL patients starting chemotherapy (CT) (September 2010 to October 2014), allowed us to investigate the cytokine spectrum in a subgroup of patients, most of the patients reported here was part of such RCT. Thus, a cohort of 41 adult patients with AL (≥15 years of age) hospitalized at the Hemato Oncology Department of the Mexican National Cancer Institute, without any previous antineoplastic treatment, and scheduled to receive CT, were followed for 21 days. The period of inclusion started in December 2013 and concluded in October 2014. Thirty-two of the 41 subjects were participants in the RCT and other nine patients were not, those nine AL patients were added to the placebo group when looking for differences attributable to doxycycline. Patients with OC or HSV infection at baseline, and all candidates for hematopoietic stem cell transplantation were excluded. During follow-up, at days 13 to 21 after starting chemotherapy, two patients died and four were transferred to the intensive care unit due to some systemic complications (bacterial endocarditis (n=1), respiratory failure (n=1), and neoplastic infiltration (n=2)); thus, 35 patients completed the follow-up period. |
| Cohort No. | 41 Patients |
| Age Group | Greater than equal 16 |
| P Value | p=0.01 |
| Sensitivity | None |
| Specificity | None |
| Positive Predictive Value | None |
| MIC | None |
| Fold Change | None |
| Pathway | None |
| Disease Introduction Mechanism | Chemotherapeutic agents used in acute leukemia (AL) during the induction phase result in severe systemic immunosuppression; thus, 40-90% of treated patients may develop oral lesions (OLs). The dysfunction of the innate and adaptive immune response produced for both AL and chemotherapy determines the development of specific OLs such as oral candidiasis (OC) and herpes simplex virus (HSV) infection. OC is the most frequent fungal infection in AL patients, affecting 28% to 40% of them. Similarly, prevalence rates of oral HSV infection are high, ranging from 14% to 50%. Special mention should be given to oral mucositis (OM), which is a complex process affecting between 21-41% adults with AL undergoing antineoplastic treatment. OM is the result of interactive biological events that take place in the epithelium and submucosa, and involves five biological phases: initiation, message generation, signal amplification, ulceration and healing. As a part of this complex network, the inflammatory response is regulated by cytokines, soluble molecules that transmit information to target cells, aiming to produce a specific response. Even though saliva represents a valuable fluid to measure cytokine expression, since it is easy to sample and store without using invasive procedures, studies assessing the expression of inflammatory cytokines (whether in the saliva or plasma) and their association with the development of oral candidiasis, herpes simplex virus infection and oral mucositis in patients with AL and chemotherapy are limited. |
| Technique | ELISA |
| Analysis Method | ELISA Based |
| ELISA kits | ELISA Magpix Multiplex Human Cytokine Magnetic Bead Kit (Millipore, United States) |
| Assay Data | None |
| Validation Techniques used | ELISA |
| Up Regulation Down Regulation | Increase |
| Sequence Data | None |
| External Link | None |
