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Release: Oct. 13, 2000

UI College of Dentistry research targets mouth ulcers in cancer patients

IOWA CITY, Iowa -- Researchers at the University of Iowa College of Dentistry are studying potential treatments for painful mouth sores common among people undergoing anti-cancer therapy.

The investigators, led by Christopher Squier, Ph.D., associate dean for research and professor of oral pathology, radiology and medicine at the college, received a $330,000 grant from the National Institutes of Health. They will develop and evaluate new topical medicines for mucositis, an ulcerative condition that affects the lining of the mouth.

Anyone who has had a canker sore has experienced the pain of mucositis on a small scale. The sores, also known as apthous ulcers, become more common as people age.

For people with cancer, mucositis and other diseases of the oral mucosa -- the soft tissue that lines the mouth -- are some of the most painful side effects of chemotherapy, affecting about 400,000 cancer patients each year. Mouth sores can become infected, especially among people with immune systems weakened by age or disease.

Current products for treating mouth ulcers aim to reduce pain and check infection, but they often contain unpleasant-tasting alcohol or astringents. They do not always work and in some cases can actually worsen the problem. Topical agents applied to the surface of the ulcer may not stick to the mucosa, or may be washed away by saliva.

The UI researchers and their colleagues, including Sevda Senel, a pharmacist at Haceteppe University in Ankara, Turkey, hope to develop new products that take advantage of several recent discoveries. Their goal is a topical medication for mouth sores that not only relieves pain, but also helps to heal them.

Scientists have identified several agents known as cytokines that may protect and heal the mucosa by manipulating cell growth. Cells in the oral mucosa divide rapidly, which may explain why the mouth is quick to show side effects from anti-cancer drugs that target fast-dividing tumor cells.

One cytokine shows particular promise in cancer-related mucositis. It halts normal mucosal cell division, sparing the cells from anti-cancer drugs. But since it and similar agents affect cell division, they must be applied directly to the mucosa to prevent any interference with chemotherapy.

New polymers derived from natural sources may help deliver medicines to mouth ulcers. The UI study will focus on chitosan, a safe substance that clings to the mucosa and also may prevent infectious microbes from attacking mucosal cells.

The researchers will study whether chitosan can deliver antimicrobial and anti-inflammatory drugs that reduce infection and pain, as well as cytokines to promote healing. They will develop and test chitosan-based medications in the laboratory, then study their effectiveness in human volunteers.

Devising new therapies for mucositis may profoundly improve quality of life for people undergoing cancer therapy and others who battle recurring mouth ulcers, particularly the elderly.

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.