{"id":4817,"date":"2015-10-13T10:30:52","date_gmt":"2015-10-13T10:30:52","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=4817"},"modified":"2015-10-13T10:33:55","modified_gmt":"2015-10-13T10:33:55","slug":"noutati-terapeutice-in-tratamentul-mucozitei-orale","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/noutati-terapeutice-in-tratamentul-mucozitei-orale\/","title":{"rendered":"Nout\u0103\u021bi terapeutice \u00een tratamentul mucozitei orale"},"content":{"rendered":"

Mucozita oral\u0103 (MO) este o complica\u021bie frecvent\u0103 \u0219i serioas\u0103 asociat\u0103 radioterapiei sau chimioterapiei, care poate limita continuarea tratamentului primar \u0219i afecteaz\u0103 calitatea vie\u021bii pacientului. Este caracterizat\u0103 de eritem oral, ulcera\u021bii, dureri \u0219i poate predispune la septicemie \u00een cazul pacien\u021bilor neutropenici. Este des \u00eenso\u021bit\u0103 de xerostomie \u0219i disgeuzie. \u00cen cazurile severe, mucozita oral\u0103 duce la dehidratare, malnutri\u021bie, sc\u0103dere \u00een greutate.<\/p>\n

Frecven\u021ba mucozitei orale este foarte mare, \u00een special \u00een r\u00e2ndul pacien\u021bilor cu radioterapie a cavit\u0103\u021bii bucale. Conform statisticilor, aproximativ 40% din pacien\u021bii care primesc chimioterapie vor dezvolta mucozit\u0103 oral\u0103, 70% din pacien\u021bii cu terapie pentru transplant medular \u0219i un procent de 100% pentru pacien\u0163ii cu cancer cap\/g\u00e2t.<\/p>\n

Cauza primar\u0103 a mucozitei orale este ac\u021biunea toxic\u0103 direct\u0103 a agen\u021bilor radio\/chimioterapeutici asupra mucoasei bucale, factorul secundar fiind infec\u021bia oral\u0103 datorat\u0103 ac\u021biunii imunosupresive a terapiei. De\u0219i mecanismul precis al ac\u021biunii citotoxice asupra mucoasei bucale r\u0103m\u00e2ne a fi clarificat, stresul oxidativ, urmat de producerea unei serii de citokine inflamatorii, este implicat \u00een etiologia mucozitei orale. Exist\u0103 o corela\u021bie pozitiv\u0103 \u00eentre severitatea mucozitei \u0219i nivelurile citokinelor proinflamatorii cum ar fi (TNF)-\u03b1, (IL)-1 \u0219i IL-6.<\/p>\n

Sonis et al (2004) men\u021bioneaz\u0103 c\u0103 mucozita oral\u0103 cuprinde 5 procese:<\/strong><\/p>\n

    \n
  1. ini\u021bializare prin producerea de specii oxigen reactive<\/li>\n
  2. activarea factorului nuclear kB (NF-kB) urmat de induc\u021bia de citokine inflamatorii (TNF)-\u03b1, (IL)-1 \u0219i IL-6<\/li>\n
  3. produc\u021bia de ceramide mediate TNF-\u03b1 \u0219i activarea caspazelor care conduc la apoptoza celular\u0103<\/li>\n
  4. ulcera\u021bii cu inflama\u021bii<\/li>\n
  5. vindecare.<\/li>\n<\/ol>\n

    Pe baza acestor procese s-au dezvoltat \u0219i testat clinic mai mul\u021bi compu\u0219i pentru prevenirea \u0219i tratarea mucozitei orale, incluz\u00e2nd antioxidan\u021bi precum amifostine, vitamina E, melatonin\u0103, alopurinol, protectori de mucoas\u0103 precum sucralfat, benzidamin\u0103 etc. \u00cens\u0103 nici unul dintre ace\u0219ti compu\u0219i nu a fost confirmat ca av\u00e2nd ac\u021biune protectoare satisf\u0103c\u0103toare.<\/p>\n

    O noutate terapeutic\u0103 cu rezultate foarte bune este gelX Oral Spray, dezvoltat \u0219i patentat de BMG Pharma. Este un produs nou, muco-protector, realiz\u00e2nd un film la suprafa\u021ba mucoasei bucale, oprind irita\u021biile \u0219i durerea. \u00cen aceast\u0103 privin\u021b\u0103 gelX este similar altor preparate acceptate at\u00e2t de c\u0103tre medici dar \u0219i de pacien\u021bi. \u00cens\u0103 ce aduce \u00een plus este faptul c\u0103 reu\u0219e\u0219te s\u0103 stopeze inflama\u021bia, utiliz\u00e2nd gluconat de zinc \u2013 o sare mineral\u0103 \u0219i taurin\u0103 \u2013 un acid aminosulfonic. C\u00e2nd sunt combinate, formeaz\u0103 un complex bioactiv \u00een condi\u021bii fiziologice. Acest complex are propriet\u0103\u021bi bacteriostatice excelente, f\u0103r\u0103 citotoxicitatea \u00eent\u00e2lnit\u0103 la alte substan\u021be. De asemenea, complexul Zn \u2013 Taurin\u0103 reface deficitul de minerale \u0219i opre\u0219te procesele inflamatoare asociate cu dureri sau cu disconfort oral.<\/p>\n

    At\u00e2t zincul c\u00e2t \u0219i taurina au propriet\u0103\u021bi cunoscute antiinflamatoare, distrug radicalii liberi \u0219i regleaz\u0103 citokinele pro-inflamatorii. Combinate, demonstreaz\u0103 activitate biologic\u0103 \u00eembun\u0103t\u0103\u021bit\u0103, comparativ cu componentele individuale, reu\u0219ind s\u0103 penetreze toate straturile pielii \u0219i mucoasa.<\/p>\n

    De asemenea, gelX Oral Spray a fost formulat atfel \u00eenc\u00e2t s\u0103 fie bine tolerat, non-toxic, cu propriet\u0103\u021bi anti-bacteriene \u0219i anti-fungice. gelX Oral Spray:<\/strong><\/p>\n

      \n
    1. \u00ceNCETINE\u0218TE procesul instal\u0103rii mucozitei prin inhibarea ciclului inflamator, cu ac\u021biuni anti-bacteriene \u0219i anti-fungice prin inhibarea prostaglandinelor mediate COX-2<\/li>\n
    2. REDUCE severitatea ulcera\u021biilor \u0219i a durerii<\/li>\n
    3. EXTINDE perioada de confort a pacientului.<\/li>\n<\/ol>\n

      Eficacitatea combina\u021biilor cu zinc pentru prevenirea \u0219i tratarea mucozitei orale a fost demonstrat\u0103 de o serie de studii clinice recente. Watanabe et al (2010) a concluzionat c\u0103 polaprezinc (zinc L-carnosine) reduce riscul dezvolt\u0103rii mucozitei orale asociate radiochimioterapiei cu 90.6% la pacien\u021bii cu cancer cap\/g\u00e2t. Profilul de siguran\u021ba este foarte bun, f\u0103r\u0103 s\u0103 interac\u021bioneze cu medica\u021bia de baz\u0103.<\/p>\n

      \u00cen prezent se desf\u0103\u0219oar\u0103 un studiu clinic de amploare \u00een mai multe centre europene pentru a testa eficacitatea combina\u021biei zinc-taurin\u0103 (gelX).<\/p>\n

      \u00cen concluzie, gelX Oral Spray este o alternativ\u0103 terapeutic\u0103 modern\u0103 pentru prevenirea \u0219i tratarea mucozitei orale la pacien\u021bii cu radio\/chimioterapie, cu rezultate foarte bune, f\u0103r\u0103 reac\u021bii adverse raportate \u0219i f\u0103r\u0103 s\u0103 interac\u021bioneze cu medica\u021bia de baz\u0103.<\/p>\n

      \"poza<\/a><\/p>\n

      Cristina Cavalli,\u00a0Medical Manager,\u00a0BMG Pharma, Milano<\/p>\n

       <\/p>\n

      [highlight]<\/p>\n

      Bibliografie:<\/p>\n

        \n
      1. BMG 0901 gelX Information Review<\/li>\n
      2. Kumar, NB (2012) Nutritional Management of Cancer Treatment Effects, Springer-Verlag<\/li>\n
      3. Patapatiou, Georgiou M. et al (2012) Oral Mucositis: understanding the pathology and management. Hippokratia 16(3) p. 215-6<\/li>\n
      4. Sonis, Stephen T. (2004) A Biological Approach to Mucositis. J Support Oncol 2(1) p.21-36<\/li>\n
      5. Watanabe, Tomoko et al (2010) Polaprezinc prevents oral mucositis associated with radiochemotherapy in patients with head and neck cancer. International Journal of Cancer 127 p. 1984-1990<\/li>\n<\/ol>\n

         <\/p>\n","protected":false},"excerpt":{"rendered":"

        Mucozita oral\u0103 (MO) este o complica\u021bie frecvent\u0103 \u0219i serioas\u0103 asociat\u0103 radioterapiei sau chimioterapiei, care poate limita continuarea tratamentului primar \u0219i afecteaz\u0103 calitatea vie\u021bii pacientului. Este caracterizat\u0103 de eritem oral, ulcera\u021bii, […]<\/p>\n","protected":false},"author":4,"featured_media":4820,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[168,1],"tags":[411,410,412],"class_list":["post-4817","post","type-post","status-publish","format-standard","has-post-thumbnail","category-oncologie","category-stiri-noutati","tag-gelx","tag-mucozita","tag-radiochimioterapie"],"yoast_head":"\nNout\u0103\u021bi terapeutice \u00een tratamentul mucozitei orale<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/noutati-terapeutice-in-tratamentul-mucozitei-orale\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nout\u0103\u021bi terapeutice \u00een tratamentul mucozitei orale\" \/>\n<meta property=\"og:description\" content=\"Mucozita oral\u0103 (MO) este o complica\u021bie frecvent\u0103 \u0219i serioas\u0103 asociat\u0103 radioterapiei sau chimioterapiei, care poate limita continuarea tratamentului primar \u0219i afecteaz\u0103 calitatea vie\u021bii pacientului. 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