DOI QR코드

DOI QR Code

Establishment of a Single Dose Radiation Model of Oral Mucositis in Mice

일회 방사선조사를 이용한 마우스 구강점막염 모델의 확립

  • Ryu, Seung-Hee (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Moon, Soo-Young (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Choi, Eun-Kyung (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim, Jong-Hoon (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Ahn, Seung-Do (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Song, Si-Yeol (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Park, Jin-Hong (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Noh, Young-Ju (Department of Radiation Oncology, Ulsan University Hospital, College of Medicine, University of Ulsan) ;
  • Lee, Sang-Wook (Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan)
  • 류승희 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 문수영 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 최은경 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 김종훈 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 안승도 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 송시열 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 박진홍 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 노영주 (울산대학교병원 방사선종양학과) ;
  • 이상욱 (울산대학교 의과대학 서울아산병원 방사선종양학과)
  • Published : 2008.12.31

Abstract

Purpose: Oral mucositis induced by radiotherapy to the head and neck area, is a common acute complication and is considered as the most severe symptom for cancer patients in the early stages of treatment. This study was proposed to establish the oral mucositis mouse model induced by a single dose of radiation for the facility of testing therapeutic candidates which can be used for the oral mucositis treatments. Materials and Methods: Fifty-five BALB/c mice were divided into four groups: control, 16 Gy, 18 Gy, and 20 Gy. Oral mucositis was induced by a single dose of radiation to the head and neck using 6 MV x-Ray from linear accelerator. After irradiation, body weight and physical abnormalities were checked daily. Tongue tissues from all groups were taken on days 1, 2, 3, 5, 7, 9, and 14, respectively and H&E staining was conducted to examine morphological changes. Results: Body weight dramatically decreased after day 5 in all irradiated mice. In the 16 Gy treatment group, body weight was recovered on day 14. The histology data showed that the thickness of the epithelial cell layer was decreased by the accumulated time after radiation treatment, up to day 9. Severe ulceration was revealed on day 9. Conclusion: A single dose of 16 Gy is sufficient dose to induce oral mucositis in Balb/C mice. Significant changes were observed in the Balb/C mice on days 7 and 9 after radiation. It is suggested that this mouse model might be a useful standard tool for studying oral mucositis induced by radiation.

목 적: 두경부 영역에 대한 방사선치료 시 발생하는 구강점막염은 방사선치료로 유발되는 급성 합병증 중에서 가장 심각하고 해결해야 할 문제점이다. 따라서 본 저자들은 마우스를 이용하여 방사선 구강점막염 모델을 확립하고자 본 연구를 진행하였다. 대상 및 방법: 본 실험에는 $7{\sim}8$주령의 20 g 내외의 웅성 BALB/c 마우스 55마리를 사용하였다. 1주일간 순화 후 대조군 5마리를 제외하고 체중에 따라 무작위로 3군으로 나누고 마우스의 두경부에 각각 16, 18, 20 Gy의 방사선을 조사하였다. 방사선조사 후 체중을 매일 측정하고 생존 유무를 관찰하였다. 방사선조사 후 1, 2, 3, 5, 7, 9, 14일째 마우스를 경추탈골사 한 후 설조직을 채취하고 hematoxylin & eosin (H&E) 염색으로 조직학적 변화를 확인하였다. 결 과: 방사선조사군의 경우 5일 이후 급격한 체중감소를 나타내었고 18 Gy와 20 Gy군에서 마우스가 사망하였다. 16 Gy군에서는 5일부터 9일까지는 평균 체중이 감소하였으나 이후 회복되었다. 조직학적 변화를 관찰한 결과 방사선조사 후 시간경과에 따라 상피층의 두께가 얇아지면서 편평해지는 경향을 나타내었으며 7일과 9일째에 가장 심각한 상태를 나타내었다. 대조군에서 평균 $113.50{\pm}2.41{\mu}m$이던 상피층 두께가 방사선조사 후 시간이 지남에 따라 유의하게 그 두께가 감소하였으며 7일째에는 43.9% 감소한 $63.70{\pm}3.28{\mu}m$로 최저치를 나타내었다(p<0.0001). 14일째에는 $121.00{\pm}2.82{\mu}m$로 대조군과 유의한 차이가 없어 정상적으로 회복되는 것으로 나타났다. 결 론: BALB/c 마우스에서 방사선조사 후 마우스의 체중변화를 관찰 할 수 있는 적절한 방사선 선량은 16 Gy였다. 또한 구강 내 상피조직의 현저한 손상은 방사선조사 후 7일과 9일째 관찰할 수 있었고 9일째에는 심각한 궤양화가 나타났다. 18 Gy와 20 Gy 조사 후 9일과 10일째에 모든 마우스가 사망하였지만 16 Gy 조사군에서는 14일째 조직이 정상적으로 회복되었다.

Keywords

References

  1. The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685-1690 https://doi.org/10.1056/NEJM199106133242402
  2. Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst 1996;88:890-899 https://doi.org/10.1093/jnci/88.13.890
  3. Fung K, Lyden TH, Lee J, et al. Voice and swallowing outcomes of an organ-preservation trial for advanced laryngeal cancer. Int J Radiat Oncol Biol Phys 2005;63:1395-1399 https://doi.org/10.1016/j.ijrobp.2005.05.004
  4. Al-Sarraf M, LeBlanc M, Giri PG, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 1998;16:1310-1317 https://doi.org/10.1200/JCO.1998.16.4.1310
  5. Forastiere AA, Goepfert H, Maor M, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091-2098 https://doi.org/10.1056/NEJMoa031317
  6. Alden ME, O'Reilly RC, Topham A, Lowry LD, Brodovsky H, Curran WJ, Jr. Elapsed radiation therapy treatment time as a predictor of survival in patients with advanced head and neck cancer who receive chemotherapy and radiation therapy. Radiology 1996;201:675-680 https://doi.org/10.1148/radiology.201.3.8939214
  7. Garden AS, Chambers MS. Head and neck radiation and mucositis. Curr Opin Support Palliat Care 2007;1:30-34 https://doi.org/10.1097/SPC.0b013e32813aeb34
  8. Epstein JB, Beaumont JL, Gwede CK, et al. Longitudinal evaluation of the oral mucositis weekly questionnaire-head and neck cancer, a patient-reported outcomes questionnaire. Cancer 2007;109:1914-1922 https://doi.org/10.1002/cncr.22620
  9. Sonis ST. Pathobiology of oral mucositis: novel insights and opportunities. J Support Oncol 2007;5:3-11
  10. Trotti A. Toxicity in head and neck cancer: a review of trends and issues. Int J Radiat Oncol Biol Phys 2000;47:1-12 https://doi.org/10.1016/S0360-3016(99)00558-1
  11. Plevova P. Prevention and treatment of chemotherapy- and radiotherapy-induced oral mucositis: a review. Oral Oncol 1999; 35:453-470 https://doi.org/10.1016/S1368-8375(99)00033-0
  12. Spielberger R, Stiff P, Bensinger W, et al. Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med 2004;351:2590-2598 https://doi.org/10.1056/NEJMoa040125
  13. Garden AS, Lewin JS, Chambers MS. How to reduce radiation-related toxicity in patients with cancer of the head and neck. Curr Oncol Rep 2006;8:140-145 https://doi.org/10.1007/s11912-006-0049-x
  14. Beaven AW, Shea TC. The effect of palifermin on chemotherapyand radiation therapy-induced mucositis: a review of the current literature. Support Cancer Ther 2007;4:188-197 https://doi.org/10.3816/SCT.2007.n.014
  15. Sukhotnik I, Shehadeh N, Coran AG, et al. Oral insulin enhances cell proliferation and decreases enterocyte apoptosis during methotrexate-induced mucositis in the rat. J Pediatr Gastroenterol Nutr 2008;47:115-122 https://doi.org/10.1097/MPG.0b013e31806008f1
  16. Suemaru K, Cui R, Li B, et al. Topical application of royal jelly has a healing effect for 5-fluorouracil-induced experimental oral mucositis in hamsters. Methods Find Exp Clin Pharmacol 2008;30:103-106 https://doi.org/10.1358/mf.2008.30.2.1159655
  17. Sonis ST, Tracey C, Shklar G, Jenson J, Florine D. An animal model for mucositis induced by cancer chemotherapy. Oral Surg Oral Med Oral Pathol 1990;69:437-443 https://doi.org/10.1016/0030-4220(90)90376-4
  18. Dorr W, Spekl K, Martin M. Radiation-induced oral mucositis in mice: strain differences. Cell Prolif 2002;35(Suppl 1):60-67 https://doi.org/10.1046/j.1365-2184.35.s1.6.x
  19. Ponnaiya B, Cornforth MN, Ullrich RL. Radiation-induced chromosomal instability in BALB/c and C57BL/6 mice: the difference is as clear as black and white. Radiat Res 1997;147: 121-125 https://doi.org/10.2307/3579411
  20. Ullrich RL, Ponnaiya B. Radiation-induced instability and its relation to radiation carcinogenesis. Int J Radiat Biol 1998;74:  747-754 https://doi.org/10.1080/095530098141023
  21. Okayasu R, Suetomi K, Yu Y, et al. A deficiency in DNA repair and DNA-PKcs expression in the radiosensitive BALB/c mouse. Cancer Res 2000;60:4342-4345