Challenges in the local delivery of peptides and proteins for oral mucositis management

Eur J Pharm Biopharm. 2018 Jul:128:131-146. doi: 10.1016/j.ejpb.2018.04.025. Epub 2018 Apr 24.

Abstract

Oral mucositis, a common inflammatory side effect of oncological treatments, is a disorder of the oral mucosa that can cause painful ulcerations, local motor disabilities, and an increased risk of infections. Due to the discomfort it produces and the associated health risks, it can lead to cancer treatment restrains, such as the need for dose reduction, cycle delays or abandonment. Current mucositis management has low efficiency in prevention and treatment. A topical drug application for a local action can be a more effective approach than systemic routes when addressing oral cavity pathologies. Local delivery of growth factors, antibodies, and anti-inflammatory cytokines have shown promising results. However, due to the peptide and protein nature of these novel agents, and the several anatomic, physiological and environmental challenges of the oral cavity, their local action might be limited when using traditional delivering systems. This review is an awareness of the issues and strategies in the local delivery of macromolecules for the management of oral mucositis.

Keywords: Cancer; Cytokines; Drug delivery; Growth factors; Oral mucositis; Peptides and proteins; Radiation and chemotherapy.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects*
  • Cytokines / administration & dosage
  • Cytokines / pharmacokinetics
  • Humans
  • Intercellular Signaling Peptides and Proteins / administration & dosage
  • Intercellular Signaling Peptides and Proteins / pharmacokinetics
  • Mouth Mucosa / drug effects
  • Mouth Mucosa / metabolism*
  • Neoplasms / drug therapy*
  • Peptides / administration & dosage
  • Peptides / pharmacokinetics
  • Permeability
  • Saliva / chemistry
  • Stomatitis / chemically induced
  • Stomatitis / drug therapy*

Substances

  • Anti-Inflammatory Agents
  • Antineoplastic Agents
  • Cytokines
  • Intercellular Signaling Peptides and Proteins
  • Peptides