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By Sylvain Choquet

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Beattie G, Whelan J, Cassidy J, Milne L, Burns S, Leonard R (1989) Herpes simplex virus, Candida albicans and mouth ulcers in neutropenic patients with non-haematological malignancy. Cancer Chemother Pharmacol 25:75–76 20. Bergmann OJ (1992) Oral infections in haematological patients—pathogenesis and clinical significance. Dan Med Bull 39(1):15–29 21. Schimpff SC (1980) Infection prevention during profound granulocytopenia: new approaches to alimentary canal microbial suppression. Ann Intern Med 93:358–361 22.

Central in the pathogenesis of most of these inflammatory conditions is the occurrence of conditioning-induced tissue damage and disturbance of the normal host bacterial homeostasis in these tissues. Chemotherapy and radiotherapy initiate an inflammatory cascade by activating nuclear factor-jB [99], resulting in the production and release of pro-inflammatory cytokines and chemokines (IL-1, IL-6, IL-8, TNFa, IFNc) by macrophages, IECs, and endothelial cells [99–101]. This inflammatory response is subsequently aggravated by the loss of barriers facilitating the translocation of microbes or microbial wall components stimulating PRRs [102–104] finally, resulting in clinical disorders.

Eng) 99. Sonis ST (2002) The biologic role for nuclear factor-kappaB in disease and its potential involvement in mucosal injury associated with anti-neoplastic therapy. Crit Rev Oral Biol Med 13(5):380–389 (PubMed PMID: 12393757. Epub 2002/10/24. Eng) 100. Logan RM, Stringer AM, Bowen JM, Yeoh AS, Gibson RJ, Sonis ST, et al (2007) The role of pro-inflammatory cytokines in cancer treatment-induced alimentary tract mucositis: pathobiology, animal models and cytotoxic drugs. Cancer Treat Rev 33(5):448–460 (PubMed PMID: 17507164.

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