For UK Healthcare Professionals Only

What is mucositis?

Mucositis describes inflammatory and/or ulcerative lesions of the mucosa, which often result from chemotherapeutic agents or radiation.12 It is a common complication of cancer treatments, which can have significant, and sometimes dose-limiting, consequences.13

Oral Mucositis (OM)

OM is an acute inflammatory and ulcerative complication of the mucosal membrane that commonly occurs during cancer therapy. OM is one of the side-effects14 of cancer treatment and can result from systemic chemotherapy, radiation therapy, or a combination of the two.

Proctitis (rectal mucositis)

Actinic proctitis, caused by radiation treatment in the pelvic region; and proctitis caused by chemotherapy is inflammation of the rectal mucosa.

Radiation proctitis, or radiation induced rectal mucositis, is defined as an inflammatory process of the rectal mucosa that can occur almost immediately after the initiation of therapy or in some cases, up to 3 months after starting treatment.15 Symptoms of acute radiation proctitis include burning pain sensations, diarrhoea, nausea, cramps, tenesmus, urgency, mucous discharge, and minor bleeding.

Vulvovaginitis (vaginal mucositis)

Actinic vulvovaginitis caused by radiation treatment in the pelvic region and vulvovaginitis caused by chemotherapy, is the inflammation of the vaginal mucosa.

What is Mucosamin®?

  • Protects
  • Relieves
  • Heals

The Mucosamin® range contains Sodium hyaluronate and amino acids, which helps to treat and relieve the symptoms of mucositis. Mucosamin® protects the healthy mucosa, whilst providing pain relief and promoting wound healing of painful lesions.

How does Mucosamin® work

Mucositis

  • Protection

    Helps to maintain mucosal integrity¹

    Forms a barrier to help protect the oral mucosa3

  • Relief

    Hydrates and modulates osmotic balance4

    Creates a film to cover exposed nerve endings5

    Helps reduce inflammation6

    Protects local mucosa from free radicals to prevent tissue injury1,7

  • Healing

    Supports epithelial wound repair2,7

Dry mouth

Adhesion

  • Hyaluronic acid (HA) has mucoadhesive properties and binds to proteoglycans on the surface of oral epithelial cells, through the formation of hydrogen bonds and electrostatic interactions.8

 

 

 

Hydration

  • HA binds to water at the mucosa through the formation of hydrogen bonds with water molecules4,9
  • Increased levels of HA associated with greater saliva production10
  • HA modulates tissue hydration and osmotic balance4

 

Relief

  • Due to the mucoadhesive and hydrating properties of HA, moisture is retained at the mucosa to provide relief of symptoms.

 

 

 

 

The role of hyaluronic acid (HA)

The role of amino acids (glycine, L-proline, L-leucine and L-lysine HCl)

 

References

  • Reference 1.
    Cirillo, N. et al. (2014) A hyaluronic acid-based compound inhibits fibroblast senescence induced by oxidative stress in vitro and prevents oral mucositis in vivo. J of Cell Phys.
  • Reference 2.
    Mucosamin Mouthwash and Oral Spray IFUs
  • Reference 3.
    1010461483 v 1.0 October 2018 Data on File
  • Reference 4.
    Mariggio M.A. et al. (2009) Enhancement of fibroblast proliferation, collagen biosynthesis and production of growth factors as a result of combining sodium hyaluronate and amino acids. Int J Immunopathol Pharmacol, 22: 485-492
  • Reference 5.
    Campos, M. et al. Oral mucositis in cancer treatment: Natural history, prevention and treatment (review). Mol Clin Oncol. 2014: 2; 337- 340
  • Reference 6.
    Kapoor, P. et al. (2011) Topical hyaluronic acid in the treatment of oral ulcers. Indian J Dematol. 56(3): 300-302
  • Reference 7.
    Colella, G. et al. (2010) Efficacy of a spray compound containing a pool of collagen precursor synthetic amino acids (L-Proline, L-Leucine, L-Lysine and Glycine) combined with sodium hyaluronate to manage chemo/radiotherapy-induced oral mucositis. Int J Immunopathol Pharmacol, 23(1):143-15
  • Reference 8.
    Walicova, V. et al. (2016) The influence of hyaluronan addition on thickness, weight, uniformity of mass and water content of mucoadhesive films. Czech and Solvak Pharmacy, 65(3); 94-98
  • Reference 9.
    Manasa, M. et al. (2012) A Review of Hyaluronic Acid. Int. J. Res. Chem. Environ, 2(4); 6-11.
  • Reference 10.
    Higuchi, Y. et al. (2009) Salivary levels of hyaluronic acid in female patients with dry mouth compared with age-matched controls: a pilot study. Biomedical Research, 30(1): 63-68
  • Reference 11.
    Colella, G. et al. (2009) Amino acid-enriched sodium hyaluronate enhances keratinocyte scattering, chemotaxis and wound healing through integrin B1 dependent mechanisms. The Journal of Stomatological Investigation, 3: 21-29.
  • Reference 12.
    Peterson, D. et al. on behalf of the ESMO Guidelines Committee Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up, Annals of Oncology, Volume 26, Issue suppl_5, September 2015, Pages v139–v151, https://doi.org/10.1093/annonc/mdv202 [Accessed July 2020]
  • Reference 13.
    Oral Cancer Foundation. Mucositis. https://oralcancerfoundation.org/complications/mucositis/ (Accessed July 2020).
  • Reference 14.
    European Oncology Nursing Society. Oral mucositis guidelines. Available from: https://www.ons.org/pep/mucositis?display=pepnavigator&sort_by=created&items_per_page=50 [Accessed October 2020]
  • Reference 15.
    Do, N. L. et al. Radiation proctitis: Current strategies in management. Gastroeneterol Res Pract