Comparative study about use of propolis and royal jellies in treatment of chemically induced oral mucositis: Experimental study in vivo
Oral mucositis; Treatment; Signaling pathways; Phytotherapics; Oxidative stress.
Purpose: Evaluate effects of propolis, royal jellies comparing to low-intensity laser photobiomodulation therapies on an animal model of 5-fluorouracil (5-FU)-induced Oral Mucositis (OM). Material and Methods: It is an In vivo, experimental, controlled and blind study. Seventy-two male Wistar rats were randomly allocated into four groups (n=18): control (no treatment), photobiomodulation therapy (PBMT) (intraoral laser 6 J/cm2), propolis gel (P) and royal jelly (RJ). On days 0 and 2, animals received an intraperitoneal injection of 5-FU. On Days 3 and 4, the buccal mucosa was scratched. Therapies were initiated on Day 5. Six animals per group were euthanized on Days 8, 10, and 14. Phytochemical analysis of P and RJ were performed by Thin Layer Chromatography (TLC). Clinical analysis was performed using photography and histopathological (Hematoxylin / Eosin) evaluation was based on re-epithelization and inflammation scores. Immunohistochemical (pAKT, p-S6 and NFκB) and oxidative stress studies (Superoxide Dismutase-SOD, Glutathione reduced- GSH and Malonyldialdehyde-MDA) were investigated. Results: TLC analysis revealed the presence of compounds such as terpenes, saponins, essential oils and flavonoids in P and a high amount of sucrose (Rf 0.34) in RG. On days 8 and 10, the animals of PBMT, P and GR groups showed clinical improvement of OM and accelerated healing with lower morphological scores, increased immunoexpression of pS6 proteins (except on day 10), pAKT (p <0.05, ANOVA and Tukey test) and NF-kB transcription factor (Mann Whitney test; p <0.05) when compared to the group control. On day 14, group P increased the GSH antioxidant levels when compared to the control group (p <0.05, ANOVA and Tukey test). Conclusions: Our results showed that P and GR, as well as PBMT with intraoral laser, are effective therapies in the treatment of OM. The presence of sugars in GR and flavonoids, terpenes and essential oils in P justifies the excellent wound healing action and its anti-inflammatory effects. The presence of sugars in the GR and flavonoids in the P justifies the excellent wound healing action and its anti-inflammatory effects. Additionally, the propolis-treated group exhibited better oxidative stress reduction characteristics in 5-FU-induced OM in rats when compared to the other treatment groups.