1. The Intersection of the Oral Microbiome and Salivary Metabolites in Head and Neck Cancer: From Diagnosis to Treatment.
- Author
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Gonzalez Agurto, Maria, Olivares, Nicolas, Canedo-Marroquin, Gisela, Espinoza, Daniela, and Tortora, Sofia C.
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HEAD & neck cancer diagnosis , *HEAD & neck cancer treatment , *RADIOTHERAPY , *HUMAN microbiota , *EVALUATION of medical care , *CANCER patients , *METABOLITES , *CANCER chemotherapy , *SALIVA - Abstract
Simple Summary: Head and neck cancers (HNCs) represent 4–5% of all malignancies globally. Salivary metabolites, as metabolic intermediates and signalling molecules, are gaining attention as diagnostic biomarkers for several diseases, including HNC; however, the metabolites' role in cancer treatment outcomes and oral side effects remains underexplored. Current studies focus on the oral microbiome's significance in promoting a pro-inflammatory environment that facilitates tumour development and invasion. Specific microorganisms and their metabolites influence chemotherapy efficacy through several mechanisms. Radiotherapy (RT), a standard HNC treatment, can modify the oral microbiota and salivary metabolite profiles, leading to a wide range of side effects. To reduce oral complications, intensity-modulated radiotherapy (IMRT) was developed; however, cancer survivors often experience a reduced quality of life. This review highlights the microbial and host interactions affecting salivary metabolites and their implications for cancer treatment and patient outcomes. Head and neck cancers (HNCs) are the seventh most common cancer worldwide, accounting for 4–5% of all malignancies. Salivary metabolites, which serve as key metabolic intermediates and cell-signalling molecules, are emerging as potential diagnostic biomarkers for HNC. While current research has largely concentrated on these metabolites as biomarkers, a critical gap remains in understanding their fluctuations before and after treatment, as well as their involvement in oral side effects. Recent studies emphasise the role of the oral microbiome and its metabolic activity in cancer progression and treatment efficacy by bacterial metabolites and virulence factors. Oral bacteria, such as P. gingivalis and F. nucleatum, contribute to a pro-inflammatory environment that promotes tumour growth. Additionally, F. nucleatum enhances its virulence through flagellar assembly and iron transport mechanisms, facilitating tumour invasion and survival. Moreover, alterations in the oral microbiome can influence chemotherapy efficacy and toxicity through the microbiota–host irinotecan axis, highlighting the complex interplay between microbial communities and therapeutic outcomes. Salivary metabolite profiles are influenced by factors such as gender, methods, and patient habits like smoking—a major risk factor for HNC. Radiotherapy (RT), a key treatment for HNC, often causes side effects such as xerostomia, oral mucositis, and swallowing difficulties which impact survivors' quality of life. Intensity-modulated radiotherapy (IMRT) aims to improve treatment outcomes and minimise side effects but can still lead to significant salivary gland dysfunction and associated complications. This review underscores the microbial and host interactions affecting salivary metabolites and their implications for cancer treatment and patient outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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