Discussion
pulpitis, swelling, inflammation, edema, periodontitis, infections, pain, infection, active periodontal diseases, friction, mucositis, ALL, Acute leukemia, acute leukemia
PERIODONTAL DISEASE, PULPITIS, ACUTE LEUKEMIA, PERIAPICAL PERIODONTITIS, INFLAMMATORY RESPONSES, INFLAMMATION, EDEMA, INFECTIONS, REMISSION, MUCOSITIS, DISEASES, ACUTE LEUKEMIA, PERIODONTITIS, INFECTION, COMPLICATIONS, INFILTRATE, DISEASE, MALNUTRITION, MUCOSAL INFLAMMATION
Acute leukemia is a malignant clonal disease involving hematopoietic stem cells. Abnormal primitive cells proliferate and extensively infiltrate the bone marrow to inhibit normal hematopoiesis. At present, combined chemotherapy remains the primary form of treatment for acute leukemia. Acute leukemia commonly causes OM due to the characteristics of the disease itself and the influence of chemotherapy drugs [OM causes local redness, swelling and pain, difficulty chewing, and issues with the patient’s normal eating. If left untreated for a long time, these symptoms can lead to malnutrition, further weakening the patient’s resistance, exacerbating infections, intensifying pain, prolonging treatment time, and imposing a greater financial burden on the patient [IL-11 is an anti-inflammatory factor in the interleukin family. IL-11 not only stimulates the differentiation and maturation of hematopoietic progenitor cells (megakaryocytes, granulocytes, and erythroid cells) but also counteracts and regulates the inflammatory cytokines produced by infection and damage caused by inflammation through a negative feedback regulation mechanism. At the same time, IL-11 acts on epithelial cells, maintains metabolism and homeostasis, and protects and strengthens the mucosal epithelium, thereby reducing edema and inhibiting inflammatory responses [In this study, patients with acute leukemia who were treated with chemotherapy were selected as research subjects to observe the occurrence time, severity, pain, degree, duration, mucosal healing time, and effects of OM after topical treatment with IL-11 gargle on eating. Our results showed that IL-11 treatment could not completely prevent the occurrence of OM, but did reduce the incidence and grade of the condition. Furthermore, IL-11 treatment lowered pain caused by OM, reduced its impact on eating, and promoted mucosal recovery. Preventing OM complications not only relieved patients of potential pain but also ensured the intensity and efficacy of chemotherapy, thus improving the prognosis of acute leukemia. Overall, we concluded that IL-11 was effective in treating OM. However, further research is needed on the mechanism of IL-11 in treating mucositis. More specifically, future research should use subgroup analysis to better understand how IL-11 reduces the effects of cytokines and promotes the repair of mucosal epithelial cells.Periodontal diseases such as pulpitis, periapical periodontitis, and periodontitis that already exist in patients before chemotherapy can also impact the occurrence and development of oral mucosal inflammation. We excluded patients with active periodontal diseases that required treatment before the study and tried to exclude the impact of this factor on the results. In this study, 11 elderly patients used dentures, including 6 in the IL-11 group and 5 in the control group. The friction and movement of dentures might cause oral mucosal inflammation and worsen oral mucosal inflammation, but no difference was found between the two groups and the analysis of later results was not affected.Cell subsets, including CD3+, CD4+, and CD8 + cells, are important indicators for evaluating the immune function of the body. All T cells are positive for CD3 and further divided into CD4+, CD8+, and regulatory T cells based on their respective function. CD4 + cells mediate cellular immune responses and assist humoral immune responses. The main function of CD8 + cells is to kill target cells specifically and directly. CD4 + and CD8 + cells are in a constant state of balance and play an essential role in maintaining normal immune function. A decrease in the ratio of CD4 + to CD8 + cells indicates that the immune function of the body is in an imbalanced state, which may easily lead to various diseases including OM [OM treatment excludes the application of anti-infection and biological factors, and includes other drug and nondrug therapies. For example, most of the patients with ALL had OM of grade III or above during the high-dose methotrexate course in this trial. The treatment for these patients included not only IL-11 but also local and systemic administration of leucovorin to reduce the damage caused by chemotherapy and speed up mucosal healing. In addition, various oral mucosa protective agents, oral care solutions, traditional Chinese medicine preparations, honey adjuvants, and other natural medicines can be used to improve the discomfort caused by OM, effectively reducing the incidence of mucositis and improving its remission rate [The findings indicate that the incidence and severity of OM are affected by different chemotherapy or radiotherapy protocols [This study had several limitations. First, it was a single-site, prospective, observer-blinded, nonrandomized controlled trial. It had small sample size and included patients who received treatment in our hospital, leading to bias in the analysis results. We need to further expand the sample size in future studies to increase the credibility of the findings. Second, the single application of IL-11 in treating oral mucosal inflammation had limited efficacy, and the combined effects of other drugs and nondrug treatments were not addressed in this study. Finally, the mechanism of IL-11 in treating oral mucosal inflammation needs further basic experimental research.In summary, a precise prevention plan should be formulated according to risk stratification for treating OM after chemotherapy for acute leukemia. Besides IL-11 gargle, individualized prevention and treatment regimens for OM should incorporate other drugs and nonpharmaceutical measures. We may better relieve suffering and improve quality of life by providing personalized treatment plans according to the characteristics of the patient.