Published online Nov 15, 2017. doi: 10.4291/wjgp.v8.i4.176
Peer-review started: March 20, 2017
First decision: May 3, 2017
Revised: May 20, 2017
Accepted: June 30, 2017
Article in press: July 3, 2017
Published online: November 15, 2017
Processing time: 240 Days and 11.6 Hours
To determine if almond extracts reduce the severity of chemotherapy-induced mucositis as determined through biochemical, histological and behavioural markers.
Intestinal mucositis is a debilitating condition characterized by inflammation and ulceration of the gastrointestinal mucosa experienced by cancer patients undergoing chemotherapy. Certain bioactive plant products have shown promise in accelerating mucosal repair and alleviating clinical symptoms. This study evaluated almond extracts for their potential to reduce the severity of chemotherapy-induced mucositis in Dark Agouti rats. Female Dark Agouti rats were gavaged (days 3-11) with either PBS, almond hull or almond blanched water extract at two doses, and were injected intraperitoneally with 5-fluorouracil (5-FU-150 mg/kg) or saline on day 9 to induce mucositis. Burrowing behavior, histological parameters and myeloperoxidase activity were assessed.
Bodyweight was significantly reduced in rats that received 5-FU compared to saline-treated controls (P < 0.05). Rats administered 5-FU significantly increased jejunal and ileal MPO levels (1048%; P < 0.001 and 409%; P < 0.001), compared to healthy controls. Almond hull extract caused a pro-inflammatory response in rats with mucositis as evidenced by increased myeloperoxidase activity in the jejunum when compared to 5-FU alone (rise 50%, 1088 ± 96 U/g vs 723 ± 135 U/g, P = 0.02). Other extract-related effects on inflammatory activity were minimal. 5-FU significantly increased histological severity score compared to healthy controls confirming the presence of mucositis (median of 9.75 vs 0; P < 0.001). The extracts had no ameliorating effect on histological severity score in the jejunum or ileum. Burrowing behavior was significantly reduced in all chemotherapy-treated groups (P = 0.001). The extracts failed to normalize burrowing activity to baseline levels.
Almond extracts at these dosages offer little beneficial effect on mucositis severity. Burrowing provides a novel measure of affective state in studies of chemotherapy-induced mucositis.
Core tip: In spite of their procyanadin content and anti-oxidant capacity the almond extracts tested failed to provide any ameliorating effect on chemotherapy-induced mucositis in rats as determined through biochemical and histological evaluation. Currently studies utilising animal models of gastrointestinal disease largely fail to assess measures of patient affect. In order to achieve successful translational outcomes assessment of patient experience is important since these disease conditions are often self-limiting. Burrowing behaviour shows promise as a novel measure of affective state in studies of chemotherapy-induced mucositis.