The Protective Role of Statins against 5-Flourouracil- induced Oral Mucositis in Colorectal Cancer Patients. | ||
| Archives of Pharmaceutical Sciences Ain Shams University | ||
| Articles in Press, Accepted Manuscript, Available Online from 18 March 2025 | ||
| Document Type: Review Article | ||
| DOI: 10.21608/aps.2025.342950.1211 | ||
| Authors | ||
| Radwa Salah Lotfy* 1; Lamiaa Mohamed El Wakeel2; Rasha Aboelhassan3; May Ahmed Shawki4 | ||
| 1Clinical Pharmacy Department, Nasser Institute for Research and Treatment, Cairo, Egypt | ||
| 2Clinical Pharmacy Department, faculty of pharmacy, Ain Shams University | ||
| 3Adult Oncology Department, Nasser Institute for Research and Treatment | ||
| 4Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University | ||
| Abstract | ||
| Purpose: Oral mucositis (OM) is one of the most frequent complications affecting colorectal cancer (CRC) patients receiving 5-fluorouracil (5-FU). The release of inflammatory cytokines like tumor necrosis factor alpha (TNF-alpha) and generation of reactive oxygen species (ROS) may play a significant role in the development and progression of OM. Statins have shown pleiotropic effects including anti-inflammatory and antioxidant activity. Hence, they might play a protective role against 5-FU induced OM. This review aims to discuss the evidence from preclinical and clinical studies regarding the potential benefits of statins in this area. Methods: The Egyptian Knowledge Bank, Google Scholar and PubMed databases were searched for published preclinical and clinical articles describing the anti-inflammatory antioxidant activity of statins and their potential role in the prevention of 5-FU induced OM from English sources. Research was performed using different key words: such as, “pathophysiology of 5-FU induced oral mucositis”, “inflammatory cytokine and 5-FU induced oral mucositis”, “oxidative stress and 5-FU induced oral mucositis”, “pleotropic effect of statins OR (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors)”, “statins in 5-FU induced oral mucositis”. Relevant resources were extracted using source pulling method of the references. Findings: Multiple studies have proven the anti-inflammatory and antioxidant properties of statins. It showed that statins can inhibit nuclear factor kappa-B (NF-KB) which consequently inhibits the subsequent cascade of inflammatory cytokines release such as TNF-alpha plus the reduction of ROS such as malondialdehyde (MDA). The effects of statins on mucositis in animal and human models have been investigated and the results were promising. | ||
| Keywords | ||
| colorectal cancer; 5-FU, oral mucositis; TNF alpha; statins; inflammatory response; oxidative stress; pleiotropic effect | ||
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