Safran Cabin has announced the appointment of Frank Riom as Executive Vice President of Safran Cabin Services
where he has brought valuable experience to various roles
including as A380 Program Manager and A350 Program Manager
Riom has also led the European services branch of Safran’s cabling division
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Castignac, the French logistics platform owned by leading global alternative asset manager, Brookfield
today announces the acquisition of three prime location assets in France
1,154,500 sqft off-market portfolio comprises a 588,258 sqft site in Riom
a 406,941 sqft site in Vert-Saint-Denis and a 159,350 sqft site in Grenay
The Riom site is leased while the other two sites are available to let
These acquisitions take the Castignac portfolio to 30 assets and projects worth over €1 billion under management
They follow the addition of warehouses in Paris
Lyon and Orleans to the portfolio last year
Castignac’s continued focus is on investment in strategically located supply chain facilities to meet tenant demand for Grade A assets with tactical transport links to major hubs in France and elsewhere in Europe
The deal was brokered by Cushman & Wakefield with DLA Piper acting as lawyer and Etude NOTER as notary
while ICPE and environmental due diligences were undertaken by Andine GROUP
Julien Claude Bouilly, Managing Director, Head of Investments and Asset Management, Castignac, said: “This off-market portfolio acquisition concludes an exceptional investment year in 2024 for Castignac. This strengthens our strategic presence in Paris and Lyon, which are key logistics hubs in France
We are pleased to expand our presence in these critical areas
enabling us to better assist both existing and new tenants in strengthening their supply chains so they remain agile as markets continue to evolve.”
French Robots-in-Ports Plan Receives Funding Boost
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Tonight, we may see two worlds collide
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While the luxury sector seems to be in decline
Hermès stands out with the opening of its 23rd leather workshop in France
The luxurious Maison has recently completely renovated a former 7000m2 tobacco factory
an industrial site listed as a historic monument
This opening is part of the leatherworker's eco-responsible approach
aiming to select local partner companies and to source and use sustainable materials for the renovation
Hermès explained that it entrusted the Tracks-Architects firm with the renovation of these buildings
giving them the mission to reconcile the group's real estate strategy's CSR ambitions with the spirit of the Maison
The workshop employs 250 artisans who have been internally trained over the past few months in the unique skills of the independent luxury Maison
The group relied on the expertise of teams from its other leather workshop in Auvergne
located about twelve kilometers away and opened 20 years ago
Hermès aims to preserve its artisanal excellence
it opened the École Hermès des Savoir-Faire
an apprentice training center accredited by the Ministry of National Education
authorized to issue the Leatherworking Professional Aptitude Certificate and the Cutting Professional Qualification Certificate
The core business of the luxury group, leather goods and saddlery, recorded a 15.7% increase in sales in the first half
Hermès is increasing its production capacity
opening on average one new leather workshop per year for the past ten years
where recruitment and training are ongoing
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saw its first-half sales rise by 15.7% year-on-year to more than 3.2 billion euros
Group sales for the period rose by 12% to €7.5 billion.To meet this growing demand
Hermès has been increasing its production capacity at an average rate of one new leather goods production unit per year for the past ten years
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© Guillaume AmatA large exhibition hall
This one opens very largely on the “Jardin de la Culture”
This generous and continuous space is extended by a covered outdoor gallery perforated by the arches
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This plan’s organization manage viewers flows by proposing a quality path around the topic of the cinema’s world
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Tracks Architectes is an architectural firm founded in 2014 by architects Moïse Boucherie and Jeremy Griffon
Their professional development is based on a frugal architectural approach
which emphasizes the narrative and contextual aspects of a project
Each proposal develops a story deeply rooted in its program
and the revelation of a site's riches are themes of reflection that define the foundations of their projects
Throughout their career they have received a series of awards and nominations
such as those mentioned below: Mention at the 2018 First Work Prize for the "La colmena" nursery school in Perthes-en-Gâtinais (2018)
Exhibition "La arquitectura manifesta" at ENSA Bretagne in Rennes (2018)
Mention at the 2019 International Prize for Wood Architecture for the "La colmena" nursery school in Perthes-en-Gâtinais (2019)
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First National Prize for Construction Timber for the "La colmena" nursery school in Perthes-en-Gâtinais (2019)
First Regional project award for wood construction in Ile-de-France (2023)
First prize in the equipment category of the Grand Prix for terracotta tile architecture (2024)
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Radiation-induced oral mucositis (RIOM) is a prevalent oral complication that occurs in individuals undergoing radiotherapy or radiation treatment for head and neck tumors
The presence of oral mucosal rupture and ulcerative lesions
which are the defining features of this condition
can significantly affect the quality of life of patients
it can interfere with tumor therapy and contribute to an unfavorable prognosis
Current evidence suggests that cellular inflammation and programmed cell death are important factors in disease development
thalidomide (THD) has been revealed to reduce the incidence and severity of RIOM in patients undergoing chemoradiotherapy for nasopharyngeal carcinoma
the mechanism through which THD improves RIOM remains unknown
This study aimed to investigate the role of LZTS3 in RIOM by analyzing various sequencing datasets and conducting knockdown and overexpression experiments
We used small interfering RNA transfection and LZTS3 overexpression
followed by validation through polymerase chain reaction
we identified LZTS3 as a potential target for THD regulation in RIOM
we confirmed that LZTS3 has the ability to inhibit the inflammatory response and apoptosis of cells
we also found that THD can regulate the expression of LZTS3 by upregulating
thereby affecting inflammatory response and apoptosis
We repeated these results in a live animal model
THD has the potential to reduce the occurrence of oral mucositis in patients by upregulating LZTS3 levels
These findings provide a promising avenue for future drug research and development to treat RIOM
But LZTS3 has not been reported to play a role in the regulation of RIOM
I conducted knockdown and overexpression experiments of LZTS3 in irradiated cell models
and discussed the effects of THD and radiation on LZTS3
mouse models were developed to examine the protective mechanism of THD against RIOM
with a specific focus on its effect on programmed cell death and immune system responses
These findings hold potential for the identification of therapeutic targets for RIOM patients
Established guidelines for animal experiments were adhered to in this study
to ensure standard ARRIVE guidelines are followed
The protocol of this study was consistent with those of the national studies and adhered to council recommendations for the treatment and utilization of animals in laboratory settings
We acquired 4-week-old male C57BL/6J mice from the Animal Laboratory Center at Guangxi Medical University
housing them in a specific pathogen-free environment
we randomly assigned 25 mice to five groups
Mice in the RT group were exposed to 16 Gy of radiation at a 600 Mu/min rate and were administered normal saline injections daily
mice underwent the same radiation exposure
mice underwent the same radiation exposure and THD treatment via a daily intraperitoneal injection of 40 mg/mL THD (dimethylsulfoxide [DMSO] dissolution; dose
were injected with LZTS3 negative plasmid packaged with adeno-associated virus AAV1
and were treated with THD daily (intraperitoneal injection
40 mg/mL THD at a dose of 100 mg/kg) for 7 days
were injected with LZTS3 plasmid packaged with adeno-associated virus AAV1
all mice with fully damaged tongues were collected for further analysis 12 days later
All mice were killed by cervical dislocation
We obtained and cultured human oral epithelial cell lines (HOEC
340217) in a humid environment at 37 °C with 5% CO2
using a complete medium for human oral epithelial cells (CM-H203
There was no mycoplasma infection during cell culture
and the cells were transfected after two passes
HOECs were transfected with the LZTS3 overexpression plasmid (oeLZTS3)
small interfering RNA (siLZTS3) and small interfering RNA negative control (siNC)
This process involved using Lipofectamine 6000 reagent (Thermo Fisher Scientific
USA) following the manufacturer’s instruction
and RT + Th + OE-LZTS3 groups were pre-treated with a 10 mg/mL THD solution (dissolved in DMSO) for 24 h
the medium was replaced in preparation for further experiments
and all the RT groups underwent radiotherapy with a 6 Gy dose for approximately 1.1 min
After the harvested cells were washed twice in PBS
they were added to 1 mL ice bath and pre-cooled in 70% ethanol
followed by flow cytometry (CytoFLEX; BECKMAN COULTER) analyzed the cell cycle and used ModFit LT 5.0 to determine the proportion of cells in each sample at each stage
Tongue tissues were fixed in 4% paraformaldehyde and then preserved in paraffin
3 μm sections were prepared and stained with H&E and Masson’s trichrome
The CCK-8 cytotoxicity assay required seeding cells in a 96-well plate with a clear bottom at a density of 2 × 104 cell/ml
The cells were treated according to the manufacturer’s instructions (BS350B
and they were quantified using a multifunctional enzyme reader (FilterMax F3
the supernatant underwent homogenization and centrifugation at 4 ° C at 2000 rpm for 20 min
and IL-1a levels according to the instructions provided with the kit
The results were standardized to β-actin as an internal reference
and protein expression levels were quantified using Image J
Cellular damage was assessed using fluorescein isothiocyanate (FITC)-annexin V/propidium iodide (PI) staining
Fluorescent signals were detected with FACScan (BECKMAN COULTER
and FlowJo was used to analyze cellular apoptosis
Early apoptotic cells were identified as annexin-V-FITC+/PI-
late apoptotic cells as annexin-V-FITC+/PI+
The obtained mouse tongue tissues were preserved with formalin and fixed with paraffin wax
The tissue was further cut to a thickness of 3 μm
dewaxed to water and then antigen repaired
followed by exposure to anti-rat LZTS3 antibodies (1:400) and stored at 4 °C for 12 h
the slides were rinsed with PBS and exposed to biotinylated enzymic secondary antibody for 30 min
The slides treated with streptavidin biotin HRP complex were further treated with DAB chromogenic agent and stained with hematoxylin
Data are expressed using mean ± standard deviation from a minimum of three distinct experiments
To assess the differences among various groups
a one-way analysis of variance (ANOVA) was conducted
The normality of the data distribution had been assessed before the parameter test was performed
Data between groups were compared using a t-test
Statistical analysis was conducted using SPSS v25.0
while charts were constructed using Prism v7.0
The outcome of the bilateral examination was considered statistically significant at a significance level < 0.05
(A) Cell activity was measured by MTT assay
and the results showed the effect of different doses of X-ray irradiation on HOEC activity; (B) MTT assay was used to detect cell activity
the results showed that thalidomide at 10μM concentration had the best recovery effect on cell activity; (C) ELISA results showed that thalidomide could effectively inhibit RIOM cell inflammatory factors; (D) The volcano map showed that the expression of differential genes increased in the RIOM cell model after the addition of thalidomide
and the six genes with the most obvious upregulation and statistical significance were highlighted in red (Log2FC > 3
p < 0.01); (E) RT-qPCR results showed that the transcription level of IL-1β in RIOM cell models decreased significantly after overexpression of LZTS3; (F) ELISA results showed that the IL-1β
Apoptosis-associated protein expression was assessed using western blotting (WB)
Evaluation of OD value at 450 nm using CCK-8 assay following transfection
Flow cytometry was used to determine the apoptosis ratios of HOECs after transfection (*p < 0.05
These results suggest that LZTS3 can protect cells from apoptosis
LZTS3 enhances the production of inflammatory cytokines in HOECs
ELISA was used to assess the protein expression levels of IL-1α (D)
WB was used to detect protein expression levels associated with inflammation (G)
including NF-κB p65 (H) and p-NF-κB p65 (I)
THD decreased radiation-induced cell apoptosis
Apoptosis-associated protein expression was assessed using western blotting (WB) (D)
Evaluation of OD value at 450 nm using CCK-8 assay following transfection (K)
Flow cytometry (L) was used to measure the apoptosis ratios of HOECs after transfection (n = 3
Between different groups after radiotherapy
apoptosis rate and the introduction of THD relationship (J)
WB analysis (G) was performed to determine protein expression levels associated with inflammation
specifically of NF-κB p65 (H) and p-NF-κB p65 (I)
THD inhibits apoptosis by downregulating LZTS3 in irradiated mice
(A) Immunohistochemical staining of LZTS3; (B) Statistical diagram of staining intensity of LZTS3; H&E staining (C) and Masson staining (D) of the tongue tissue
and caspase-9 (M) was analyzed using western blotting (E)
THD reduces inflammation in irradiated mice
specifically NF-κB p65 (H) and p-NF-κB p65 (I)
Researchers have long strived for the safety and effective control of RIOM
no reports on LZTS3 involvement in RIOM exist
reveal that LZTS3 can inhibit apoptosis and pro-inflammatory cytokine secretion in RIOM
this study elucidated the mechanism by which THD can effectively treat RIOM by evaluating LZTS3 levels
thereby providing further support for its clinical utilization
LZTS3 was observed to inhibit pro-inflammatory molecule secretion
LZTS3 could influence apoptosis by affecting Bax
To inhibit the radiation-induced downregulation of LZTS3
THD up-regulate LZTS3 expression at the transcriptional and protein levels
consequently mitigating apoptosis and pro-inflammatory factor release
as THD effectively inhibited apoptosis and inflammation by upregulating LZTS3 expression in an irradiated mouse model
our sequencing data originated from processed cell lines
RIOM pathogenesis differs significantly across various stages
making it uncertain at which stage THD contributes
We should further explore the combined application of thalidomide with other therapeutic methods such as immunotherapy
and further verify the difference in efficacy through experimental data
this study identified the downstream acting factor LZTS3 that THD plays a therapeutic role in RIOM
LZTS3 can inhibit cell apoptosis and the release of inflammatory factors
and THD plays a protective role by up-regulating LZTS3
This lays a solid foundation for the medical application of THD and provides a potential target for the future treatment of RIOM
Data will be availability on reasonable request
The broadening scope of oral mucositis and oral ulcerative mucosal toxicities of anticancer therapies
Evaluation of radiation-induced oral mucositis by optical coherence tomography
Clin cancer Research: Official J Am Association Cancer Res
and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies
Adjunctive treatments for the prevention of chemotherapy- and radiotherapy-induced mucositis
Oral mucositis: an update on innate immunity and new interventional targets
Oral mucositis induced by anticancer therapies
Oral mucositis complicating chemotherapy and/or radiotherapy: options for prevention and treatment
Mucositis as a biological process: a new hypothesis for the development of chemotherapy-induced stomatotoxicity
Chemotherapy- and radiotherapy-induced oral mucositis: pathobiology
SADJ: J South Afr Dent Association = Tydskrif Van die Suid-Afrikaanse Tandheelkundige Vereniging
Thalidomide ameliorates rosacea-like skin inflammation and suppresses NF-κB activation in keratinocytes
Thalidomide represses inflammatory response and reduces radiculopathic pain by inhibiting IRAK-1 and NF-κB/p38/JNK signaling
Thalidomide use in the management of oromucosal disease: a 10-year review of safety and efficacy in 12 patients
Modulation of radiation-induced oral mucositis by thalidomide: preclinical studies
Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft
Efficacy and safety of thalidomide in preventing oral mucositis in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy: a multicenter
Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2
Normal tissue complication probability (NTCP) modelling of severe acute mucositis using a novel oral mucosal surface organ at risk
Clinical oncology (Royal College of Radiologists (Great Britain))
Systematic review of normal tissue complication models relevant to standard fractionation radiation therapy of the head and neck region published after the QUANTEC reports
MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy
double-blind trial of GC4419 versus placebo to reduce severe oral mucositis due to concurrent radiotherapy and cisplatin for head and neck cancer
J Clin Oncology: Official J Am Soc Clin Oncol
Long non-coding RNA (lncRNA) PGM5P4-AS1 inhibits lung cancer progression by up-regulating leucine zipper tumor suppressor (LZTS3) through sponging microRNA miR-1275
LZTS3/TAGLN suppresses cancer progression in human colorectal adenocarcinoma through regulating cell proliferation
Integrative gene expression profiling analysis to investigate potential prognostic biomarkers for colorectal cancer
Med Sci Monitor: Int Med J Experimental Clin Res
Download references
This study was supported by grants from the National Natural Science Foundation of China (82260627and 82260604)
Mei Gan and Huanshuo Miao contributed equally to this work
The Sixth Affiliated Hospital of Guangxi Medical University
Cancer Hospital of Dalian University of Technology
Cancer Hospital of China Medical University
he Sixth Affiliated Hospital of Guangxi Medical University
The First Affiliated Hospital of Gannan Medical University
provided insightful suggestions and experimental materials
All authors read and approved the final manuscript
I promise that the study was performed according to the international
national and institutional rules considering animal experiments
The study protocol was approved by the Guangxi Medical University
The authors declare that they have no competing interests
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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As governments worldwide are increasing their commitments to tackling climate change
efforts are growing to quantify and characterise the ‘green economy’
and to identify opportunities to be seized and challenges to be overcome in the transition to the net-zero economy of the future
The aim of this report and accompanying policy brief is to shed light on the quantity and quality of current green labour markets
to inform policy action and future research for the net-zero transition
The authors apply an occupation-level classification of ‘green jobs’ developed by O*NET in the United States
The O*NET database distinguishes three occupational categories that differ regarding the effect of the transition to a climate-neutral and sustainable economy on occupations
Figure 1 illustrates the ‘greenness’ of these three categories
The narrowest definition of a green job would focus on the new and emerging category but these
can be considered ‘directly green’ since they involve explicitly green tasks as defined by O*NET
Increased demand jobs are a broader concept and are considered ‘indirectly green’
Report produced with the Centre for Economic Performance and the Programme on Innovation and Diffusion (POID)
Dr Anna Valero is a Senior Policy Fellow at the Centre for Economic Performance and the Deputy Director of the Programme on Innovation and Diffusion (POID)
Jiaqi Li is a Research Assistant for Anna Valero and a MRes/PhD student at Warwick University
Sabrina Muller is a Sustainable Finance Policy Analyst at the Grantham Research Institute
Capucine Riom is a PhD candidate in Economic Geography at LSE and a Research Assistant for the Grantham Research Institute and the What Works Centre for Local Economic Growth
Dr Viet Nguyen-Tien is a Research Economist at the Centre for Economic Performance
Mirko Draca is a Professor at Warwick University
Director of the Centre for Competitive Advantage in the Global Economy (CAGE) and a Research Associate at the Centre for Economic Performance
Former Policy Analyst - Sustainable Finance
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Volume 7 - 2017 | https://doi.org/10.3389/fonc.2017.00089
Radiation-induced oral mucositis (RIOM) is a major dose-limiting toxicity in head and neck cancer patients
It is a normal tissue injury caused by radiation/radiotherapy (RT)
which has marked adverse effects on patient quality of life and cancer therapy continuity
It is a challenge for radiation oncologists since it leads to cancer therapy interruption
RIOM occurs in 100% of altered fractionation radiotherapy head and neck cancer patients
its economic cost was estimated to reach 17,000.00 USD per patient with head and neck cancers
Figure 1. Pathobiology of oral mucositis (OM) (10)
Sonis has suggested five stages (phases) of OM injury induced by radiotherapy (RT) and/or chemotherapy (CT): initiation
The pathogenesis of each phase is illustrated
Radiation-induced oral mucositis occurs in up to 80% of head and neck cancer irradiated patients and reaches up to 100% in patients with altered fractionation head and neck cancer. RIOM of grade 3 and 4 have been recorded in 56% of head and neck cancer patients treated with radiotherapy (1, 12)
Many risk factors have been identified for RIOM. These risk factors include concomitant chemotherapy (CT), bad oral hygiene, below average nutritional stratus, lack of antibiotic use at early stage mucositis, and smoking (13)
Table 1. Data analysis for RIOM predictors using IBM SPSS version 21.0 (Armonk, NY, USA) (14)
Table 2. Patient-linked factors leading to increased risk for oral mucositis (OM) (15)
Radiation-induced oral mucositis side effects and sequels include oral pain in 69% of patients, dysphagia in 56% of patients, opioid use in 53% of patients, weight loss of 3–7 kg, feeding tube insertion and hospitalization (ICU admission) in 15% of patients, and modification or interruption of treatment in 11–16% of patients (1, 12, 16)
In the United States, RIOM may add up to 1,700.00–6,000.00 USD per patient depending on the inflammatory grade of the injury (12). RIOM treatment adds an economic cost that was estimated to increase up to 17,000.00 USD per patient treated for head and neck cancers (16)
The pathophysiology of RIOM is not fully understood. Recent studies proposed that the pathogenesis of RIOM is composed of four phases: an initial inflammatory/vascular phase, an epithelial phase, a (pseudomembranous) ulcerative/bacteriological phase, and a healing phase (2, 5)
The epithelial phase is initiated within a week by the apoptotic and cytotoxic effects of RT on the proliferating basal cells. This is why the recovery period is dependent on the rate of epithelial turnover, which could be enhanced by growth factors like epidermal growth factor and keratinocyte growth factor (KGF) (19)
Table 3. Signaling pathways involved in the development of mucositis (10)
In 2004, Sonis suggested five stages (phases) of OM injury induced by radiotherapy (RT) and/or CT: initiation, signaling, amplification, ulceration, and healing (Figure 1) (16)
Figure 2. Redding’s summary of RT and/or chemotherapy (CT)-induced oral mucositis pathobiology (11)
Redding has summarized the pathobiology phases of radiation-induced oral mucositis induced by RT and/or CT
initiation phase with RT and/or CT results in direct and lethal DNA damage
which leads to release of reactive oxygen species (ROS) from epithelial
and tissue macrophages with cycles of amplifications
the DNA damage and ROS lead to three major steps: (1) fibronectin breakdown that activates macrophages ending with stimulation of matrix metalloproteinase; (2) nuclear factor-κB (NF-κB) activation that stimulates the gene expression and release of pro-inflammatory cytokines
and IL-6; and (3) ceramide pathway through sphingomyelinase and ceramide synthase
The result will be more tissue injury and stimulated apoptosis
there is restimulation of tissue damage and apoptosis by the major pro-inflammatory cytokines (TNF-α
During the ulceration and loss of the protective barrier
secondary infection adds more pro-inflammatory reactions and complicates the already existing inflammation before the healing phase starts by matrix signaling to basal epithelial cells to migrate
Figure 3. Signal amplification during OM induced by RT and/or CT (10)
Signal amplification during RT- and/or CT-induced OM is mediated by activation of NF-κB that is reactivated by IL-1β
NF-κB induces the expression of genes responsible for the MAPK
and tyrosine kinase pathways to finally activate the MMP1 and MMP3 signaling at the injured tissue cells
tumor necrosis factor-α; IL-1β
There has been more than one grading scale for RIOM. Table 4 shows the comparison of different RIOM scoring scales (14, 21–23)
Table 4. Comparison of OM scoring scales (14, 21–23)
World Health Organization Oral Toxicity Scale measures the anatomical, symptomatic, and functional elements of OM (Figure 4). The Radiation Therapy Oncology Group (RTOG) determined the acute radiation morbidity scoring criteria for mucous membranes. Finally, the Western Consortium for Cancer Nursing Research describes only the anatomical changes associated with OM (24)
World Health Organization’s Oral Toxicity Scale
Table 5. Toxicity grading of oral mucositis (OM) according to World Health Organization (WHO) and National Cancer Institute Common Toxicity Criteria (NCI-CTC) criteria (2)a
The OM Index (OMI) scores the severity of OM by the erythema, ulceration, atrophy, and edema (a scale of 0–3 was designated for each element: 0 = none and 3 = severe). The OMI is considered internally consistent with high test–retest and interscorer reliability, and it shows solid validity (27)
All these scoring scales are validated and are required in assessing RIOM and the therapeutic benefits of any new treatment of RIOM
Table 6. Oral assessment guide (30)
Because similar conditions can coexist in immunocompromised patients including cancer patients receiving RT and/or CT, differential diagnosis for RIOM is critical. Table 7 shows possible similar conditions (Figure 5) (20, 31)
Table 7. Differential diagnosis of RIOM (20, 31)
Differential diagnosis of radiation-induced oral mucositis
The general long-term prognosis is reasonably good since most lesions resolve within 2–4 weeks after stopping the RT or CT. Although RIOM is considered a self-limited injury in some patients, it could be a lethal injury in moderately to severely ill patients, which could lead to ICU admission with obligatory cessation of RT. Patient losses are a common event under these circumstances (32)
Maintaining good oral care is the main preventive measure for RIOM to minimize the risk for candidiasis or secondary bacterial infection, especially in hyperfractionated radiotherapy, combined CCRT regimens, or RT combined with a targeted agent due to increased mucositis severity (3)
We will summarize the most recent agents and measures to prevent RIOM
The good oral care can be summarized as follows:
– Rinsing with a non-irritating solution
– Daily ultrasoft tooth brushing with fluoride toothpaste
– Very soft diet with low sugar and non-acidic food and drinks (Table 8)
– Flossing is not recommended due to low platelet count
– Other preventive procedures include minimizing the microbial load (will be discussed more in the treatment section) and educating the patient on good oral hygiene
2. Cryotherapy has been recommended for CT-induced OM, but no proven role in RIOM due to insufficient evidence (33)
5. Radiation shields (intraoral devices), midline mucosa-sparing blocks, 3-D and RT field design, intensity-modulated radiation therapy (IMRT), and removal of separable prosthetics are shown in preclinical studies to reduce the radiation scatter and the RIOM injury (66–69)
6. Low-energy helium–neon laser applied before RT showed significant reduction in the duration and the severity of RIOM in head and neck cancer patients (70). MASCC/ISOO guidelines suggest the use of low-level laser therapy in CT-induced OM at centers that can provide the necessary technology and training (33)
Table 8. Diet recommended for RIOM patients (20)
Table 9. Multinational Association for Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for oral mucositis (3)
No single agent has been approved by the US-FDA for the treatment of RIOM. Symptoms reduction and complications prevention of RIOM, including nutritional support, pain control, prophylaxis, and/or treatment of secondary infections, are considered the main cornerstone in the management of RIOM (34–36)
Agents that were investigated and/or applied in RIOM treatment are discussed in the context of recently updated evidence-based preclinical and clinical studies
1. Glycyrrhetinic acid/povidone/sodium hyaluronate gel has mechanical action implemented in the relief of pain in RIOM. It adheres to the mucosal surface of the mouth, soothing oral lesions. Nevertheless, the preclinical studies are controversial, and only one clinical trial on unknown results was conducted to date (71)
2. l-Glutamine is a non-essential amino acid that counteracts RT-induced metabolic deficiencies (72). Locally applied l-glutamine reduced the RIOM in a randomized clinical trial (73). Glutamine powder for oral suspension was approved by the US-FDA for topical application in management of CT-induced OM, mainly IOMyet (74)
3. Manganese superoxide dismutase is a detoxifying agent that removes ROS. It was shown to have radioprotective effects against RT-induced colitis, esophagitis, hepatic cells apoptosis, and intestinal and eye injury (75–98)
Phase I dose escalation study of GC4419 (manganese-containing macrocyclic ligand complex similar to naturally occurring superoxide dismutase enzymes) in combination with CT/RT for squamous cell cancer of the head and neck has just been completed waiting for results release (NCT01921426)
5. The application of corticosteroids mouthwashes has shown promising results. The limited availability of a large-scale data is a gap that should be bridged through relevant clinical studies (109)
6. Allopurinol and uridine were shown to be effective in reducing 5-fluorouracil oral toxicity in preclinical studies (110–114). Despite these results, they were ineffective approaches in randomized clinical trials as a therapy to reduce the treatment-related oral toxicity (115, 116)
8. Artificial saliva spray is an over-the-counter agent frequently used to alleviate mucosal dryness in mild cases of RIOM (121)
9. Chamomile has anti-inflammatory, antipeptic, antispasmodic, and antibacterial effects. It was investigated with encouraging results as an emulsion therapy for CT-induced mucositis (122–126)
Studies are needed for its application in RIOM to determine its efficacy
10. Honey has been investigated in many preclinical studies due to its mucosal protective effect that was confirmed as a reduction in the incidence and severity of RIOM (127–132). However, the available clinical trial used only Manuka honey, and it appears to contradict the preclinical studies’ results (133)
More studies are needed to confirm the therapeutic potential of honey in RIOM
12. Vitamin A and its derivatives have anti-inflammatory and epithelial proliferative effect (152). Topical tretinoin has been shown to reduce the oral complications during bone marrow (BM) transplantation (153)
13. Vitamin-E (tocopherol) has been shown to lower the oxidative damage of the oral mucosa and reduce the incidence of symptomatic RIOM in head and neck cancer patients in a randomized double-blind clinical trial (152, 154)
14. Sodium alginate was shown to reduce the discomfort and the severity of RIOM in a randomized clinical trial (155)
16. Povidone-iodine is an antiviral, antibacterial, and antifungal agent. Randomized clinical study showed that povidone-iodine reduces the incidence, severity, and duration of CCRT-induced OM, in addition to its advantages of being cheap and easily applied (118, 158–160)
17. Capsaicin is an inhibitor of neutrophils that reduces the pain sensation. One clinical trial showed that orally applied capsaicin caused temporary relief of pain in mucositis caused by RT and CT (161)
more studies are needed for optimization of its analgesic effect
Systemic GM-CSF therapeutic potential is still controversial and requires further investigation
4. Transforming growth factor-β3 inhibits the oral basal cell proliferation. It was shown to reduce the incidence of CT-induced mucositis (194)
a reliable clinical trial is needed to assess its therapeutic potential with RT
5. Beta-carotene’s antioxidative effect (195, 196) was implemented in a randomized clinical trial where there was a significant reduction in the incidence of severe OM in CCRT (197)
6. Analgesics are strong candidates for alleviating the pain related to RIOM. A retrospective study showed that opioid therapy remains a corner stone for OM pain management in CCRT, as suggested by the MASCC/ISOO guidelines (33, 198)
7. Azelastine is a potent second-generation selective histamine antagonist that is used as an anti-inflammatory and antioxidant agent. One clinical trial showed significant reduction in the incidence and the severity of OM with CCRT (199)
8. Propantheline is an anticholinergic agent that reduces the salivary flow. One clinical trial showed that propantheline and oral cryotherapy may be feasible and effective in reducing mucosal toxicity in cancer patients receiving high-dose CT (200)
9. Immunoglobulins have lower salivary and systemic levels in patient receiving antineoplastic therapy. They have immune-modulating and anti-inflammatory properties. Intravenous or intramuscular immunoglobulins are frequently applied as prophylactic and therapeutic options for RIOM (158, 201)
10. Systemic corticosteroids were used in RIOM management. A double-blind placebo-controlled randomized trial has shown a tendency toward reduced RT interruption in prednisone-treated relative to placebo-treated patient groups without evidence of reduced RIOM incidence or severity (202)
11. Pentoxifylline regulates endotoxin-induced production of TNF-α. Although the preclinical studies showed significant reduction in the severity of RIOM with pentoxifylline (203), the clinical trials show that it is not effective in reducing the antineoplastic oral toxicity (204–208)
12. Salicylic acid derivatives should be avoided due to the increased risk for bleeding (34–36)
13. Sphingomyelinase and ceramide synthase inhibitors can be a potential candidate for RIOM. They inhibit the ceramide pathway-mediated RT-induced apoptosis (209–216)
No current clinical trials have been started for them yet
There is a current phase II clinical trial to evaluate the safety and efficacy of brilacidin oral rinse in patients with head and neck cancer (NCT02324335)
Table 10. Radiation-induced oral mucositis (RIOM) the clinical trials that have been done until 2001 (2)a
Table 10 summarizes the clinical trials that were done until 2001 for prevention (P) and treatment (T) of RIOM (2). The current clinical trials for RIOM are summarized in Table 11 and were found when searching the clinical trials website of the National Institute of Health for RIOM
We have documented 40 RIOM treatment and prevention clinical trials
Table 11. Clinical trials for RIOM as listed on http://www.ClinicalTrials.gov when searched in November 2015
RIOM is a self-limited radiotherapy-induced normal tissue injury
It is a dose-limiting toxicity in most cases of head and neck cancer patients
Many preclinical and clinical studies have been conducted for the prevention and treatment of RIOM
there are numerous prevention and treatment strategies for RIOM
there is no single agent or management regimen that has been agreed upon between caregivers that significantly improves RIOM to a clinically relevant and satisfactory standard
the current guidelines recommend good oral care
RIOM treatment focuses on palliative measures and symptoms relief; e.g.
mesenchymal stromal cells therapy for RIOM shows promise for potential therapeutic and clinically relevant benefits
more studies are still needed to confirm such therapeutic potential
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
OM is an awardee of the Lady Davis Institute/Toronto-Dominion Bank studentship
This study was supported partially by Ride To Conquer Cancer (RTCC
Jewish General Hospital Foundation) and Fonds de Recherche du Quebec-Santé (FRQS) grants
English language editing was done by Jenny Warrington
Clin Cancer Res (2005) 11(14):5121–7
CA Cancer J Clin (2001) 51(5):290–315
Curr Oral Health Rep (2015) 2:202–11
Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis – are there new strategies
Bone Marrow Transplant (1999) 24(10):1095–108
Chemotherapy-induced and/or radiation therapy-induced oral mucositis—complicating the treatment of cancer
[Current approaches in prevention and therapy of chemo- and radiotherapy-induced oral mucositis]
Wien Med Wochenschr (2001) 151(3–4):53–65
Radiation therapy and chemotherapy-induced oral mucositis
Braz J Otorhinolaryngol (2007) 73(4):562–8
Pathobiology of oral mucositis: novel insights and opportunities
Google Scholar
PubMed Abstract | Google Scholar
Int J Radiat Oncol Biol Phys (2007) 68(4):1110–20
[Analysis of oral mucositis risk factors during radiotherapy for nasopharyngeal carcinoma patients and establishment of a discriminant model]
Changes and predictors of radiation-induced oral mucositis in patients with oral cavity cancer during active treatment
Eur J Oncol Nurs (2015) 19(3):214–9
Prevention and management of oral mucositis in patients with cancer
CrossRef Full Text | Google Scholar
biology and therapeutic opportunities of oral mucositis
Perspectives on cancer therapy-induced mucosal injury
Cancer (2004) 100(9 Suppl):1995–2025
Concise review: mesenchymal stem cells: their phenotype
Google Scholar
Oral mucositis: a challenging complication of radiotherapy
Part 2: diagnosis and management of mucositis
Comparison of radiation-induced oral mucositis scoring systems
Documentation of radiation-induced oral mucositis
Strahlenther Onkol (1998) 174(Suppl 3):44–6
PubMed Abstract | Google Scholar
Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy
doi:10.1002/(SICI)1097-0142(19990515)85:10<2103::AID-CNCR2>3.0.CO;2-0
Assessing stomatitis: refinement of the Western Consortium for Cancer Nursing Research (WCCNR) stomatitis staging system
An improved reference for grading the acute effects of cancer treatment: impact on radiotherapy
Int J Radiat Oncol Biol Phys (2000) 47:13–47
26. National Cancer Institute. Common Toxicity Criteria. Version 2.0. (1999). Available from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcv20_4-30-992.pdf
Google Scholar
The 20 item oral mucositis index: reliability and validity in bone marrow and stem cell transplant patients
Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation
Prevention and management of oral mucositis for an outpatient oncology setting
Google Scholar
Guidelines for the assessment of oral mucositis in adult chemotherapy
radiotherapy and haematopoietic stem cell transplant patients
in the prevention of radiation-induced oral mucositis and myelosuppression: a controlled study in a rat model
A proteomic evaluation of the effects of the pharmaceuticals diclofenac and gemfibrozil on marine mussels (Mytilus spp.): evidence for chronic sublethal effects on stress-response proteins
Management of oral mucositis in patients who have cancer
Dent Clin North Am (2008) 52(1):61–77,viii
The MASCC/ISOO mucositis guidelines update: introduction to the first set of articles
Support Care Cancer (2013) 21(1):301–2
CrossRef Full Text | Google Scholar
The MASCC/ISOO mucositis guidelines: dissemination and clinical impact
Support Care Cancer (2013) 21(11):3161–3
CrossRef Full Text | Google Scholar
Assessment of the hamster cheek pouch as a model for radiation-induced oral mucositis
and evaluation of the protective effects of keratinocyte growth factor using this model
Int J Radiat Biol (2014) 90(10):884–91
Prevention of radiation-induced oral mucositis after adenoviral vector-mediated transfer of the keratinocyte growth factor cDNA to mouse submandibular glands
Clin Cancer Res (2009) 15(14):4641–8
Cryotherapy and keratinocyte growth factor may be beneficial in preventing oral mucositis in patients with cancer
and sucralfate is effective in reducing its severity
J Am Dent Assoc (2013) 144(8):928–9
Efficacy of palifermin (keratinocyte growth factor-1) in the amelioration of oral mucositis
CrossRef Full Text | Google Scholar
Keratinocyte growth factor is effective in the prevention of intestinal mucositis in patients with hematological malignancies treated with high-dose chemotherapy and autologous hematopoietic SCT: a video-capsule endoscopy study
Bone Marrow Transplant (2008) 42(5):337–43
Palifermin (recombinant keratinocyte growth factor-1): a pleiotropic growth factor with multiple biological activities in preventing chemotherapy- and radiotherapy-induced mucositis
Recombinant human keratinocyte growth factor palifermin reduces oral mucositis and improves patient outcomes after stem cell transplant
Drugs Today (Barc) (2007) 43(7):461–73
A protective role for keratinocyte growth factor in a murine model of chemotherapy and radiotherapy-induced mucositis
Int J Radiat Oncol Biol Phys (2006) 66(1):254–62
Palifermin: a keratinocyte growth factor that reduces oral mucositis after stem cell transplant for haematological malignancies
Expert Opin Pharmacother (2006) 7(16):2287–99
Effects of keratinocyte growth factor (palifermin) administration protocols on oral mucositis (mouse) induced by fractionated irradiation
Radiother Oncol (2005) 75(1):99–105
Reduction of radiochemotherapy-induced early oral mucositis by recombinant human keratinocyte growth factor (palifermin): experimental studies in mice
Int J Radiat Oncol Biol Phys (2005) 62(3):881–7
The use of recombinant human keratinocyte growth factor (palifermin) to ameliorate treatment-induced mucositis
Support Cancer Ther (2003) 1(1):20–2
CrossRef Full Text | Google Scholar
Cell kinetic studies in the murine ventral tongue epithelium: mucositis induced by radiation and its protection by pretreatment with keratinocyte growth factor (KGF)
Cell Prolif (2002) 35(Suppl 1):32–47
The effect of keratinocyte growth factor on tumour growth and small intestinal mucositis after chemotherapy in the rat with breast cancer
Cancer Chemother Pharmacol (2002) 50(1):53–8
The effects of keratinocyte growth factor in preclinical models of mucositis
Cell Prolif (2002) 35(Suppl 1):78–85
Amelioration of acute oral mucositis by keratinocyte growth factor: fractionated irradiation
Int J Radiat Oncol Biol Phys (2002) 54(1):245–51
Modification of oral mucositis by keratinocyte growth factor: single radiation exposure
Int J Radiat Biol (2001) 77(3):341–7
Subcutaneous compared with intravenous administration of amifostine in patients with head and neck cancer receiving radiotherapy: final results of the GORTEC2000-02 phase III randomized trial
Influence of intravenous amifostine on xerostomia
and survival after radiotherapy for head-and-neck cancer: 2-year follow-up of a prospective
Int J Radiat Oncol Biol Phys (2005) 63(4):985–90
Phase I trial and pharmacokinetics of escalating doses of paclitaxel and concurrent hyperfractionated radiotherapy with or without amifostine in patients with advanced head and neck carcinoma
Effects of amifostine on acute toxicity from concurrent chemotherapy and radiotherapy for inoperable non-small-cell lung cancer: report of a randomized comparative trial
Int J Radiat Oncol Biol Phys (2004) 58(5):1369–77
A randomized trial of amifostine as radioprotector in the radiotherapy of head and neck cancer
Protective effect of amifostine during fractionated radiotherapy in patients with pelvic carcinomas: results of a randomized trial
Int J Radiat Oncol Biol Phys (2003) 56(4):1154–60
Preliminary data of the GORTEC 2000-02 phase III trial comparing intravenous and subcutaneous administration of amifostine for head and neck tumors treated by external radiotherapy
Semin Oncol (2002) 29(6 Suppl 19):57–60
Assessment of the effect of local application of amifostine on acute radiation-induced oral mucositis in guinea pigs
Alternate delivery route for amifostine as a radio-/chemo-protecting agent
J Pharm Pharmacol (2008) 60(7):809–15
Amifostine: the first selective-target and broad-spectrum radioprotector
Amifostine in the treatment of head and neck cancer: intravenous administration
CrossRef Full Text | Google Scholar
Effect of amifostine in head and neck cancer patients treated with radiotherapy: a systematic review and meta-analysis based on randomized controlled trials
The effect of customized beam shaping on normal tissue complications in radiation therapy of parotid gland tumors
Radiother Oncol (1991) 21(3):211–7
Devices valuable in head and neck radiotherapy
Int J Radiat Oncol Biol Phys (1992) 23(3):639–45
Decreased acute toxicity by using midline mucosa-sparing blocks during radiation therapy for carcinoma of the oral cavity
The treatment outcome and radiation-induced toxicity for patients with head and neck carcinoma in the IMRT era: a systematic review with dosimetric and clinical parameters
Low-energy He/Ne laser in the prevention of radiation-induced mucositis
A multicenter phase III randomized study in patients with head and neck cancer
Support Care Cancer (1999) 7(4):244–52
Comparing pain control and ability to eat and drink with standard therapy vs Gelclair: a preliminary
randomised controlled trial on patients with radiotherapy-induced oral mucositis
Support Care Cancer (2007) 15(4):427–40
Prophylactic glutamine protects the intestinal mucosa from radiation injury
doi:10.1002/1097-0142(19900701)66:1<62::AID-CNCR2820660113>3.0.CO;2-E
Oral glutamine to alleviate radiation-induced oral mucositis: a pilot randomized trial
Int J Radiat Oncol Biol Phys (2000) 46(3):535–9
placebo-controlled trial of Saforis for prevention and treatment of oral mucositis in breast cancer patients receiving anthracycline-based chemotherapy
Study on the protective effect of a new manganese superoxide dismutase on the microvilli of rabbit eyes exposed to UV radiation
Manganese superoxide dismutase interacts with a large scale of cellular and mitochondrial proteins in low-dose radiation-induced adaptive radioprotection
Free Radic Biol Med (2012) 53(10):1838–47
Intraesophageal manganese superoxide dismutase-plasmid liposomes ameliorates novel total-body and thoracic radiation sensitivity of NOS1−/− mice
RelB regulates manganese superoxide dismutase gene and resistance to ionizing radiation of prostate cancer cells
Ann N Y Acad Sci (2010) 1201:129–36
Toxicological effects of ultraviolet radiation on lymphocyte cells with different manganese superoxide dismutase Ala16Val polymorphism genotypes
Toxicol In Vitro (2010) 24(5):1410–6
Hyde: is manganese superoxide dismutase the key to prevent radiation-induced neoplastic transformation
Cancer Biol Ther (2009) 8(20):1972–3
[Manganese superoxide dismutase gene transfection of mouse small intestinal epithelial cells protects them from radiation injury]
Zhonghua Zhong Liu Za Zhi (2005) 27(11):672–5
Gene transfer of human manganese superoxide dismutase protects small intestinal villi from radiation injury
J Gastrointest Surg (2003) 7(2):229–35; discussion 235–6
Google Scholar
Prevention of radiation-induced oral cavity mucositis by plasmid/liposome delivery of the human manganese superoxide dismutase (SOD2) transgene
doi:10.1667/0033-7587(2003)159[0361:PORIOC]2.0.CO;2
Manganese superoxide dismutase-mediated gene expression in radiation-induced adaptive responses
Mol Cell Biol (2003) 23(7):2362–78
Overexpression of the transgene for manganese superoxide dismutase (MnSOD) in 32D cl 3 cells prevents apoptosis induction by TNF-alpha
Manganese superoxide dismutase (SOD2) inhibits radiation-induced apoptosis by stabilization of the mitochondrial membrane
doi:10.1667/0033-7587(2002)157[0568:MSDSIR]2.0.CO;2
Overexpression of mitochondrial manganese superoxide dismutase protects against radiation-induced cell death in the human hepatocellular carcinoma cell line HLE
Manganese superoxide dismutase-plasmid/liposome (MnSOD-PL) administration protects mice from esophagitis associated with fractionated radiation
Modulation of radiation-induced cytokine elevation associated with esophagitis and esophageal stricture by manganese superoxide dismutase-plasmid/liposome (SOD2-PL) gene therapy
Radiat Res (2001) 155(1 Pt 1):2–14
doi:10.1667/0033-7587(2001)155[0002:MORICE]2.0.CO;2
Suppression of manganese superoxide dismutase augments sensitivity to radiation
hyperthermia and doxorubicin in colon cancer cell lines by inducing apoptosis
Decreased pulmonary radiation resistance of manganese superoxide dismutase (MnSOD)-deficient mice is corrected by human manganese superoxide dismutase-plasmid/liposome (SOD2-PL) intratracheal gene therapy
doi:10.1667/0033-7587(2000)154[0365:DPRROM]2.0.CO;2
Effects of a single exposure to UVB radiation on the activities and protein levels of copper-zinc and manganese superoxide dismutase in cultured human keratinocytes
Photochem Photobiol (1997) 65(4):707–13
Increased manganese superoxide dismutase activity
and mRNA levels and concurrent induction of tumor necrosis factor alpha in radiation-initiated Syrian hamster cells
doi:10.1002/(SICI)1098-2744(199612)17:4<175::AID-MC1>3.0.CO;2-D
Manganese superoxide dismutase expression correlates with p53 status and local recurrence of cervical carcinoma treated with radiation therapy
Expression of manganese superoxide dismutase reduces tumor control radiation dose: gene-radiotherapy
Cytotoxicity and manganese superoxide dismutase induction by tumor necrosis factor-alpha and ionizing radiation in MCF-7 human breast carcinoma cells
Lymphokine Cytokine Res (1993) 12(5):303–8
Overexpression of mitochondrial manganese superoxide dismutase promotes the survival of tumor cells exposed to interleukin-1
film-forming agent for relief from painful oral ulcers associated with chemotherapy
The effects of sucralfate suspension and diphenhydramine syrup plus kaolin-pectin on radiotherapy-induced mucositis
Oral Surg Oral Med Oral Pathol (1991) 71(3):288–93
Radioprotective effect of lidocaine on neurotransmitter agonist-induced secretion in irradiated salivary glands
Treatment of radiation- and chemotherapy-induced stomatitis
Otolaryngol Head Neck Surg (1990) 102(4):326–30
Treatment of oral ulcers with hydroxypropylcellulose film (Zilactin)
Google Scholar
Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation
BMJ Support Palliat Care (2017) 7(1):7–16
Prevention and treatment of oral mucositis in children with cancer
J Pediatr Pharmacol Ther (2012) 17(4):340–50
Indian J Palliat Care (2009) 15(2):95–102
Morphine mouthwash for the management of oral mucositis in patients with head and neck cancer
Effect of topical morphine (mouthwash) on oral pain due to chemotherapy- and/or radiotherapy-induced mucositis: a randomized double-blinded study
Spec Care Dentist (1990) 10(1):21–5
Development of film dosage form containing allopurinol for prevention and treatment of oral mucositis
Preparation and properties of carrageenan microspheres containing allopurinol and local anesthetic agents for the treatment of oral mucositis
Colloids Surf B Biointerfaces (2009) 71(1):27–35
Allopurinol gel mitigates radiation-induced mucositis and dermatitis
Allopurinol mouthwash as prophylactic therapy for 5-fluorouracil-induced mucositis
Google Scholar
Human uridine phosphorylase-1 inhibitors: a new approach to ameliorate 5-fluorouracil-induced intestinal mucositis
Invest New Drugs (2014) 32(6):1301–7
Allopurinol mouth rinse for prophylaxis of fluorouracil-induced mucositis
Eur J Cancer Care (Engl) (2010) 19(3):308–12
Uridine allows dose escalation of 5-fluorouracil when given with N-phosphonacetyl-l-aspartate
doi:10.1002/1097-0142(19930301)71:5<1875::AID-CNCR2820710526>3.0.CO;2-9
Randomized trial of a chlorhexidine mouthwash for alleviation of radiation-induced mucositis
and povidone iodine in the treatment of oral mucositis among patients undergoing radiotherapy in head and neck malignancies: a drug trail
Contemp Clin Dent (2011) 2(1):8–12
Randomized clinical trial of chlorhexidine versus placebo for prevention of oral mucositis in patients receiving chemotherapy
Oncol Nurs Forum (1996) 23(6):921–7
[“Randomized clinical trial of chlorhexidine versus placebo for prevention of oral mucositis in patients receiving chemotherapy”
Report of discussion of this article in the IKA Nursing Research Utilization Board]
A comparison of artificial saliva and pilocarpine in radiation-induced xerostomia
J Laryngol Otol (1994) 108(8):663–5
Chamomile infusion cryotherapy to prevent oral mucositis induced by chemotherapy: a pilot study
Support Care Cancer (2016) 24(10):4393–8
Effect of topical chamomile on immunohistochemical levels of IL-1beta and TNF-alpha in 5-fluorouracil-induced oral mucositis in hamsters
Cancer Chemother Pharmacol (2013) 71(2):293–9
Healing action of topical chamomile on 5-fluoracil induced oral mucositis in hamster
Support Care Cancer (2011) 19(5):639–46
Wild chamomile (Matricaria recutita L.) mouthwashes in methotrexate-induced oral mucositis
Phytomedicine (2005) 12(1–2):25–7
Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis
doi:10.1002/(SICI)1097-0142(19960201)77:3<522::AID-CNCR14>3.0.CO;2-6
Topical honey application to reduce radiation-induced oral mucositis: a therapy too sweet to ignore
J Evid Based Dent Pract (2012) 12(4):203–5
CrossRef Full Text | Google Scholar
Systematic review and meta-analysis on the use of honey to protect from the effects of radiation-induced oral mucositis
Adv Skin Wound Care (2012) 25(1):23–8
Effect of topical honey on limitation of radiation-induced oral mucositis: an intervention study
Int J Oral Maxillofac Surg (2010) 39(12):1181–5
randomised trial of active manuka honey and standard oral care for radiation-induced oral mucositis
Br J Oral Maxillofac Surg (2012) 50(3):221–6
Increased risk for radiation-related caries in cancer patients using topical honey for the prevention of oral mucositis
Int J Oral Maxillofac Surg (2011) 40(11):1335–6; author reply 1235
Efficacy of He-Ne laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients
Oral Surg Oral Med Oral Pathol Oral Radiol Endod (2008) 105(2):180–6
A randomized placebo-controlled trial of manuka honey for radiation-induced oral mucositis
Support Care Cancer (2014) 22(3):751–61
Efficacy of sucralfate mouth wash in prevention of 5-fluorouracil induced oral mucositis: a prospective
Sucralfate mouthwash for prevention and treatment of 5-fluorouracil-induced mucositis: a randomized
Support Care Cancer (2003) 11(1):41–7
Radiation-induced mucositis: a randomized clinical trial of micronized sucralfate versus salt & soda mouthwashes
Comparison of granulocyte-macrophage colony-stimulating factor and sucralfate mouthwashes in the prevention of radiation-induced mucositis: a double-blind prospective randomized phase III study
Int J Radiat Oncol Biol Phys (2002) 54(2):479–85
Comment on: granulocyte macrophage-colony stimulating factor (GM-CSF) and sucralfate in prevention of radiation-induced mucositis: a prospective randomized study
Int J Radiat Oncol Biol Phys (2001) 50(5):1373–4
Prevention of mucositis in bone marrow transplantation: a double blind randomised controlled trial of sucralfate
Granulocyte macrophage-colony stimulating factor (GM-CSF) and sucralfate in prevention of radiation-induced mucositis: a prospective randomized study
Int J Radiat Oncol Biol Phys (2000) 46(3):525–34
Clinical and histopathological evaluation of sucralfate in prevention of oral mucositis induced by radiation therapy in patients with head and neck malignancies
Sucralfate in the prevention of radiation-induced oral mucositis
J Clin Gastroenterol (1999) 28(1):40–3
Google Scholar
Sucralfate for radiation mucositis: results of a double-blind randomized trial
Int J Radiat Oncol Biol Phys (1997) 37(2):275–9
Effects of sucralfate on mucositis during and following radiotherapy of malignancies in the head and neck region
Symptomatic acute mucositis can be minimized or prophylaxed by the combination of sucralfate and fluconazole
Sucralfate mouth washing in the prevention of radiation-induced mucositis: a placebo-controlled double-blind randomized study
Int J Radiat Oncol Biol Phys (1994) 30(1):177–82
The efficacy of sucralfate suspension in the prevention of oral mucositis due to radiation therapy
Int J Radiat Oncol Biol Phys (1994) 28(3):693–8
Efficacy of oral sucralfate suspension in prevention and treatment of chemotherapy-induced mucositis
[Radiation-induced mucositis: a new indication of sucralfate?]
Google Scholar
CrossRef Full Text | Google Scholar
Low plasma concentrations of retinol and alpha-tocopherol in hematopoietic stem cell transplant recipients: the effect of mucositis and the risk of infection
Am J Clin Nutr (2002) 76(6):1358–66
The use of tretinoin as oral mucositis prophylaxis in bone marrow transplantation patients: a preliminary study
Protective effect of alpha-tocopherol in head and neck cancer radiation-induced mucositis: a double-blind randomized trial
[Clinical evaluation of sodium alginate on oral mucositis associated with radiotherapy]
Nihon Gan Chiryo Gakkai Shi (1990) 25(6):1129–37
Prevention of oral mucositis in radiation therapy: a controlled study with benzydamine hydrochloride rinse
Int J Radiat Oncol Biol Phys (1989) 16(6):1571–5
Benzydamine hydrochloride in prevention and management of pain in oral mucositis associated with radiation therapy
Oral Surg Oral Med Oral Pathol (1986) 62(2):145–8
Povidone-iodine to prevent mucositis in patients during antineoplastic radiochemotherapy
Dermatology (1997) 195(Suppl 2):57–61
Prophylaxis with povidone-iodine against induction of oral mucositis by radiochemotherapy
Support Care Cancer (1998) 6(4):373–7
The comparative effects of povidone-iodine and normal saline mouthwashes on oral mucositis in patients after high-dose chemotherapy and APBSCT – results of a randomized multicentre study
Support Care Cancer (2005) 13(7):554–8
Oral capsaicin provides temporary relief for oral mucositis pain secondary to chemotherapy/radiation therapy
J Pain Symptom Manage (1995) 10(3):243–8
Role of the cyclooxygenase pathway in chemotherapy-induced oral mucositis: a pilot study
Support Care Cancer (2010) 18(1):95–103
Cyclooxygenase-2 and vascular endothelial growth factor expression in 5-fluorouracil-induced oral mucositis in hamsters: evaluation of two low-intensity laser protocols
Support Care Cancer (2009) 17(11):1409–15
The relationship between mucosal cyclooxygenase-2 (COX-2) expression and experimental radiation-induced mucositis
Prostaglandin inhibitor and radiotherapy in advanced head and neck cancers
Arch Otolaryngol Head Neck Surg (1986) 112(5):552–3
Multitargeted effects of hangeshashinto for treatment of chemotherapy-induced oral mucositis on inducible prostaglandin E2 production in human oral keratinocytes
Integr Cancer Ther (2014) 13(5):435–45
Protection from radiation-induced oral mucositis by a mouth rinse containing the prostaglandin E1 analog
misoprostol: a placebo controlled double blind clinical trial
Adv Exp Med Biol (1997) 400B:811–8
Topical prostaglandin E2 and chemo- and radio-induced oral mucositis
Protection from radiation-induced oral mucositis by misoprostol
a prostaglandin E(1) analog: a placebo-controlled
Prostaglandin E2 for prophylaxis of oral mucositis following BMT
Bone Marrow Transplant (1993) 11(5):379–82
Local benefit of prostaglandin E2 in radiochemotherapy-induced oral mucositis
Br J Oral Maxillofac Surg (1990) 28(2):89–91
Prostaglandin E2 in the treatment of oral mucositis due to radiochemotherapy in patients with haematological malignancies
Bone Marrow Transplant (1989) 4(Suppl 3):106
The effect of l-cysteine and N-acetylcysteine on porphyrin/heme biosynthetic pathway in cells treated with 5-aminolevulinic acid and exposed to radiation
Photodermatol Photoimmunol Photomed (1996) 12(5):194–9
[Radiation protection through cytokine release by N-acetylcysteine]
Strahlenther Onkol (1996) 172(2):91–8
The effects of N-acetylcysteine and epigallocatechin-3-gallate on liver tissue protein oxidation and antioxidant enzyme levels after the exposure to radiofrequency radiation
Int J Radiat Biol (2015) 91(2):187–93
N-acetylcysteine relieves oxidative stress and protects hippocampus of rat from radiation-induced apoptosis by inhibiting caspase-3
N-acetylcysteine ameliorates nitrosative stress on radiation-inducible damage in rat liver
N-acetylcysteine ameliorates gamma-radiation-induced deterioration of bone quality in the rat femur
J Int Med Res (2011) 39(6):2393–401
[Protective effect of N-acetylcysteine on the intestinal barrier dysfunction after radiation injury in rats]
Zhonghua Wei Chang Wai Ke Za Zhi (2010) 13(3):219–22
The preventive effect of N-acetylcysteine on radiation-induced dermatitis in a rat model
Effect of N-acetylcysteine on radiation-induced genotoxicity and cytotoxicity in rat bone marrow
a thiol antioxidant on radiation-induced cytotoxicity in Chinese hamster ovary cells
Life Sci (2008) 82(21–22):1122–30
Protective effect of N-acetylcysteine against radiation induced DNA damage and hepatic toxicity in rats
Biochem Pharmacol (2008) 75(3):773–80
l-N-acetylcysteine protects against radiation-induced apoptosis in a cochlear cell line
Acta Otolaryngol (2008) 128(4):440–5
The effect of N-acetylcysteine on biomarkers for radiation-induced oxidative damage in a rat model
Acta Med Okayama (2008) 62(6):403–9
radiation carcinogenesis and the protective potential of vitamin A and N-acetylcysteine
J Cancer Res Clin Oncol (1996) 122(6):343–50
The effect of N-acetylcysteine inhalation on the tolerance to thoracic radiation in mice
Topical use of N-acetylcysteine for reduction of skin reaction to radiation therapy
Semin Oncol (1983) 10(1 Suppl 1):86–92
Studies of oral neutrophil levels in patients receiving G-CSF after autologous marrow transplantation
Prophylaxis with GM-CSF mouthwashes does not reduce frequency and duration of severe oral mucositis in patients with solid tumors undergoing high-dose chemotherapy with autologous peripheral blood stem cell transplantation rescue: a double blind
Evaluation of GM-CSF mouthwash for prevention of chemotherapy-induced mucositis: a randomized
Randomized phase II study of GM-CSF to reduce mucositis caused by accelerated radiotherapy of laryngeal cancer
Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma
Int J Radiat Oncol Biol Phys (1997) 37(5):1005–10
Prevention of chemotherapy-induced ulcerative mucositis by transforming growth factor beta 3
The modifying effect of beta-carotene on gamma radiation-induced elevation of oxidative reactions and genotoxicity in male rats
E and beta-carotene against gamma-ray-induced DNA damage in mouse cells
Mutat Res (1998) 417(2–3):85–94
The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis
CrossRef Full Text | Google Scholar
Temporal course and predictive factors of analgesic opioid requirement for chemoradiation-induced oral mucositis in oropharyngeal cancer
Head Neck (2016) 38(Suppl 1):E1521–7
Prophylaxis of oral mucositis associated with chemoradiotherapy for oral carcinoma by azelastine hydrochloride (azelastine) with other antioxidants
Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy
Tohoku J Exp Med (2006) 210(4):315–20
Can prophylactic application of immunoglobulin decrease radiotherapy-induced oral mucositis
Am J Clin Oncol (1997) 20(4):407–11
Corticosteroids and radiation mucositis in head and neck cancer
A double-blind placebo-controlled randomized trial
Radiother Oncol (1998) 47(2):145–8
Modulation of radiation-induced oral mucositis by pentoxifylline: preclinical studies
Strahlenther Onkol (2015) 191(3):242–7
crossover trial of pentoxifylline for the prevention of chemotherapy-induced oral mucositis
Oral Surg Oral Med Oral Pathol Oral Radiol Endod (1995) 80(1):36–42
ciprofloxacin and prednisone failed to prevent transplant-related toxicities in bone marrow transplant recipients and were associated with an increased incidence of infectious complications
Bone Marrow Transplant (1997) 20(12):1075–80
Effects of oral pentoxifylline on TNF-alpha levels
transplant-related toxicities and engraftment after bone marrow transplantation
Bone Marrow Transplant (1994) 14(6):1011–2
Intravenous pentoxifylline failed to prevent transplant-related toxicities in allogeneic bone marrow transplant recipients
Bone Marrow Transplant (1993) 12(4):357–62
Pentoxifylline did not prevent transplant-related toxicity in 31 consecutive allogeneic bone marrow transplant recipients
Elevated sphingomyelinase activity and ceramide concentration in serum of patients undergoing high dose spatially fractionated radiation treatment: implications for endothelial apoptosis
Cancer Biol Ther (2005) 4(9):979–86
Activation of a nuclear sphingomyelinase in radiation-induced apoptosis
Radiation-induced apoptosis of endothelial cells in the murine central nervous system: protection by fibroblast growth factor and sphingomyelinase deficiency
Bone marrow transplantation in acid sphingomyelinase-deficient mice: engraftment and cell migration into the brain as a function of radiation
Decreasing the apoptotic threshold of tumor cells through protein kinase C inhibition and sphingomyelinase activation increases tumor killing by ionizing radiation
Acid sphingomyelinase-deficient human lymphoblasts and mice are defective in radiation-induced apoptosis
Interindividual heterogeneity of molecular weight of human brain neutral sphingomyelinase determined by radiation inactivation method
Molecular weight of human brain neutral sphingomyelinase determined in situ by the radiation inactivation method
biochemical and histological study of the effect of antimicrobial photodynamic therapy on oral mucositis induced by 5-fluorouracil in hamsters
Photodiagnosis Photodyn Ther (2015) 12(2):298–309
Antimicrobial therapy to prevent or treat oral mucositis
Lancet Infect Dis (2003) 3(7):405–12
Effect of local application of the antimicrobial peptide IB-367 on the incidence and severity of oral mucositis in hamsters
Oral Surg Oral Med Oral Pathol Oral Radiol Endod (1999) 87(5):544–51
Local antimicrobial therapy of oral mucositis in paediatric patients undergoing bone marrow transplantation
Antimicrobial polymers as synthetic mimics of host-defense peptides
Wiley Interdiscip Rev Nanomed Nanobiotechnol (2013) 5(1):49–66
and activity of antimicrobial peptide-mimetic polymers
Macromol Biosci (2013) 13(10):1285–99
Mimics of host defense proteins; strategies for translation to therapeutic applications
Curr Top Med Chem (2017) 17(5):576–89
Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy
Support Care Cancer (2006) 14(1):44–51
A comparative study of the efficacy and safety of fluconazole oral suspension and amphotericin B oral suspension in cancer patients with mucositis
Combination and single-agent empirical antibacterial therapy for febrile cancer patients with neutropenia and mucositis
Google Scholar
Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients
Prevention of mucositis in irradiated head and neck cancer patients
J Exp Ther Oncol (1996) 1(2):135–8
PubMed Abstract | Google Scholar
Mucositis prevention by selective elimination of oral flora in irradiated head and neck cancer patients
J Oral Pathol Med (1990) 19(10):486–9
Herpes virus infections: clinical manifestations and therapeutic strategies in immunocompromised patients
Varicella zoster virus rhombencephalomyelitis following radiation therapy for oropharyngeal carcinoma
Is ultra-violet radiation the main force shaping molecular evolution of varicella-zoster virus
placebo-controlled study of topical 5% acyclovir-1% hydrocortisone cream (ME-609) for treatment of UV radiation-induced herpes labialis
Antimicrob Agents Chemother (2002) 46(6):1870–4
Alteration in the radiation-induced LD release in HeLa cells by acyclovir
Clin Chim Acta (2000) 294(1–2):129–38
Effect of acyclovir on the radiation-induced micronuclei and cell death
Effect of acyclovir on radiation- and chemotherapy-induced mouth lesions
Antimicrob Agents Chemother (1989) 33(6):862–5
Cutaneous herpes simplex virus lesions induced by ultraviolet radiation
A review of model systems and prophylactic therapy with oral acyclovir
Enhancement of radiation effects by acyclovir
Int J Radiat Oncol Biol Phys (1986) 12(8):1537–40
Effects of bone marrow or mesenchymal stem cell transplantation on oral mucositis (mouse) induced by fractionated irradiation
Strahlenther Onkol (2014) 190(4):399–404
Modification of radiation-induced oral mucositis (mouse) by adult stem cell therapy: single-dose irradiation
Radiat Environ Biophys (2014) 53(4):629–34
Mouth care for nasopharyngeal cancer patients undergoing radiotherapy
Smoking and mucosal reactions to radiotherapy
[Radiotherapy of head-neck neoplasms: prevention of inflammation of the mucosa by sucralfate treatment]
Double blind randomized trial of sucralfate vs placebo during radical radiotherapy for head and neck cancers
Management of mucositis in oral irradiation
Clin Oncol (R Coll Radiol) (1996) 8(2):106–11
PubMed Abstract | Google Scholar
Effect of chlorhexidine rinsing on the oropharyngeal ecology in patients with head and neck cancer who have irradiation mucositis
Oral Surg Oral Med Oral Pathol (1989) 67(2):154–61
Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial
Oral Surg Oral Med Oral Pathol (1990) 69(3):331–8
[Use of standardized oral hygiene in the prevention and therapy of mucositis in patients treated with radiochemotherapy of head and neck neoplasms]
Laryngol Rhinol Otol (Stuttg) (1988) 67(11):576–9
The reduction of radiation mucositis by selective decontamination antibiotic pastilles: a placebo-controlled double-blind trial
A randomized trial of a nonabsorbable antibiotic lozenge given to alleviate radiation-induced mucositis
Management of oral mucositis during local radiation and systemic chemotherapy: a study of 98 patients
J Prosthet Dent (1991) 66(3):361–9
Treatment for irradiation-induced mucositis
PubMed Abstract | Google Scholar
a new agent for the treatment of radiation mucositis of the oropharynx
The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation
Effects of benzydamine on the oral mucositis during antineoplastic radiotherapy and/or intra-arterial chemotherapy
Int J Tissue React (1987) 9(2):115–9
Local prostaglandin E2 in patients with oral malignancies undergoing chemo- and radiotherapy
J Craniomaxillofac Surg (1988) 16(8):371–4
Acute mucositis in the stimulated oral mucosa of patients during radiotherapy for head and neck cancer
A randomized study of very accelerated radiotherapy with and without amifostine in head and neck squamous cell carcinoma
Int J Radiat Oncol Biol Phys (2000) 46(5):1105–8
Subcutaneous administration of amifostine during fractionated radiotherapy: a randomized phase II study
J Clin Oncol (2000) 18(11):2226–33
Amifostine—a radioprotector in locally advanced head and neck tumors
Strahlenther Onkol (1999) 175(Suppl 4):27–9
Amifostine: a radioprotector in locally advanced head and neck tumors
Selective cytoprotection with amifostine in concurrent radiochemotherapy for head and neck cancer
Supportive use of amifostine in patients with head and neck tumors undergoing radio-chemotherapy
Is it possible to limit the duration of the application of amifostine
Strahlenther Onkol (1999) 175(Suppl 4):23–6
[Side effects of postoperative radiochemotherapy with amifostine versus radiochemotherapy alone in head and neck tumors
Preliminary results of a prospective randomized trial]
Strahlenther Onkol (1999) 175(Suppl 4):18–22
Treatment of irradiation-induced mucositis with growth factors (rhGM-CSF) in patients with head and neck cancer
Anticancer Res (1999) 19(1B):799–803
Effect of granulocyte-macrophage colony-stimulating factor on prevention of mucositis in head and neck cancer patients treated with chemo-radiotherapy
The effect of granulocyte colony-stimulating factor on oral mucositis in head and neck cancer patients treated with hyperfractionated radiotherapy
Filgrastim (r-metHuG-CSF) and its potential use in the reduction of radiation-induced oropharyngeal mucositis: an interim look at a randomized
Cytokines Cell Mol Ther (1999) 5(3):175–80
Eliopoulos N and Muanza T (2017) Radiation-Induced Oral Mucositis
Received: 10 June 2016; Accepted: 21 April 2017; Published: 22 May 2017
Copyright: © 2017 Maria, Eliopoulos and Muanza. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
distribution or reproduction in other forums is permitted
provided the original author(s) or licensor are credited and that the original publication in this journal is cited
in accordance with accepted academic practice
distribution or reproduction is permitted which does not comply with these terms
*Correspondence: Thierry Muanza, dG11YW56YUB5YWhvby5jb20=
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Volume 14 - 2024 | https://doi.org/10.3389/fcimb.2024.1477143
Oral mucositis is a common and debilitating oral complication in head and neck cancer patients undergoing radiotherapy
resulting in diminished quality of life and potential treatment disruptions
Oral microbiota has long been recognized as a contributing factor in the initiation and progression of radiation-induced oral mucositis (RIOM)
Numerous studies have indicated that the radiation-induced oral microbial dysbiosis promotes the occurrence and severity of oral mucositis
approaches that modulate oral microbial ecology are promising for the management of RIOM
Probiotics as a relatively predicable and safe measure that modulates microecology have garnered significant interest
we discussed the correlation between RIOM and oral microbiota
with a particular focus on the efficacy of probiotics in the control of RIOM
in order to provide novel paradigm for the management of this disease
palifermin (keratinocyte growth factor-1) is the only drug that is approved by the FDA to relieve chemotherapy-induced oral mucositis in patients with malignant hematological diseases
there remains a significant need for safe and effective means to prevent and treat RIOM
we critically review the role of oral microbial ecology in the development of RIOM
introduce the recent advance in the application of probiotics to the control of this disease
and discuss the current limitations and future efforts to promote the clinical translation of probiotics in the management of RIOM
According to Sonis, the pathophysiology of RIOM is a dynamic process consisting of five consecutive overlapping phases: initiation, primary damage response (inflammatory upregulation and activation), amplification of the damage responses, ulceration, and healing (Sonis, 2004; Elad et al., 2022)
Radiotherapy can directly injure DNA and lead to apoptosis of epithelial cells
while oxidative stress generates reactive oxygen species (ROS) that further activate pathways such as the nuclear factor-κB (NF-κB) pathway associated with mucositis
leading to excessive production of pro-inflammatory cytokines and further damage to basal epithelial cells and submucosal tissues
further exacerbating tissue damage and superimposing secondary infections that aggravate mucosal lesions
The interplays between the oral microbiota and damaged mucosal tissues play an important role in the development of RIOM
further support the causal effect of oral microbiota in the development of RIOM
it can be speculated that radiotherapy per se induces an early mucosal inflammatory response along with alterations in oral microbiota
and the dysbiotic microbiota in turn amplifies inflammatory response induced by radiotherapy
and ultimately promotes the development of RIOM
These strategies benefit the prevention and symptom alleviation
but have limited efficacy and present challenges such as potential side effects and high costs
there is still a need to explore more effective
relatively safe and economical strategies to promote the management of RIOM
Potential mechanisms of probiotics in the management of RIOM
Clinical trials on probiotics for the management of RIOM
Although the impact on oral microbial ecology was not reported
the protective effects of this synbiotic mouthwash against RIOM are likely accredited to the direct action on oral microbiota and local immune response in the oral cavity
As oral cavity is relatively a conserved ecological niche that may be exclusive to foreign colonizers, a reliable and persistent colonization of gut-derived probiotics administered per oral is arguable (Yli-Knuuttila et al., 2006; Meurman and Stamatova, 2007; Caglar et al., 2009)
probiotic strains isolated from oral cavity may have an innate advantage of reliable/persistent colonization in the oral cavity and thus yield a predictable long-term protective effect against oral mucositis
we also observed that approximately 1/3 of the S
salivarius K12-treated patients still developed severe oral mucositis
This heterogeneity in treatment outcome may be due to the difference in the treatment-naïve microbiota that has varied resistance to radiation and probiotic interventions
salivarius K12 not only exerts probiotic activity via modulating microecology but also benefits the host through anti-inflammatory and immunomodulatory capability
the heterogeneity in host response to the pleiotropic effects of S
salivarius K12 may also explain the varied treatment outcome by this oral probiotic strain
whether application of these probiotics can effectively tackle these concurrent oral complications and clinical challenges other than RIOM has yet to be investigated in well-controlled clinical trials
there still lacks in-depth mechanistic studies with respect to the protective effects of probiotic on RIOM
future studies with proper animal models and genetic tools are still needed to further delineate the radioprotective effects of probiotics at molecular and cellular levels
the frequency/dosage/duration and delivery mode of probiotics could also significantly confound the efficacy of probiotics against RIOM
which warrant more controlled clinical trials in the future to generate high quality clinical evidence
cautions should still be taken particularly when probiotics are applied to immunocompromised or critically ill patients
which will also be a promising direction for future research and development
Accumulating evidence has shown the association between RIOM and oral microbial ecology
and application of probiotics has shown beneficial effects on this disease
Although the clinical outcomes of probiotics vary by specific strains
way of delivery and regimen of radiotherapy
they can effectively alleviate RIOM and improve patients’ quality of life likely via inhibiting the overgrowth of opportunistic pathogens
regulating host immune response and promoting mucosal repair
thus representing a promising adjunctive therapy for the better management of RIOM
The author(s) declare financial support was received for the research
This work was supported by National Natural Science Foundation of China (82370947)
The author(s) declared that they were an editorial board member of Frontiers
This had no impact on the peer review process and the final decision
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article
or claim that may be made by its manufacturer
is not guaranteed or endorsed by the publisher
Mucosal microflora in head and neck cancer patients
Antibiotic-induced gut microbiota depletion accelerates the recovery of radiation-induced oral mucositis in rats
Strategies to mitigate chemotherapy and radiation toxicities that affect eating
Immunomodulatory effects of probiotics on cytokine profiles
PubMed Abstract | Crossref Full Text | Google Scholar
Burden of oral mucositis: A systematic review and implications for future research
A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters
doi: 10.1111/j.1365-2672.2006.02837.x
Evaluation of safety and human tolerance of the oral probiotic Streptococcus salivarius K12: a randomized
Influence of the probiotic Streptococcus salivarius strain M18 on indices of dental health in children: a randomized double-blind
Probiotics as an adjunct therapy for the treatment of halitosis
Oral colonization by Lactobacillus reuteri ATCC 55730 after exposure to probiotics
doi: 10.1111/j.1365-263X.2009.00989.x
Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner
The commensal Streptococcus salivarius K12 downregulates the innate immune responses of human epithelial cells and promotes host-microbe homeostasis
D’Agostino
Effect of Probiotics Lactobacillus rhamnosus and Lactobacillus plantarum on Caries and Periodontal Diseases: A Systematic Review
Lactobacillus brevis CD2 for prevention of oral mucositis in patients with head and neck tumors: A multicentric randomized study
Apoptotic effects of selected strains of lactic acid bacteria on a human T leukemia cell line are associated with bacterial arginine deiminase and/or sphingomyelinase activities
PubMed Abstract | Crossref Full Text | Google Scholar
Alkaline sphingomyelinase: an old enzyme with novel implications
PubMed Abstract | Crossref Full Text | Google Scholar
Oral complications of cancer and cancer therapy: from cancer treatment to survivorship
Oral administration of probiotics reduces chemotherapy-induced diarrhea and oral mucositis: A systematic review and meta-analysis
pseudomonads and enteric bacteria in the oral cavity of patients undergoing head and neck radiotherapy
doi: 10.1590/S1517-838220110003000024
A dosimetric comparison of oral cavity sparing in the unilateral treatment of early stage tonsil cancer: IMRT
Taste dysfunction following radiotherapy to the head and neck: A systematic review
The microbiota in adaptive immune homeostasis and disease
PubMed Abstract | Crossref Full Text | Google Scholar
Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines
Distinct shifts in the oral microbiota are associated with the progression and aggravation of mucositis during radiotherapy
Lactobacillus plantarum alleviates irradiation-induced intestinal injury by activation of FXR-FGF15 signaling in intestinal epithelia
placebo-controlled trial of probiotics to reduce the severity of oral mucositis induced by chemoradiotherapy for patients with nasopharyngeal carcinoma
The oral microbiome - an update for oral healthcare professionals
The oral microbiota and cardiometabolic health: A comprehensive review and emerging insights
Crossref Full Text | Google Scholar
Effect of synbiotic mouthwash on oral mucositis induced by radiotherapy in oral cancer patients: a double-blind randomized clinical trial
Crossref Full Text | Google Scholar
Probiotics as antifungals in mucosal candidiasis
Radiation-induced increased platelet-activating factor activity in mixed saliva
Interventions for the management of radiotherapy-induced xerostomia and hyposalivation: A systematic review and meta-analysis
doi: 10.1016/j.oraloncology.2016.12.031
doi: 10.1111/j.1601-0825.2007.01386.x
PubMed Abstract | Crossref Full Text | Google Scholar
Efficacy of Bacillus clausii UBBC - 07 spores in the amelioration of oral mucositis in head and neck cancer patients undergoing radiation therapy
The effect of intensity-modulated radiotherapy to the head and neck region on the oral innate immune response and oral microbiome: A prospective cohort study of head and neck tumour patients
Relationship between oral mucositis and the oral bacterial count in patients with head and neck cancer undergoing carbon ion radiotherapy: A prospective study
Incidence and risk factors for infection in oral cancer patients undergoing different treatments protocols
Streptococcus salivarius K12 alleviates oral mucositis in patients undergoing radiotherapy for Malignant head and neck tumors: A randomized controlled trial
Oral microbiome and onset of oral mucositis in patients with squamous cell carcinoma of the head and neck
Anti-inflammatory effects of Lactobacillus brevis (CD2) on periodontal disease
doi: 10.1111/j.1601-0825.2006.01291.x
Lactobacillus rhamnosus GG protects the intestinal epithelium from radiation injury through release of lipoteichoic acid
macrophage activation and the migration of mesenchymal stem cells
Seminario-Amez
Probiotics and oral health: A systematic review
Lactobacillus brevis CD2 lozenges reduce radiation- and chemotherapy-induced mucositis in patients with head and neck cancer: a randomized double-blind placebo-controlled study
PubMed Abstract | Crossref Full Text | Google Scholar
Oral microbial carriage in oral squamous cell carcinoma patients at the time of diagnosis and during radiotherapy - a comparative study
doi: 10.1016/j.oraloncology.2012.03.018
PubMed Abstract | Crossref Full Text | Google Scholar
doi: 10.1016/j.oraloncology.2009.08.006
PubMed Abstract | Crossref Full Text | Google Scholar
Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: a double-blind randomised clinical trial
Oral mucositis and microbial colonization in oral cancer patients undergoing radiotherapy and chemotherapy: A prospective analysis in a tertiary care dental hospital
PubMed Abstract | Crossref Full Text | Google Scholar
Prevention of streptococcal pharyngitis by anti-Streptococcus pyogenes bacteriocin-like inhibitory substances (BLIS) produced by Streptococcus salivarius
PubMed Abstract | Google Scholar
The host microbiome regulates and maintains human health: A primer and perspective for non-microbiologists
Low-dose irradiation affects the functional behavior of oral microbiota in the context of mucositis
Host-microbiome cross-talk in oral mucositis
Oral microbial influences on oral mucositis during radiotherapy treatment of head and neck cancer
Oral sequelae of head and neck radiotherapy
Probiotic streptococcus salivarius K12 alleviates radiation-induced oral mucositis in mice
Crossref Full Text | Google Scholar
Mucositis reduction by selective elimination of oral flora in irradiated cancers of the head and neck: a placebo-controlled double-blind randomized study
Prevention and control strategy of radiotherapy-/chemotherapy-induced oral mucositis
doi: 10.3760/cma.j.cn112144-20220130-00038
A phase II randomized clinical trial and mechanistic studies using improved probiotics to prevent oral mucositis induced by concurrent radiotherapy and chemotherapy in nasopharyngeal carcinoma
Oral microbiota transplantation fights against head and neck radiotherapy-induced oral mucositis in mice
Topical application of honey in the management of chemo/radiotherapy-induced oral mucositis: A systematic review and network meta-analysis
Colonization of Lactobacillus rhamnosus GG in the oral cavity
doi: 10.1111/j.1399-302X.2006.00258.x
Inhibitory effect of Streptococcus salivarius K12 and M18 on halitosis in vitro
Zawistowska-Rojek
PubMed Abstract | Crossref Full Text | Google Scholar
Assessment of global health risk of antibiotic resistance genes
Ascidian-inspired temperature-switchable hydrogels with antioxidant fullerenols for protecting radiation-induced oral mucositis and maintaining the homeostasis of oral microbiota
The potential effect of oral microbiota in the prediction of mucositis during radiotherapy for nasopharyngeal carcinoma
Influence of oral probiotic streptococcus salivarius K12 on ear and oral cavity health in humans: systematic review
Keywords: radiation-induced oral mucositis
Zheng S and Xu X (2024) Probiotics in the management of radiation-induced oral mucositis
Received: 07 August 2024; Accepted: 27 August 2024;Published: 18 September 2024
Copyright © 2024 Li, Li, Zheng and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited
*Correspondence: Xin Xu, eGluLnh1QHNjdS5lZHUuY24=
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher
94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish
In the French commune of Riom, the Tracks Architectes designed the renovation of a former tobacco factory
"#HER," to create a new program dedicated to leather manufacturing
The listed building dates back to 1877 and is located near the city center
The "#HER" project aims to preserve the industrial and artisan heritage
enhancing the envelope and roof of the old building
which was declared a Historic Monument in 2004
While respecting the building's distinctive image
the proposal eliminates additions such as service elevators and air extractors
the architects aimed to "destroy as little as possible and build as little as possible."
Moving away from conventional single-story workshop models, the Tracks Architectes developed a vertical approach
incorporating interconnected levels that foster user connectivity
incorporating patios and skylights allows natural light to enter the interior
creating a welcoming and stimulating workspace
The reuse of existing buildings aligns with sustainability criteria
significantly reducing the carbon footprint
the judicious choice of construction materials
reflects traditional methods that minimise the ecological impact
By maintaining the site's manufacturing purpose
the intervention preserves and revitalises the site
enabling contemporary production practices
Renovation of a former tobacco factory by Tracks Architectes
Project description by Tracks Architectes
The project for the new leather’s manufacture in Riom is being established within a section of the town’s former Tobacco Factory
the twenty or so buildings are bordered to the east by railway tracks
and west by residential areas and intermediate housing
The rehabilitation of the Tobacco Factory preserves and enhances the building's envelope and roof
which have been listed in the Inventory of Historic Monuments since 2004
The project integrates itself humbly and discreetly within the existing structure
Unlike the group's usual single-story workshops
this building necessitates a multi-story leather’s manufacture facility
A vertical design approach was therefore adopted to ensure an efficient and effective workflow and connectivity across all spaces
The intervention aims to maintain the site’s manufacturing vocation
and revitalize this industrial heritage by adapting it to contemporary production practices: "destroy as little as possible and build as little as possible." Unsightly additions (such as freight elevators and rooftop exhausts) have been removed
and in keeping with the original roof trusses
some roof sections have been replaced with skylights or an open patio
bringing natural light into the heart of the workshops
The new entrance is marked by grand openings that extend the existing ones
a fully glazed footbridge now connects the first floors of the two buildings
to make use of the attic space with its magnificent curved concrete framework
skylights integrated into the sloping roof provide illumination for the workspaces
the project significantly reduces its carbon footprint
The use of bio-based materials (wooden structures
hemp insulation) aligns with traditional construction methods while minimizing ecological impact (natural ventilation)
the landscaping project creates a green setting for the site
incorporating rainwater retention strategies and highlighting a selection of local plant species
Tracks Mandataire Architectes
Heritage Architect - ABDPAStructural Engineer - BATISERFFluids Engineer - BARBANELEconomist - BMFHigh Environmental Quality Engineer - TRIBUAcoustic Engineer - ALTIAKitchen Designer - BEGCLandscape Architect - LUC LEOTOINGCivil Engineer - OKARE INGENIERIE
Les manufactures d'Auvergne.- Hermès Immobilier
Guillaume Amat
Archive REMODELING-RENOVATION
This miniature from The Book of the City of Ladies by Christine de Pizan
considered the first professional woman author in Europe
is one of over 140 items in Medieval Women: In Their Own Words
When researching potential items to include in the British Library’s current exhibition Medieval Women: In Their Own Words (on view through March 2
I was struck by the exceptional importance of books and documents for recovering women’s histories
While many surviving artifacts from the Middle Ages were probably made and used by women
they often tell us a great deal about the people who shaped and interacted with them
The exhibition seeks to uncover the varied lives of women across society
yet it is also an exploration of the close relationship between medieval women and written culture.
Letter from Joan of Arc to the citizens of Riom
The opening of the Mortuary Roll of Lucy of Hedingham
showing illustrations of the Crucifixion and the Virgin and Child; the soul of Abbess Lucy being lifted to Heaven; and the funeral of Abbess Lucy.
women authors were greatly outnumbered by male authors
girls were rarely educated to the same level as boys
works by female authors survive in a wide range of genres
often voicing distinctly female perspectives
Those on display in Medieval Women include works by Christine de Pizan (d
the first professional woman author in Europe
who disputed conventional representations of women in male-authored literature; Hildegard of Bingen (d
who described her ideas about God through feminized imagery; Gwerful Mechain (d
a Welsh poet who celebrated female sexuality in her rollicking “Poem on the Vagina”; and Ḥafṣa bint al-Ḥājj ar-Rakūniyya (d
a poet from Granada who wrote in Arabic and countered the effusive sentiments of her lover Abū Jaʿfar with coolheaded reserve.
there were probably more medieval women authors than we realize owing to the combined effects of religious censorship and anonymity
It is sobering to think how close we came to losing the works of English mystics Julian of Norwich (d
Julian of Norwich wrote two versions of her Revelations of Divine Love
the first known female-authored work in the English language
The “Short Version” survives in just one medieval copy
while the “Long Version” survives only in seventeenth- and eighteenth-century copies made by exiled English nuns in France (probably from a single now-lost medieval manuscript)
which was discovered in 1934 (allegedly while the owners of a country house were searching for ping-pong balls)
it was known only from a series of extracts
stripped of Margery’s voice and biographical details
that were published in the early sixteenth century
Widespread suspicion of women’s writings and centuries of religious upheaval were nearly enough to obliterate these important works
How many more medieval women’s writings have we lost entirely
Most extant documents from the Middle Ages contain more formal types of texts
an unparalleled cache of over 1,000 letters belonging to a fifteenth-century Norfolk gentry family
They reveal women juggling the demands of domestic life and social advancement
from shopping lists and love matches to armed skirmishes against rival families
They also include the first surviving Valentine’s letter in English
sent by Margery Brews to her “right worshipful and well-beloved Valentine” John Paston in February 1477
with an inscription naming the female scribes in the lower margin.
perhaps the most famous woman from the Middle Ages
is vivid in the popular imagination in part because her defiant words are preserved in the records of her heresy trial
after which she was burned at the stake in 1431
A letter from earlier in her short but brilliant career as a spiritual visionary and military leader is on display in the UK for the first time as part of this exhibition
on loan from the Archives municipales de Riom
Joan sent the letter to the citizens of Riom
entreating the city to send military supplies
Joan dictated her letter to a scribe but signed her name
Little connects us more powerfully to a historical person than seeing their signature
the authentic mark of their presence in the world
We can see women’s influence in book culture even when their own words do not survive
rates of book ownership increased dramatically
and women are recognized as key drivers of this change
Elite women often patronized literature; for example
commissioned the first book printed in English
Caxton’s Recuyell of the Histories of Troye (1473)
The exhibition includes a personalized treatise that Margaret commissioned from her almoner (or alms distributor)
It takes the form of a dialogue between Margaret and Christ
as illustrated in the beautiful frontispiece
which shows them conversing in her bedroom
Some of the most poignant traces of women in books reveal their physical touch
manuscripts containing the Passion (or life story) of St
were effective amulets for women giving birth
A copy of the Passion of St Margaret made in fourteenth-century Padua ends with a childbirth prayer beginning “Exi infans Christus te vocat” (Come forth infant
This is accompanied by a picture of a birthing scene that has been moistened and smudged
probably by the devotional kissing of women hoping for a safe birth.
left: A childbirth prayer at the end of the Passion of St Margaret
with a picture of a birthing scene that has been smudged
likely by women who used it as a devotional to pray for a safe pregnancy
right: An illustration of Margaret of York kneeling before the Resurrected Christ from Dialogue de la duchesse de Bourgogne à Jésus Christ.
Book production was another area in which women were active
A majestic gradual (choir book for the Mass) from the Cistercian Abbey of Seligenthal
contains inscriptions stating that a thirteenth-century nun named Elisabeth first wrote the manuscript
choir mistress of the convent for thirty-five years
As well as demonstrating these women’s scribal and musical skills
the inscriptions suggest that the manuscript was in use at the abbey for at least 200 years.
The introduction of movable type printing to Europe in the fifteenth century created opportunities for women in the printing industry
and their contributions are generally invisible
The first woman in Europe to print a book under her own name was Estellina Conat
Estellina printed the first edition of Jedaiah Ben Abraham Bedersi’s Beḥinat ha-‘Olam (The Contemplation of the World)
a Hebrew poem written after the expulsion of Jews from France in 1306
or printer’s statement at the end of the book
the wife of my worthy husband Abraham Conat
printed] this book.” She used the word “katavti” (wrote) because no Hebrew term for printing existed yet.
The British Library is fortunate to be one of the world’s great repositories of words
we were keen to use as many different sources as possible to recover the lives of medieval women
While books and documents are not the only items on display—there is
and even a lion’s skull—we hope that visitors will be as excited as we were to discover that medieval books have such vital and little-known stories to tell.
out-of-print and rare books in nearly all subject areas
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the exhibition showcases Italian designer Matteo Cibic's works in ceramic
creating an eight-part journey of self-examination
by Bansari PaghdarPublished on : Nov 13
The French art museum has showcased several designers and contemporary artists since its establishment, but Double Paradiso is the first exhibition dedicated to an Italian designer since the Made in Italy exhibition in 1986
The vestibule greets visitors with the show's second section
where an eccentric bust of Pinocchio—embodying the dreams
pride and weaknesses of oneself—stands as the primary subject of Double Paradiso
It presents itself as an amusing reinterpretation of the ancient Roman bust
featuring motifs inspired by contemporary Italian earthenware
One might feel strange yet excited to arrive at the otherworldly apothecary that is The Theatre of Envy, as glass poison vases
powders and pill containers sit idly behind glass panes
chance and fate and poses a question for all who find themselves taken with the 'theatrical game' of his 'ambivalent symbolism'—do these vases hold a rosier future
or does a dark fate await those who dare to taste their contents
urging guests to explore the museum and its contents with a different perspective while meditating
Showcasing over two decades of expertise in working with ceramic
Cibic shapes the whimsical utopian bestiary setting of the Double Paradiso
featuring characteristic arches that puncture a concrete cube
the project includes three distinct movie theaters
with 543 seats and a conference room that holds 112 people
tracks architectes divided the project into two intersecting volumes
that complement each other in their texture
the first volume borrows his height from the wall of the existing enclosure
‘volvic stone’ offers a material available to be reused as large aggregates for the concrete of the outer sails of the first low volume
the facade is intervened and arches are cut through
showing the building behind.the facade thus marks the footprints of the new construction and reinterprets the use of local material in a contemporary way
a second lighter volume with complementary proportions
imposes itself as an urban landmark orchestrated by the punctured wall
a concrete white monolith makes up the building
yet holds an apparent fragility due to its succession of arches
it stands in front of the ‘jardin de la culture’ and the ‘couvent des redemptoristines’
the facade’s strong graphic identity strengthens the fantasized image of a cloister around the large green parvis
the volumetric division opens the large gallery of the cinema hall to the outside
the architects explain that though the facade arches
‘the invitation is made: go through these monumental doors,’ and into the sun-bathed living space that hosts a large exhibition hall
the generous and continuous space is extended by a covered outdoor gallery perforated by the arches
this plan’s organization is inspired by the cinematic realm
having circulation paths wind around rooms and volumes
architecture: tracks architectes
designboom has received this project from our ‘DIY submissions‘ feature, where we welcome our readers to submit their own work for publication. see more project submissions from our readers here.
happening now! partnering with antonio citterio, AXOR presents three bathroom concepts that are not merely places of function, but destinations in themselves — sanctuaries of style, context, and personal expression.
The squad will train at France’s national performance centre – INSEP – over the winter.
A further four will be eliminated in January 2024, leaving eight – four men and four women – to compete in the next international season. The final six-athlete team for the 2024 Olympics will be selected just ahead of the Games
and that’s what I did,” said former European Champion Barbelin
who beat the national 72-arrow qualifying record by one point with 676 during the trials
“It was great to finally manage to beat the French record that I had been trying to beat for a long time.”
The field of archers was cut to just eight in each gender after four days – and eight 72-arrow 70-metre rounds – of competition
the recurve men were led by 16-year Baptiste Addis
“I maintained a consistency over the first four days, with four rounds of more than 680 points, of which I am really proud,” he told journalists from the French federation
I was reaching my mental and physical limit but I still gave everything
but the goal is to now be in the world’s top
Addis was individual bronze and team gold medallist with France’s under-18 team at the recent World Archery Youth Championships in Limerick
The large French clubs of Nîmes and Riom both provide four archers to the squad
Announcement available on the French federation website.
Archive TECHNOLOGY
among several located in the agglomeration’s territory
and will provide an economic boost to the area,” said Hermès
reaffirming “its strong connection to the Auvergne region
where it relies on several local partnerships.” Hermès already operates a facility in the region
and the new factory will grow the total number of Hermès jobs in Auvergne to 500
The adoption of new digital technologies has been central to these changes
In the context of the broader debate about the effects of technological change on employment and jobs (see, for example, Acemoglu and Restrepo, 2019) a key question relates to how Covid-19-induced technology adoption has and will affect workers
create new tasks and change the demand for skills
and can complement (certain types of) labour
the adoption of marketing automation technologies powered by artificial intelligence (AI) makes it possible for businesses to leverage data at scale and raises the demand for skills associated with data analytics
A survey of recent studies on the effects of automation on labour demand finds more empirical support for a positive impact on employment overall at the firm level (Aghion et al, 2022)
Automating firms can become more productive and grow
generating new jobs (potentially at the expense of their competitors
though relationships at the industry level are also positive)
The Centre for Economic Performance (CEP) and the Confederation of British Industry (CBI) have conducted two bespoke business surveys, the first in July 2020 and the second a year later
nature and effects of technology adoption in response to the crisis
The second survey included a series of questions that sought to shed light on how technology adoption since the onset of the pandemic has affected the workforce. The rise of working from home and the associated increased flexibility have clearly been enabled by the widespread adoption of remote working technologies such as Zoom or Microsoft Teams
But this work set out to explore how effects on workers vary according to the types of technology introduced
or the characteristics of firms doing the adopting
As set out in a previous Economics Observatory article, the effects of a crisis on technology adoption are theoretically ambiguous (Valero and Van Reenen, 2021)
But the evidence to date suggests that the pandemic has accelerated technology adoption in firms
in part due to the nature of the crisis (requirements for social distancing) and the readiness of digital technologies that allowed firms and workers to adapt quickly in sectors where this is feasible
reaffirmed the strong innovation response among UK businesses
Three-quarters of firms adopted digital technologies over this timeframe (see Figure 1)
Over half (55%) had adopted new digital capabilities and nearly 70% had adopted new management practices
over 60% of firms had introduced new products and services
while the adoption of digital technologies and management practices occurred early on (March-June 2020) at many firms
a large share of firms continued to innovate beyond the initial lockdowns
the share of firms adopting new digital capabilities was constant
while product innovation increased over time
But were these activities induced by the pandemic
And are new processes and products here to stay beyond it
Most firms considered that the pandemic had accelerated their innovation plans
and between 11% and 34% of firms (across innovation types) reported that the pandemic actually prompted them to innovate
most firms expected them to outlast the pandemic
the reported effects on business performance are broadly positive
28% of businesses had adopted new technologies (the share is higher among businesses with ten or more employees)
While this is substantially smaller than the 75% in Figure 1
it still represents a rise compared with pre-pandemic ‘process innovators’ discussed above
46% of the BICS sample answered that they were ‘not sure’ when asked about technology adoption – versus a negligible share in the CEP-CBI survey where the respondents were perhaps more used to being asked detailed questions on technology-related issues
While remote working technologies are perhaps the most commonly discussed among adopters in the CEP-CBI survey
new technologies also related to a range of business functions
followed by people management and remote working
Technologies for remote working – such as video conferencing or collaboration technologies – were the most adopted specific technology types
either alone or in ‘bundles’ with other technologies including online marketing tools (for example
a new website or social media platforms/e-commerce)
In terms of overall impact on the size of the workforce
most firms (63%) reported that newly adopted digital technologies had no impact (see Figure 3)
The share saying that they had reduced the need for workers (16%) was similar to the share reporting an increased need (13%)
Given that the furlough scheme was in operation during this period – and a high share of survey respondents
had accessed it – it was potentially too early to detect changes with respect to employment resulting from new digital processes
There was more evidence of changes in working practices
An increase in flexible working stands out
productivity and worker satisfaction were also reported to have risen in over 40% of firms that adopted new technologies
Almost half (45%) stated that they had reorganised staff or reallocated employees to new tasks as a result of new technology adoption
And while most firms reported no change to working hours
18% reported a rise due to the implementation of new technologies
There were also associated changes in hiring activity. Over a quarter reported an increase in hiring in specialist skills, and a similar share stated that they were hiring from a broader geography than before the pandemic (see Figure 4). This is a phenomenon enabled by increased remote working and brings implications for the future shape of cities(Nathan, 2021)
Remote working was still prevalent in July 2021
and at that point – before Omicron emerged and guidance changed – expectations for working patterns for January 2022 looked very different to pre-pandemic
with one to two days at home being the most popular option among firms
Firms that had adopted new digital technologies prior to the pandemic were more likely to report improved worker productivity because of new technology adoption
controlling for other key business characteristics
But they were less likely to report an increase in flexible working
had fewer ‘teething’ problems with new technologies and already had flexible working practices in place
firms with a higher degree share among employees were more likely to report an increase in overall workforce size as a result of technology adoption
consistent with new digital technologies and skills being complementary
There were also different effects according to the type of technology being adopted
Where firms adopted technologies relevant for people management
remote work or other ‘business-as-usual’ tasks
they were more likely to report increased flexible working
Firms that adopted remote working technologies also saw a rise in average working hours. This is consistent with other studies that have shown that home workers have put in more hours since Covid-19 (see, for example, Barrero et al, 2021)
Firms that adopted new technologies relevant for research and development (R&D) functions were more likely to report an increase in workforce size
Covid-19 has increased technology adoption and other types of innovation in businesses
and these activities are affecting the workforce
Firms considered that skills constraints were the biggest barrier to technology adoption in the second CEP-CBI survey
perhaps reflecting more widespread shortages at that time
Continued digitisation in businesses will occur at the same time that the move towards net-zero emissions brings changes to strategies, operations and jobs
environmental considerations are being taken into account to either a great or some extent by around two-thirds of firms in the CEP-CBI survey
This is happening across a number of areas
including decisions on technology adoption
working practices and office design or location
It presents an opportunity for a joined-up approach to business support and skills policies to boost productivity growth in an inclusive and sustainable way
The new CEP-CBI survey data provide a first look at the potential effects of pandemic-induced technology adoption on the workforce
There are well-known caveats in the analysis of self-reported performance measures
we might expect biases that result in firms over-reporting socially desirable behaviours (such as positive effects of adoption on company or worker performance) and under-reporting socially undesirable behaviours (such as a reduction in headcount)
But knowing the responses were anonymous should mitigate these effects
Merging business surveys with administrative data will allow researchers to track the actual performance of firms
and trace the effects of technology adoption on employment and other worker outcomes over time
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French fashion house to open factories in Louviers
Sormonne and Riom as bags become must-haves
is opening three new factories as it struggles to keep up with demand for its £5,000-plus Birkin and Kelly handbags
The company said on Friday it planned to open new leather goods factories in the French towns of Louviers
Sormonne and Riom before 2024 in order to increase and speed up its production of the expensive bags
It has also recently opened its first leather-working school to train more craftspeople in the art of handbag making
The company, which already has more than 4,300 leather workers on its staff, said it was hiring more than 400 artisans each year. However, Hermès said it needed far more to keep up with demand for its handbags, which has jumped during the Covid pandemic as soaring stock markets have left the world’s richest people with a lot more disposable income
The bags have become must-have collectibles for the super-rich and celebrities, including Victoria Beckham, Katie Holmes, Rita Ora and Kelly Brook, with some women owning hundreds of the most sought-after designs
Rare Hermès bags have also proven extremely popular at auction, with some selling for almost £300,000
and we have a product that is very handcrafted,” the executive chairman of Hermès
“It takes 15 hours [to create] an Hermès bag
I’m not going to start doing them in 13 hours to raise production.”
Dumas said there was often a long waiting list for the bags
we’re always very sad when we have to say no to our customers
because we don’t have that.” He ruled out raising prices
The lack of handbag stock led to a 5.4% drop in fourth-quarter sales at its leather goods and saddlery division
which accounts for almost half of total sales
The news sent Hermès shares down 7% on Friday
before recovering slightly to a 5% decline
which was still its biggest one-day fall since 2016
Overall sales rose to €2.38bn in the three months to December
with American and Chinese shoppers driving strong growth
but were below analyst forecasts of €2.53bn
The slow growth at Hermès contrasts with an acceleration at other luxury groups such as LVMH Moët Hennessy Louis Vuitton
which have posted much better-than-expected results
BackLe Mans 2008 - The Audi R10 TDIs at the Ford turnA look back at an unusual event that took place during 24 Hours week in 2008: the official Audi R10 TDIs at a photo session in the Ford turn
Related News24h Le Mans02/05/2025 The trailer for the documentary ‘American Thunder: NASCAR to Le Mans’ unveiledIn 2023
during the Centenary edition of the 24 Hours of Le Mans
‘American Thunder: NASCAR to Le Mans’ retraces this adventure in a full-length documentary
broadcast exclusively on Prime Video on 12 June
The second round of the 2025 European Le Mans Series (ELMS) takes place this Sunday 4 May at the Circuit Paul Ricard
An impressive 44 cars are expected on the grid
with a large French contingent on home soil in terms of both drivers and teams
For the 93rd edition of the Le Mans 24 Hours (11-15 June 2025)
the #59 McLaren 720S LMGT3 Evo entered by United Autosports in the LMGT3 class will feature a unique livery: the Meningitis Flag
The aim of this livery is to raise awareness of a disease that is all too often overlooked: meningitis
The Automobile Club de l’Ouest is proud to announce that Roger Federer
the revered champion and global sporting icon
will don the mantle of official starter at the 93rd 24 Hours of Le Mans
the fourth round of the FIA WEC World Endurance Championship
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MercoPress, en Español
Montevideo, May 6th 2025 - 06:30 UTC
An impartial group of independent international observers
Referendum International Observation Mission (RIOM) will monitor the referendum on the political future of the Falkland Islands on Sunday and Monday
The team is free from external pressure and will determine whether the vote is free and fair and representative of the Islanders’ will
The RIOM mission is led by Head of Mission Brad Smith and Deputy Head of Mission
Juan Manuel Henao and will include a number of elected officials
technical experts and eminent persons from the Americas and South Pacific
A press release from the group said: “International observation standards will be observed
as well as applicable Falkland Islands election laws and regulations
A final Referendum Report is expected two weeks after the vote
Who appointed this Observation Mission
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The Swiss pharmaceutical services firm Carbogen Amcis will undertake a $110 million expansion program
adding an active pharmaceutical ingredient (API) facility at its site in Hunzenschwil
and building a new facility for parenteral drug products near its site in Riom
Carbogen plans to install 12 vessels by 2024 with capacity ranging from 630–4,000 L
designed to supply finished drugs for clinical trials and small-scale commercial use
will include two automated lines—one for liquid filling and lyophilization
and one for liquid-form production—when it opens in 2023
Carbogen also plans to add chromatography equipment and laboratories
Carbogen CEO Mark Griffiths says the API expansion addresses a need for more capacity after several years of growth
The finished-drug facility targets what he sees as an underserved need for sterile drug production in high-tech areas such as oncology and antibody-drug conjugates at late-stage clinical
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Carbogen plans to install 12 vessels by 2024 with capacity ranging from 630–4,000 L
The finished-drug facility targets what he sees as an underserved need for sterile drug production in high-tech areas such as oncology and antibody-drug conjugates at late-stage clinical and early-commercial scale
“We see a big appetite for customers that want small commercial batches
Griffiths anticipates continued growth in pharmaceutical services as companies seek to move production outsourcing back to the US and Europe from China and India—a trend that has accelerated during the pandemic
“They are wandering around looking for capacity
But he says the primary motivation for the expansion is a forecast of continued demand from small-to-midsize biotech innovators
which have fueled the firm’s growth in recent years
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Hermès has opened its latest leather goods factory
and is the company’s 23rd leather goods factory in the country
Riom forms a hub with the nearby Sayat leather goods factory
which has been producing leather goods for more than 20 years
Hermès has opened 12 leather goods workshops across France
Three other projects are currently underway – in L’Isle d’Espagnac in Charente
and Charleville-Mézières in the Ardennes – for which recruitment and training are ongoing
Hermès said it is dedicated to keeping the majority of its production in France through its 60 production and training sites and to developing its network of next to 300 stores in 45 countries
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The Government’s commitment to achieving net zero greenhouse gas emissions by 2050 will mean investment
across the economy: from the decarbonisation of buildings and surface transport
This briefing note explores the impact that the net zero transition will have on the UK labour force
by setting out the types of ‘green’ and ‘brown’ jobs that are most likely to experience change
analysing core differences in the workers that are employed in these jobs
and in the type of tasks that they typically perform
We also examine how green and brown jobs have changed over time
and in particular consider the origins of green job workers today
including the share of workers that move from a brown job into a green job
and the key characteristics of those making such a move
For all research queries about this report, please contact Jonathan Marshall. For press queries, please contact the Resolution Foundation press office
Jonathan MarshallSenior Economist,Resolution FoundationEmail Jonathan
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With no formwork required, and customisation costing no more, there could be big time and cost savings on site
Researchers in Switzerland have pioneered a method of 3D printing structural concrete columns at high speed using minimal material and without formwork.
Masters students on the architecture and digital fabrication programme at ETH Zurich developed design software and robotic extrusion techniques to print each of nine unique 2.7m tall columns in less than two and a half hours.
The freeform undulating structures were created with support from the National Centre of Competence in Research into Digital Fabrication for installation at the ‘Concrete Choreography’ dance show at the Origen Festival in Riom.
Each column was printed in multiple thin layers by a specially adapted six-axis manufacturing robot suspended from a gantry. The robot extruded a mix of regular concrete and additives designed to control the material’s behaviour and accelerate the curing time.
The process developed by researchers involves the formation of honeycomb-like voids within the structure to help stabilise it while minimising material use. However, on this occasion the voids were subsequently filled in with ordinary concrete, with a reinforcement cage through the centre of the columns, to ensure a strong bond with the printed shell.
‘The software enables us to distribute the concrete exactly where it is needed structurally, which allows us to save a lot of material,’ says Dillenburger. ‘Our vision is to be able to strategically place concrete and not pour massive concrete elements in the conventional way. In theory, the technique could save up to 80% of concrete, compared with conventional construction.’
ETH students were asked to explore how emerging digital technologies could inform the design of a contemporary column order, similar to those devised by ancient Greeks and Romans. The columns had to be visually expressive and form a key element of the stage design at the festival.
The resulting rippled, curvaceous columns are reminiscent of Antoni Gaudi’s work, and Dillenburger believes the famed Spanish architect would have been keen to exploit 3D concrete printing technology were he alive today.
‘Gaudi was very experimental with engineering and state of the art technology, simulating and “form finding” his constructions using advanced physical models. Today’s digital computational design and robots make it possible to build very differentiated and unique architecture, so I think he would be open to the process.’
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Sam Bennett’s hopes of making the Decathlon AG2R La Mondiale team for the Tour de France in July will bolstered when he roared back to form at the recent Four Days of Dunkirk
And now the Irishman looks like his name will definitely be on the team sheet announced for the French Grand Tour in coming weeks after being included in his team’s selection for the upcoming Critérium du Dauphiné (2.UWT)
which gets underway in Saint-Pourçain-sur-Sioule on Sunday
is the traditional fine-tuning outing for riders with hopes of making their Tour teams
It will be a much harder outing than the Four Days of Dunkirk
tougher stages and much higher quality opposition
if Bennett’s recent wins were the first step in returning to the highest level – which means winning again on the Tour – then his inclusion in the Critérium du Dauphiné team is the next development in that process
in a season when his team is enjoying an incredible run of success
which also includes Edvald Boasson Hagen and Oliver Naesen
both of whom can be crucial support riders for the Irishman in the sprints
Dorian Godon and Nico Prodhomme and is a strong unit
with Godon also showing a turn of speed – and skill in the bunches – that could aid Bennett or deliver stage wins for himself in France next week
Bennett has ridden the Dauphiné three times in his career and has
He was victorious on stage 3 of the 2019 edition
where he saw off Wout van Aert (Jumbo Visma) and Davide Ballerini (Astana Pro Team) for victory
A stage win in the 2024 edition would really confirm his return to top level after his recent success and he may get a chance as early as the first stage
and perhaps stage 5 to Saint-Priest look like the only two obvious stages for the fast men
the field is not expected to be stacked with sprinters
though Mads Pedersen is already confirmed for Lidl Trek
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