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  • 學位論文

建立放射線引發口腔潰瘍之小鼠模型及組織病理之分析

Establishment and histopathological analysis of radiation induced mucositis mouse model

指導教授 : 賈景山 郭生興

摘要


放射線照射引發口腔黏膜潰瘍是頭頸部癌症放射線治療中常見的副作用,但目前仍無有效的治療藥劑。臨床上的治療方法如給予含有麻醉劑的漱口藥水、維持好的口腔衛生、營養支持、感染控制、及給予角質細胞生長因子或輻射保護劑等支持性照護,上述方法雖然臨床上可達到部份的控制,然而卻無法經濟有效地以及於分子層級有針對性地減輕口腔黏膜潰瘍。發炎前驅物活性氧分子ROS及細胞激素IL-1β、TNF-α常見於口腔粘膜潰瘍組織中,證明口腔黏膜潰瘍是一種發炎相關疾病。牛樟芝Antrodia camphorata是台灣特有的傳統中草藥,具有抗發炎、抗氧化和免疫調節的功能。本實驗將建立小鼠吻部局部照射放射線單一劑量37.5 Gy所引發的口腔黏膜潰瘍模型,並以舌背黏膜為觀查對象,作為評估放射線引發口腔黏膜炎之臨床疾病理變化,以及觀察牛樟芝抗發炎作用緩解口腔潰瘍的有效性。實驗於放射線照射前五天起開始分別餵食水以及牛樟芝,並於照射後第0、3、6、9、12天分批犧牲小鼠,取其舌背黏膜作病理組織分析上皮厚度及肥大細胞,以及前發炎細胞激素基因的表現量偵測。實驗結果顯示,兩組小鼠體重於照射放射線後開始下降,但兩組無顯著差異;兩組舌背黏膜厚度普遍上都由舌根往舌尖方向依序遞減之現象,餵食牛樟芝組的平均舌背黏膜及舌頭各部位皆有比餵食水的組別更厚的趨勢;此外牛樟芝組亦有抑制肥大細胞數目增生或聚集的作用;發炎相關細胞激素基因表現的差異則不明顯;另外根據本實驗結果建立臨床小鼠之放射線引發口腔黏膜炎之分級方法。總結,本研究初步建立放射線治療引發口腔潰瘍之小鼠模型,此外餵食牛樟芝有緩和小鼠口腔黏膜炎的趨勢。

並列摘要


Radiation-induced mucositis (RIM) is a common side effect of radiation therapy in head and neck cancer patients. So far, management has been directed to to supportive cares such as mouth rinse with anesthetics, nutritional support, infection treatment, or systemic administration of keratinocyte growth factor or radioprotectors. Whereas these interventions have been valuable for clinical management, they have not been efficiently or collectively directed to molecularly targeted prevention and treatment. RIM is an inflammation-associated disease, because reactive oxygen species and proinflammatory cytokine such as IL-1β and TNF-α were detected in mucositis tissue. Antrodia camphorata (AC) is a typical Chinese herb found only in Taiwan, and it has anti-inflammation, antioxidant and immunomodulatory properties. This study established a RIM mice model via local irradiation of single dose—37.5 Gy toward snout and observes the dorsal surface mucosa of tongue for evaluating the clinical and histopathological changes. Water or AC was feed from day 5 before iiradiation. After irradiated on day 0, each group of mice were sacrificed on day 0, 3, 6, 9, 12, and the tongue were incised for histopathological analysis of epithelial thickness, mast cells counts and pro-inflammatory cytokine gene expression. The body weight began to decline after radiation exposure, but there were no significant differences; epithelial thickness of dorsal surface mucosa revealed gradually descending amount of thickness from tongue posterior toward tip in both groups; AC group showed generalized thicker than the water group. In addition, AC group seemed to have the effect that inhibits mast cell hyperplasia or recruitment. Gene expression profiles of pro-inflammation cytokine showed no significant difference. We also established the grading system of dorsal surface mucosa in RIM mice model. In conclusion, the radiation induced mucositis mouse model was established and we founded that AC would ameliorate RIM in mice.

並列關鍵字

oral mucositis mouse model radiation

參考文獻


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