5-Fluorouracil-induced intestinal mucositis: Pathogenesis and potential therapeutic interventions

Area of Science:

• Gastroenterology
• Oncology
• Pharmacology

Background:

• Intestinal mucositis is a frequent and severe toxicity of 5-fluorouracil (5-FU) chemotherapy.
• It affects up to 80% of patients, causing debilitating symptoms like diarrhea and weight loss.
• These symptoms can necessitate dose reduction or treatment cessation, negatively impacting patient prognosis and quality of life.

Purpose of the Study:

• To review the complex mechanisms underlying 5-FU-induced intestinal mucositis (FIM).
• To explore emerging factors contributing to FIM pathogenesis.
• To summarize potential pharmacological strategies for managing FIM.

Main Methods:

• Literature review of mechanisms and interventions for 5-FU-induced intestinal mucositis.
• Synthesis of current understanding of FIM pathogenesis.
• Identification and summary of potential therapeutic targets.

Main Results:

• FIM involves direct epithelial cell apoptosis, oxidative stress, inflammation, and barrier disruption.
• Impaired neuroregulation and intestinal senescence are newly recognized contributors to FIM.
• Multiple molecular pathways are implicated in FIM development.

Conclusions:

• Understanding FIM's multi-stage pathogenesis is crucial for developing effective treatments.
• Targeting identified mechanisms and novel factors may mitigate 5-FU toxicity.
• This review provides a foundation for future research and clinical applications in managing FIM.