Therapeutic effects of Vitamin D and IL-22 on methotrexate-induced
mucositis in mice
Abstract
Background: Mucositis is a common side effect of cancer therapies and
transplant conditioning regimens. Management of mucositis involves
multiple approaches from oral hygiene, anti-inflammatory,
anti-apoptotic, cytoprotective and antioxidant agents, to cryo-,
physical therapy, and growth factors. There is room for novel,
affordable treatment options or improvement of currently available
therapies. Vitamin D (Vit D) has been shown to regulate mucosa- resident
cell populations such as Th17 or innate lymphoid cells and critical
mucosal cytokine IL-22, however their therapeutic potential has not been
put to test in preclinical mouse models. In this study, we aimed to test
the therapeutic potential of Vit D injections and IL-22 overexpression
in a murine model of chemotherapy-induced mucositis. Methods: Balb/c
mice were given daily intraperitoneal injections of Vit D. Another group
received IL-22 plasmid via hydrodynamic gene delivery. Mucositis was
induced by methotrexate. Weight loss, intestinal histopathology and
IL-22, IL-17A and GM-CSF protein levels in intestinal tissue were
measured. Intestinal Il23, Ifng, Tnfa and Il10 gene expression were
analyzed by real-time qPCR. Intestinal lamina propria B cell, neutrophil
and total innate lymphoid cells were quantified. Results: Daily Vit D
injections significantly ameliorated intestinal inflammation and
elevated intestinal IL-22 levels compared with control groups. Temporal
overexpression of IL-22 by hydrodynamic gene delivery slightly increased
intestinal IL-22 but failed to confer significant protection from
mucositis. Conclusion: To our knowledge, this is the first experimental
demonstration in animal model of mucositis that Vit D and IL-22
supplementation may be beneficial and warrants further trials in human
patients.