الفهرس 
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Abstract
The goals of chemotherapy induced mucositis management are to prevent or reduce the severity of the drug toxicity and to manage the associated symptoms. Mucositis management allows the continued delivery of treatment without interruption or dose reduction leading to improvement of overall prognosis. But unfortunately there is no standard protocol that is used to completely cure or prevent oral mucositis.
Nowadays stem cells are a subject of interest as a potentially revolutionary new way to treat diseases and injuries, with wide-ranging medical benefits as wound healing, ulcer treatment and management of side effects of chemotherapy.
So, this study was evaluating the effect of intravenous injection of mesenchymal bone marrow stem cells on induced stomatitis in rats receiving chemotherapy. 56 male Wister rats weighting around 250 grams were used in the present study. Mesenchymal bone marrow stem cells (MBSCs) were purchased from biochemistry department in faculty of medicine Cairo University which was were labeled with PKH26 die. While 5-Fluorouracil was used as a chemotherapeutic drug. Rats were divided into 4 groups (3 experimental and 1 control):
group 1: Rats were exposed to stomatitis induction only, group 2: Rats were injected with 5-FU and exposed to stomatitis induction , group 3: Rats were injected with 5-FU and treated with stem cells at the same time then exposed to stomatitis induction, and group 4: Rats were injected with 5-FU followed by stomatitis induction then treated with stem cells.
Each group was subdivided into 2 subgroups according to the time of scarification as follow: Subgroup A: 1A, 2A, 3A and 4A (7 rats were sacrificed at day 8). Subgroup B: 1B, 2B, 3B, and 4B (7 rats were sacrificed at day 10).
group 2, 3, and 4 were Intraperitoneally injected with 5-Fluorouracil (5-fu) at day 1 and 3. Then all the animals were subjected to scratching of buccal mucosa by a tip of needle at day 3, 4 and 5. group 3 were injected with stem cells before stomatitis induction while group 4 was injected with stem cells after stomatitis induction. Clinical examination (including mucositis scoring system and body weight loss monitoring), Routine histological examination, Immunohistochemical profile using PCNA stain, Florescent microscope examination and analysis of all the data with SPSS software were performed to investigate the effect of stem cells in the treatment of stomatitis.
By analyzing the statistical data of the OMS we found that, the descending order of the mean values of OMS for all groups was: subgroup 3A, followed by subgroup 2A, subgroup 3B, subgroup 4A, subgroup 2B, subgroup 4B, subgroup 1A and finally subgroup 1B.
Comparison of the animal’s weight at first and last day in each group revealed that in group 1, there was a high significant gain in the body weight at the end of the experiment. In contrast, group 3 showed a significant loss in the body weight at the end of the experiment followed by gr. 2 and finally gr. 4 which was the least group in weight loss.
Florescent microscope examination of the specimens showed successful migration of stem cells to the buccal mucosa of group 3 and 4 at day 8 and 10 but it was noticed that stem cells aggregates were more numerous in subgroup A than subgroup B.
Histological examination of the buccal mucosa of the animals revealed that, subgroup 1 was the superior in tissue regeneration at day 8 and day 10. On the other hand, subgroup 3A was the worst group in tissue healing followed by subgroup 2A and subgroup 4A at day 8. Finally at day 10 subgroup 4B showed better improvement than the other groups as ulcers were almost completely closed and the inflammatory cells markedly decreased.
The Statistical results of immunohistochemical stain at day 10 revealed that, the mean values of PCNA stain of experimental groups (gr. 2B, 3B) only showed a significant decrease than that of the control group (gr. 1B) which indicated no improvement in these groups. While the experimental group 4B showed a non-significant decrease in mean value than that of the control group (gr. 1B) which indicated better improvement in this group than the other groups.
from the present study we concluded that, IV injection of BM-MSCs after stomatitis induction in rats receiving 5-FU chemotherapy leads to improvement of stomatitis score, accelerate healing of buccal mucosa and restore body weight loss after chemotherapy treatment. While IV injection of BM-MSCs before stomatitis induction has no role in prevention or treatment of chemotherapy induced stomatitis.