{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:47:08Z","timestamp":1783950428376,"version":"3.55.0"},"reference-count":89,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Mucositis is a pathological condition characterised by inflammation and ulceration of the mucous membranes lining the alimentary canal, particularly in the mouth (oral mucositis) and the gastrointestinal tract. It is a common side effect of cancer treatments, including chemotherapy and radiotherapy, and it is sometimes responsible for treatment interruptions. Preventing mucositis throughout the alimentary tract is therefore crucial. However, current interventions mainly target either oral or gastrointestinal side effects. This review aimed to investigate the use of systemically administered anti-inflammatory agents to prevent mucositis in cancer patients undergoing cancer treatment. PubMed, Ovid, Scopus, Web of Science, WHO ICTRP and ClinicalTrials.gov were screened to identify eligible randomised controlled trials (RCTs). The published literature on anti-inflammatory agents provides mixed evidence regarding the degree of efficacy in preventing\/reducing the severity of mucositis in most anticancer treatments; however, sample size continued to be a significant limitation, alongside others discussed. Our review yielded a list of several anti-inflammatory agents that exhibit potential mucositis-preventive effects in cancer patients undergoing cancer treatment, which can be used to inform clinical practice.<\/jats:p>","DOI":"10.3390\/biom14050560","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T15:05:01Z","timestamp":1715007901000},"page":"560","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Systemic Anti-Inflammatory Agents in the Prevention of Chemoradiation-Induced Mucositis: A Review of Randomised Controlled Trials"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0017-5233","authenticated-orcid":false,"given":"Ali I.","family":"Mohammed","sequence":"first","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lexi","family":"Fedoruk","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Fisher","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2113-2374","authenticated-orcid":false,"given":"Andy Xiaoqian","family":"Liu","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5264-1713","authenticated-orcid":false,"given":"Samar","family":"Khanna","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaelan","family":"Naylor","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyi","family":"Gong","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4293-2511","authenticated-orcid":false,"given":"Antonio","family":"Celentano","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2512-1557","authenticated-orcid":false,"given":"Mohammad S.","family":"Alrashdan","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates"},{"name":"Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid 22110, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1429-1323","authenticated-orcid":false,"given":"Nicola","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"},{"name":"School of Dentistry, University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1053\/j.ackd.2019.08.005","article-title":"Nephrotoxic Chemotherapy Agents: Old and New","volume":"27","author":"Nicolaysen","year":"2020","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_3","first-page":"95","article-title":"Hepatotoxicity Secondary to Chemotherapy","volume":"2","author":"Grigorian","year":"2014","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"419","DOI":"10.3322\/caac.21204","article-title":"Chemotherapy-induced peripheral neurotoxicity: A critical analysis","volume":"63","author":"Park","year":"2013","journal-title":"CA Cancer J. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2365","DOI":"10.1002\/ijc.31836","article-title":"The bidirectional interaction of the gut microbiome and the innate immune system: Implications for chemotherapy-induced gastrointestinal toxicity","volume":"144","author":"Secombe","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"561","DOI":"10.2307\/3573230","article-title":"Comparison of lethality and chromosomal damage induced by x-rays in synchronized Chinese hamster cells in vitro","volume":"43","author":"Dewey","year":"1970","journal-title":"Radiat. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/0360-3016(95)00095-G","article-title":"A perpetual cascade of cytokines postirradiation leads to pulmonary fibrosis","volume":"33","author":"Rubin","year":"1995","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1667\/RR3597.1","article-title":"Late effects of radiation on the central nervous system: Role of vascular endothelial damage and glial stem cell survival","volume":"166","author":"Coderre","year":"2006","journal-title":"Radiat. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/hed.10326","article-title":"Oral mucositis: A challenging complication of radiotherapy, chemotherapy, and radiochemotherapy. Part 2: Diagnosis and management of mucositis","volume":"26","author":"Scully","year":"2004","journal-title":"Head Neck"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1002\/cncr.25633","article-title":"Incidence and risk factors for lower alimentary tract mucositis after 1529 courses of chemotherapy in a homogenous population of oncology patients: Clinical and research implications","volume":"117","author":"Krishna","year":"2011","journal-title":"Cancer"},{"key":"ref_11","first-page":"3","article-title":"Oral mucositis in cancer therapy","volume":"2","author":"Sonis","year":"2004","journal-title":"J. Support. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13046-020-01715-7","article-title":"Oral mucositis: The hidden side of cancer therapy","volume":"39","author":"Pulito","year":"2020","journal-title":"J. Exp. Clin. Cancer Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/s40496-015-0069-4","article-title":"Oral Mucositis Induced By Anticancer Therapies","volume":"2","author":"Zecha","year":"2015","journal-title":"Curr. Oral Health Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.3389\/fonc.2017.00089","article-title":"Radiation-induced oral mucositis","volume":"7","author":"Maria","year":"2017","journal-title":"Front. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1002\/cncr.11671","article-title":"The burdens of cancer therapy. Clinical and economic outcomes of chemotherapy-induced mucositis","volume":"98","author":"Elting","year":"2003","journal-title":"Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.cden.2004.07.009","article-title":"Oral mucositis","volume":"49","author":"Lalla","year":"2005","journal-title":"Dent. Clin. N. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1002\/hed.10318","article-title":"Oral mucositis: A challenging complication of radiotherapy, chemotherapy, and radiochemotherapy: Part 1, pathogenesis and prophylaxis of mucositis","volume":"25","author":"Scully","year":"2003","journal-title":"Head Neck"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.cden.2007.09.001","article-title":"Psychosocial and economic impact of cancer","volume":"52","author":"Elting","year":"2008","journal-title":"Dent. Clin. N. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/pan.14324","article-title":"Intravenous opioids for chemotherapy-induced severe mucositis pain in children: Systematic review and single-center case series of management with patient- or nurse-controlled analgesia (PCA\/NCA)","volume":"32","author":"Walker","year":"2022","journal-title":"Pediatr. Anesth."},{"key":"ref_20","first-page":"lgz002","article-title":"Oral Microbiome and Cancer Therapy-Induced Oral Mucositis","volume":"2019","author":"Mougeot","year":"2019","journal-title":"J. Natl. Cancer Inst. Monogr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1002\/cncr.20162","article-title":"Perspectives on cancer therapy-induced mucosal injury: Pathogenesis, measurement, epidemiology, and consequences for patients","volume":"100","author":"Sonis","year":"2004","journal-title":"Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/j.1365-2354.2008.00943.x","article-title":"Benzydamine for prophylaxis of radiation-induced oral mucositis in head and neck cancers: A double-blind placebo-controlled randomized clinical trial","volume":"18","author":"Kazemian","year":"2009","journal-title":"Eur. J. Cancer Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.4161\/cbt.7.7.6207","article-title":"Serum levels of NFkappaB and pro-inflammatory cytokines following administration of mucotoxic drugs","volume":"7","author":"Logan","year":"2008","journal-title":"Cancer Biol. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00280-008-0732-8","article-title":"Is the pathobiology of chemotherapy-induced alimentary tract mucositis influenced by the type of mucotoxic drug administered?","volume":"63","author":"Logan","year":"2009","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1748-717X-5-22","article-title":"Pro-inflammatory cytokines play a key role in the development of radiotherapy-induced gastrointestinal mucositis","volume":"5","author":"Ong","year":"2010","journal-title":"Radiat. Oncol."},{"key":"ref_26","first-page":"82","article-title":"Mechanisms Underlying Chemotherapy-Associated Mucositis: The Role of Inflammatory Mediators and Potential Therapeutic Targets","volume":"7","author":"Arifa","year":"2018","journal-title":"EMJ Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s00280-007-0534-4","article-title":"Role of cytokines (TNF-alpha, IL-1beta and KC) in the pathogenesis of CPT-11-induced intestinal mucositis in mice: Effect of pentoxifylline and thalidomide","volume":"61","author":"Melo","year":"2008","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"967","DOI":"10.3390\/curroncol30010074","article-title":"Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials","volume":"30","author":"Colella","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1007\/s00405-015-3694-6","article-title":"Radiation induced oral mucositis: A review of current literature on prevention and management","volume":"273","author":"Mallick","year":"2016","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.2165\/00003495-200565150-00008","article-title":"Palifermin: In myelotoxic therapy-induced oral mucositis","volume":"65","author":"Siddiqui","year":"2005","journal-title":"Drugs"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1038\/ijos.2013.93","article-title":"Clinical effectiveness of palifermin in prevention and treatment of oral mucositis in children with acute lymphoblastic leukaemia: A case-control study","volume":"6","author":"Lauritano","year":"2014","journal-title":"Int. J. Oral Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.oraloncology.2017.05.018","article-title":"Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis","volume":"71","author":"Antunes","year":"2017","journal-title":"Oral Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.radonc.2013.08.010","article-title":"Phase III trial of low-level laser therapy to prevent oral mucositis in head and neck cancer patients treated with concurrent chemoradiation","volume":"109","author":"Antunes","year":"2013","journal-title":"Radiother. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1002\/cncr.34074","article-title":"Efficacy and safety of thalidomide in preventing oral mucositis in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy: A multicenter, open-label, randomized controlled trial","volume":"128","author":"Liang","year":"2022","journal-title":"Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1002\/ptr.5704","article-title":"Effect of Oral Silymarin Administration on Prevention of Radiotherapy Induced Mucositis: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trial","volume":"30","author":"Elyasi","year":"2016","journal-title":"Phytother. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"100253","DOI":"10.1016\/j.phanu.2021.100253","article-title":"Evaluation of oral nano-silymarin formulation efficacy on prevention of radiotherapy induced mucositis: A randomized, double-blinded, placebo-controlled clinical trial","volume":"15","author":"Hosseini","year":"2021","journal-title":"PharmaNutrition"},{"key":"ref_37","first-page":"e4019","article-title":"Preventing and Therapeutic Effect of Propolis in Radiotherapy Induced Mucositis of Head and Neck Cancers: A Triple-Blind, Randomized, Placebo-Controlled Trial","volume":"8","author":"Bolouri","year":"2015","journal-title":"Iran. J. Cancer Prev."},{"key":"ref_38","first-page":"196","article-title":"The Effect of Propolis Tablet on Oral Mucositis Caused by Chemotherapy","volume":"29","author":"Salehi","year":"2018","journal-title":"Gazi Med. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0360-3016(03)01562-1","article-title":"Zinc sulfate in the prevention of radiation-induced oropharyngeal mucositis: A prospective, placebo-controlled, randomized study","volume":"58","author":"Ertekin","year":"2004","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3497","DOI":"10.1002\/hed.26407","article-title":"Preventive use of gabapentin to decrease pain and systemic symptoms in patients with head and neck cancer undergoing chemoradiation","volume":"42","author":"Smith","year":"2020","journal-title":"Head Neck"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1089\/acm.2017.0081","article-title":"Beneficial Effects of Adjuvant Melatonin in Minimizing Oral Mucositis Complications in Head and Neck Cancer Patients Receiving Concurrent Chemoradiation","volume":"23","author":"Onseng","year":"2017","journal-title":"J. Altern. Complement. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/scd.12358","article-title":"Oral administration of nanomicelle curcumin in the prevention of radiotherapy-induced mucositis in head and neck cancers","volume":"39","author":"Delavarian","year":"2019","journal-title":"Spec. Care Dent."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kia, S.J., Basirat, M., Saedi, H.S., and Arab, S.A. (2021). Effects of nanomicelle curcumin capsules on prevention and treatment of oral mucosits in patients under chemotherapy with or without head and neck radiotherapy: A randomized clinical trial. BMC Complement. Med. Ther., 21.","DOI":"10.1186\/s12906-021-03400-4"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1007\/s10637-021-01074-w","article-title":"Effects of glutamine for prevention of radiation-induced esophagitis: A double-blind placebo-controlled trial","volume":"39","author":"Alshawa","year":"2021","journal-title":"Investig. New Drugs"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1016\/j.oraloncology.2014.08.001","article-title":"Randomized double-blind placebo-controlled trial of celecoxib for oral mucositis in patients receiving radiation therapy for head and neck cancer","volume":"50","author":"Lalla","year":"2014","journal-title":"Oral Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/S0167-8140(97)00174-6","article-title":"Corticosteroids and radiation mucositis in head and neck cancer. A double-blind placebo-controlled randomized trial","volume":"47","author":"Leborgne","year":"1998","journal-title":"Radiother. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e1700","DOI":"10.1097\/MJT.0000000000000269","article-title":"Calcitriol for Oral Mucositis Prevention in Patients with Fanconi Anemia Undergoing Hematopoietic SCT: A Double-Blind, Randomized, Placebo-Controlled Trial","volume":"23","author":"Hamidieh","year":"2016","journal-title":"Am. J. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1756-3305-5-9","article-title":"Anti-inflammatory\/anti-fibrotic effects of the hepatoprotective silymarin and the schistosomicide praziquantel against Schistosoma mansoni-induced liver fibrosis","volume":"5","author":"Hammam","year":"2012","journal-title":"Parasites Vectors"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1002\/hep.26179","article-title":"Hepatoprotective and antiviral functions of silymarin components in hepatitis C virus infection","volume":"57","author":"Polyak","year":"2013","journal-title":"Hepatology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1177\/1534735407301441","article-title":"Chemopreventive efficacy of silymarin in skin and prostate cancer","volume":"6","author":"Deep","year":"2007","journal-title":"Integr. Cancer Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"6800","DOI":"10.4049\/jimmunol.163.12.6800","article-title":"Silymarin suppresses TNF-induced activation of NF-kappa B, c-Jun N-terminal kinase, and apoptosis","volume":"163","author":"Manna","year":"1999","journal-title":"J. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/0261-5614(94)90003-5","article-title":"Glutamine and the immune system","volume":"13","author":"Calder","year":"1994","journal-title":"Clin. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/BF01919315","article-title":"The possible role of glutamine in some cells of the immune system and the possible consequence for the whole animal","volume":"52","author":"Newsholme","year":"1996","journal-title":"Experientia"},{"key":"ref_54","first-page":"25","article-title":"Glutamine: Metabolism and application in nutrition support","volume":"13","author":"Coster","year":"2004","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s00726-008-0225-4","article-title":"Glutamine, arginine, and leucine signaling in the intestine","volume":"37","author":"Wu","year":"2009","journal-title":"Amino Acids"},{"key":"ref_56","first-page":"e24198","article-title":"STAT signaling in inflammation","volume":"2","author":"Kaplan","year":"2013","journal-title":"Jakstat"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/S0955-0674(00)00199-X","article-title":"The Stat family in cytokine signaling","volume":"13","author":"Ihle","year":"2001","journal-title":"Curr. Opin. Cell Biol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1002\/ptr.1029","article-title":"Recent progress in pharmacological research of propolis","volume":"15","author":"Banskota","year":"2001","journal-title":"Phytother. Res."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Zulhendri, F., Lesmana, R., Tandean, S., Christoper, A., Chandrasekaran, K., Irsyam, I., Suwantika, A.A., Abdulah, R., and Wathoni, N. (2022). Recent Update on the Anti-Inflammatory Activities of Propolis. Molecules, 27.","DOI":"10.3390\/molecules27238473"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s12986-020-00485-5","article-title":"Molecular and cellular mechanisms of the effects of Propolis in inflammation, oxidative stress and glycemic control in chronic diseases","volume":"17","author":"Pahlavani","year":"2020","journal-title":"Nutr. Metab."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1007\/s00520-011-1277-7","article-title":"A randomized, double-blind, placebo-controlled trial of misoprostol for oral mucositis secondary to high-dose chemotherapy","volume":"20","author":"Lalla","year":"2012","journal-title":"Support Care Cancer"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.oraloncology.2006.04.011","article-title":"Nuclear factor-\u03baB (NF-\u03baB) and cyclooxygenase-2 (COX-2) expression in the oral mucosa following cancer chemotherapy","volume":"43","author":"Logan","year":"2007","journal-title":"Oral Oncol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1500S","DOI":"10.1093\/jn\/130.5.1500S","article-title":"The role of zinc in growth and cell proliferation","volume":"130","author":"MacDonald","year":"2000","journal-title":"J. Nutr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1023\/A:1010095930854","article-title":"Zinc, metallothioneins, immune responses, survival andageing","volume":"1","author":"Mocchegiani","year":"2000","journal-title":"Biogerontology"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"5640","DOI":"10.1007\/s12011-023-03631-1","article-title":"The Role of Zinc in Bone Tissue Health and Regeneration\u2014A Review","volume":"201","author":"Molenda","year":"2023","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Lin, P.H., Sermersheim, M., Li, H., Lee, P.H.U., Steinberg, S.M., and Ma, J. (2017). Zinc in Wound Healing Modulation. Nutrients, 10.","DOI":"10.3390\/nu10010016"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1097\/MCO.0b013e3283312956","article-title":"Zinc: Role in immunity, oxidative stress and chronic inflammation","volume":"12","author":"Prasad","year":"2009","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Wessels, I., Maywald, M., and Rink, L. (2017). Zinc as a Gatekeeper of Immune Function. Nutrients, 9.","DOI":"10.3390\/nu9121286"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1210\/en.2012-2045","article-title":"New Insights into the Anti-inflammatory Mechanisms of Glucocorticoids: An Emerging Role for Glucocorticoid-Receptor-Mediated Transactivation","volume":"154","author":"Vandevyver","year":"2013","journal-title":"Endocrinology"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1042\/cs0940557","article-title":"Anti-inflammatory actions of glucocorticoids: Molecular mechanisms","volume":"94","author":"Barnes","year":"1998","journal-title":"Clin. Sci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1183\/09031936.06.00125404","article-title":"Corticosteroid effects on cell signalling","volume":"27","author":"Barnes","year":"2006","journal-title":"Eur. Respir. J."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jsbmb.2010.02.018","article-title":"Mechanisms and resistance in glucocorticoid control of inflammation","volume":"120","author":"Barnes","year":"2010","journal-title":"J. Steroid. Biochem. Mol. Biol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.biocel.2008.06.010","article-title":"Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases","volume":"41","author":"Aggarwal","year":"2009","journal-title":"Int. J. Biochem. Cell Biol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/jpi.12360","article-title":"Melatonin as an antioxidant: Under promises but over delivers","volume":"61","author":"Reiter","year":"2016","journal-title":"J. Pineal Res."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Ferlazzo, N., Andolina, G., Cannata, A., Costanzo, M.G., Rizzo, V., Curr\u00f2, M., Ientile, R., and Caccamo, D. (2020). Is Melatonin the Cornucopia of the 21st Century?. Antioxidants, 9.","DOI":"10.3390\/antiox9111088"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Bantounou, M., Plascevic, J., and Galley, H.F. (2022). Melatonin and Related Compounds: Antioxidant and Anti-Inflammatory Actions. Antioxidants, 11.","DOI":"10.3390\/antiox11030532"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1016\/S0140-6736(04)16308-3","article-title":"Thalidomide","volume":"363","author":"Franks","year":"2004","journal-title":"Lancet"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.cbi.2015.05.017","article-title":"Anti-inflammatory effect of thalidomide dithiocarbamate and dithioate analogs","volume":"238","author":"Talaat","year":"2015","journal-title":"Chem.-Biol. Interact."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"881","DOI":"10.2310\/JIM.0b013e31821b8755","article-title":"Vitamin D and the immune system","volume":"59","author":"Aranow","year":"2011","journal-title":"J. Investig. Med."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Liu, W., Zhang, L., Xu, H.J., Li, Y., Hu, C.M., Yang, J.Y., and Sun, M.Y. (2018). The Anti-Inflammatory Effects of Vitamin D in Tumorigenesis. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19092736"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jsbmb.2005.06.002","article-title":"Immunoregulation by 1,25-dihydroxyvitamin D3: Basic concepts","volume":"97","author":"Mathieu","year":"2005","journal-title":"J. Steroid. Biochem. Mol. Biol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/eji.200425491","article-title":"Calcium and 1 alpha,25-dihydroxyvitamin D3 target the TNF-alpha pathway to suppress experimental inflammatory bowel disease","volume":"35","author":"Zhu","year":"2005","journal-title":"Eur. J. Immunol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"305054","DOI":"10.1155\/2010\/305054","article-title":"Vitamin d and serum cytokines in a randomized clinical trial","volume":"2010","author":"Yusupov","year":"2010","journal-title":"Int. J. Endocrinol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"4799","DOI":"10.1210\/en.2008-0060","article-title":"Altered endocrine and autocrine metabolism of vitamin D in a mouse model of gastrointestinal inflammation","volume":"149","author":"Liu","year":"2008","journal-title":"Endocrinology"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1590\/S0100-69912012000500011","article-title":"Vitamin D and skin repair: A prospective, double-blind and placebo controlled study in the healing of leg ulcers","volume":"39","author":"Burkiewicz","year":"2012","journal-title":"Rev. Col. Bras. Cir."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1046\/j.1471-4159.1999.0730859.x","article-title":"1,25-dihydroxyvitamin D3 regulates the synthesis of gamma-glutamyl transpeptidase and glutathione levels in rat primary astrocytes","volume":"73","author":"Garcion","year":"1999","journal-title":"J. Neurochem."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S1368-8375(97)00065-1","article-title":"Scoring oral mucositis","volume":"34","author":"Parulekar","year":"1998","journal-title":"Oral Oncol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1111\/j.1600-0846.2008.00316.x","article-title":"Delivering drugs by the transdermal route: Review and comment","volume":"14","author":"Tanner","year":"2008","journal-title":"Skin Res. Technol."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Adepu, S., and Ramakrishna, S. (2021). Controlled Drug Delivery Systems: Current Status and Future Directions. Molecules, 26.","DOI":"10.3390\/molecules26195905"}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/14\/5\/560\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:40:17Z","timestamp":1760107217000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/14\/5\/560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,6]]},"references-count":89,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["biom14050560"],"URL":"https:\/\/doi.org\/10.3390\/biom14050560","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,6]]}}}