The biological basis for the attenuation of mucositis: the example of interleukin-11

Oral mucositis is common, painful, dose-limiting toxicity of drug and radia tion therapy for cancer. In granulocytopenic patients, the ulcerations whic h accompany mucositis are frequent portals of entry for indigenous oral bac teria often leading to bacteremias or sepsis. The complexity of mucositis a s a biological process has only recently been appreciated. The condition ap pears to represent a sequential interaction of the oral mucosal cells and t issues, pro-inflammatory cytokines, and local environmental factors in the mouth such as micro-organisms and saliva. The recognition that the pathophy siology of mucositis is a multifactorial process has presented opportunitie s for intervention based on biological attenuation. Interleukin-11, a pleot ropic cytokine, has a range of activities which is potentially relevant to mucositis. Consequently, it has been used successfully to modify the develo pment, severity and course of mucositis in an animal model which closely mi mics the equivalent human condition.