Effects of N-Acetyl-Cysteine in the Prevention of 5-Fluorouracil Induced-Oral Mucositis Hamsters

Oral mucositis is the most common and dose-limiting complication of cancer treatment. N-acetylcysteine (NAC) is an antioxidant that minimizes oxidative stress and the lipid peroxidation of cellular membranes. Objective: The present study aimed to evaluate the effects of NAC as a treatment for 5-fluorouracil-induced oral mucositis in hamsters. Methods: The animals were divided into two groups: therapeutic NAC (group I; n = 15) and control group (group II; n = 15). Mucositis was induced in hamsters by intraperitoneal injection of 5-fluorouracil on days 0 and 2, and the left cheek pouch was irritated by superficial scratching on days 3 and 4. In group I, oral mucositis was induced and treated with NAC intraperitoneal infusion during seven days. In group II, mucositis was induced, and no treatment was done. Oral mucosa was photographed from days 4 and 7. Photographs were randomly scored according to the severity of induced mucositis (0 to 5). Excisional biopsies of the palatal mucosa were performed, and the hamsters were sacrificed. Tissue sections were evaluated for morphological and histological analysis. Samples of cheek pouches were removed from animals per group for Malondialdehyde (MDA) measurement. Results: Group I showed better prevention of oral mucosa structural damage than group II. Clinical evaluation demonstrated that group I had a better outcome and faster healing. Group I presented more granulation tissue and fibroblasts. According to Malondialdehyde values, group I showed a decrease in lipid peroxidation. Conclusions: The results suggest that NAC treatment had a positive effect in reducing mucositis severity and a pronounced effect in treating established mucositis.