Natural Remedies Target Different Therapeutic Pathways in Oral Mucositis Induced by Cancer Chemo or Radiotherapy

Oral mucositis (OM) is an inflammatory condition affecting oral mucosa. The etiology of this type of inflammation is associated with exposure to radiotherapy or chemotherapeutic drugs. Herbal drug has been used to induce healing of different types of gastrointestinal ulcers. The role of medicinal plant in cancer therapy induced oral mucositis has been investigated extensively. Preclinical studies refer to healing activity of some medicinal plant such as Chamomile, royal jelly, Calendula officinalis and Salvadora perisca in oral mucositis induced by either chemotherapy or radiotherapy. Some herbal drug is proved to have potential efficacy in decreasing both incidence and severity of oral mucositis in clinical studies. The molecular targets that is modulated by herbal drug is various including scavenging reactive oxygen species (ROS), inhibition inflammatory cascade, prevention of keratinocyte apoptosis and induction of some growth factors. This review illustrates the common herbal drugs that have been used for oral mucositis management focusing on different therapeutic pathways that are implicated in this process.