What question did this study set out to answer?

March 6, 2026Open Access

Effectiveness of Streptococcus salivarius probiotics on alleviating radiation-induced oral mucositis via inflammatory and microecological modulation: a prospective pragmatic interventional study in nasopharyngeal carcinoma

Key Points

This study aims to evaluate the effectiveness of Streptococcus salivarius probiotics on alleviating radiation-induced oral mucositis in nasopharyngeal carcinoma patients.
Conducted a prospective interventional study with nasopharyngeal carcinoma patients receiving chemoradiotherapy.
Grouped patients based on probiotic exposure: no probiotic, SsK12, or SsM18.
Performed weekly oral assessments to monitor onset and severity of oral mucositis.
Utilized group-based trajectory modeling and multivariate analyses to explore associated predictive factors.
Oral mucositis occurred in 95.7% of patients, with severe cases in 42.4%.
SsM18 significantly delayed onset of mucositis (p = 0.014) and reduced duration of severe mucositis (p = 0.019).
GBTM identified two distinct mucositis trajectories: 'Rapid-Onset, Severe' and 'Late-Onset, Mild'.
Elevated Interleukin-6 levels and high BOAS scores were independent predictors of 'Rapid-Onset, Severe' trajectory.

Abstract

Background Radiation-induced oral mucositis (OM) is a prevalent and debilitating complication of head and neck radiotherapy, yet its severity varies markedly between patients. Emerging evidence suggests that this heterogeneity is influenced by the pre-existing oral microbiome and host inflammatory tone. Methods This prospective, pragmatic interventional study grouped nasopharyngeal carcinoma (NPC) patients receiving chemoradiotherapy by probiotic exposure: no probiotic, Streptococcus salivarius K12 (SsK12), or Streptococcus salivarius M18 (SsM18). Weekly oral assessments were used to characterize the onset, duration, and severity of OM. Group-based trajectory modeling (GBTM) was used to identify OM trajectories. Univariate, multivariate, and mediation analyses were used to explore associated factors and potential relationships. Results Among 69 evaluable patients, OM occurred in 95.7%, with severe OM (SOM) in 42.4%. Compared with non-probiotic group, SsM18 significantly delayed OM onset ( p = 0.014), reduced SOM duration ( p = 0.019), and shortened total OM duration ( p = 0.031), outperforming SsK12. GBTM identified two distinct OM trajectories: ‘Rapid-Onset, Severe’ group and ‘Late-Onset, Mild’ group. Multivariate analysis revealed that elevated log-transformed Interleukin-6 levels (odds ratio OR = 4.20, p = 0.020), and high Beck Oral Assessment Scale (BOAS) score (OR = 3.06, p = 0.044) as independent predictors of ‘Rapid-Onset, Severe’ trajectory. The Teeth subdomain of BOAS was identified as an independent predictor for earlier OM onset ( p = 0.042). Mediation analysis suggested that the association between a higher Teeth subdomain score and OM was partially mediated by IL-6 elevation (proportion mediated: 30–50%). Conclusions Radiotherapy-induced OM was associated with baseline oral health and inflammatory status. SsM18 supplementation was associated with improved OM-related outcomes, suggesting a potential role for precision probiotic strategies. Clinical trial information https://www.chictr.org.cn/ , identifier ChiCTR2600118357.

AI से पूछें

Bookmark

View Full Paper

Cite This Study

Huang et al. (Tue,) studied this question.

synapsesocial.com/papers/69aa6eb1531e4c4a9ff58f27 https://doi.org/https://doi.org/10.3389/fimmu.2026.1745549

AI से पूछें

Bookmark

View Full Paper