The Efficacy of Oral Hydrogel Containing Hyaluronic Acid, Polyvinylpyrrolidone, and Glycyrrhizin for Prevention and Treatment of Oral Mucositis Induced by Chemotherapy

Abstract

Background: Oral mucositis, inflammation, and painful wound of oral mucosal membranes is commonly known as a serious side effect of chemotherapy and radiotherapy. The aim of this study was to prepare and evaluate physicochemical hydrogel containing glycyrrhizin, hyaluronic acid, and polyvinylpyrrolidone for treatment and prevention of oral mucositis. Methods: The hydrogel containing glycyrrhizin 0.2% w/v was prepared by adding 1, 3, and 1 percent hydroxyethyl cellulose, polyvinylpyrrolidone, and hyaluronic acid in deionized water. Different percentages of preservatives were also added to the formulation. Physicochemical characteristics such as viscosity, pH, stability, and antimicrobial effectiveness were evaluated in details. Finally, the efficacy of the formulation was evaluated in Wistar rats with chemotherapy-induced mucositis. Findings: Macroscopically, the formulation was found to be without particles, it was touchable and transparent, and also had good consistency and uniformity in terms of physical appearance. The viscosity and pH was obtained 6.5 ± 0.2 and 1500 cp, respectively. Glycyrrhizin was completely released during 3 hours. The viscosity, pH, and physical appearance did not significantly change during stability studies. Oral mucositis was induced in rats after seven days intraperitoneal injection of fluorouracil. In the group received the formulation, the severity of mucositis significantly reduced more compared to control group. Conclusion: The current formulation successfully reduced the severity of oral mucositis in rats, and its efficacy was comparable with commercial formulation (Gelclair®). Therefore, the developed formulation has the potential to be used in the treatment of oral mucositis and other oral or subcutaneous wounds.

Keywords

• neoplasms, glycyrrhizic acid, stomatitis, hydrogels, hyaluronic acid