Wumei extract modulates inflammation and oral microbiota for radiation-induced oral mucositis.

INTRODUCTION

Radiation-induced oral mucositis (RIOM) is a common and debilitating complication of radiotherapy for head and neck cancer. Although Wumei extract (WME, Prunus mume) has been reported to have anti-inflammatory and mucosal protective effects, its therapeutic potential and underlying mechanisms in RIOM remain unclear.

METHODS

A mouse model of radiation-induced tongue dorsal mucositis (RITDM) was established using fractionated low-dose irradiation followed by a terminal high dose. Mice were treated with saline or WME, and outcomes including body weight, ulcer severity, histopathology, proliferation, apoptosis, and inflammatory cytokine expression were evaluated. Oral microbiota changes were analyzed using 16S rRNA and ITS sequencing. In vitro, irradiated human oral keratinocytes (HOK) were assessed for proliferation and migration with or without WME treatment.

RESULTS

WME significantly attenuated radiation-induced body weight loss, reduced ulcer severity, and preserved epithelial structure. It enhanced epithelial proliferation, reduced apoptosis, and downregulated TNF-α and IL-1β expression. Radiation enriched pro-inflammatory bacteria (Rodentibacter pneumotropicus, Mammaliicoccus sciuri, Streptococcus acidominimus) and fungi (Fusarium oxysporum), while WME treatment partially affected these dysbiotic profiles. In vitro, WME promoted proliferation and migration of irradiated HOK.

CONCLUSION

WME alleviates RIOM by supporting epithelial regeneration, suppressing apoptosis and inflammation, and promotes oral microbiota balance, suggesting its potential as a novel adjunctive therapy for patients undergoing head and neck radiotherapy.