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Influência dos polimorfismos dos genes GSTs e MTHFR no desenvolvimento da xerostomia induzida por quimioterapia no tratamento do cancro do útero: revisão integrativa
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| Projeto de pós-graduação_41323 | 1.86 MB | Adobe PDF |
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A xerostomia induzida por quimioterapia constitui uma complicação frequente e clinicamente relevante em pacientes com cancro do colo do útero, com impacto significativo na saúde oral e na qualidade de vida. A variabilidade interindividual observada na sua gravidade sugere a influência de fatores biológicos intrínsecos, incluindo determinantes genéticos. O objetivo desta revisão integrativa foi reunir a evidência disponível sobre a influência dos polimorfismos dos genes GSTs (GSTM1, GSTT1, GSTP1) e MTHFR (C677T, A1298C) na suscetibilidade à xerostomia induzida por quimioterapia no tratamento do cancro do colo do útero. A revisão foi conduzida segundo as diretrizes PRISMA-ScR e a metodologia de revisões integrativas, com pesquisa em bases de dados biomédicas e seleção de estudos empíricos relevantes, complementados por literatura teórica de suporte. Os resultados reunidos sugerem que variantes genéticas associadas à redução da capacidade antioxidante e à disfunção do metabolismo do folato podem aumentar a vulnerabilidade das glândulas salivares ao dano induzido por quimioterapia. Esta revisão integrativa evidencia que a xerostomia associada à quimioterapia decorre de uma interação multifatorial, envolvendo determinantes farmacológicos, fisiopatológicos e genéticos. A articulação entre contributos da farmacogenética, da biologia das glândulas salivares e da oncologia ginecológica assume particular relevância na compreensão da variabilidade inter-individual observada em contexto clínico. Neste sentido, a realização de estudos futuros, prospetivos e com desenho metodológico robusto, será fundamental para clarificar o papel destes polimorfismos enquanto potenciais marcadores de risco, bem como para sustentar o desenvolvimento de estratégias mais eficazes de prevenção, monitorização e intervenção em Medicina Dentária oncológica.
Chemotherapy-induced xerostomia is a frequent and clinically relevant complication in patients with cervical cancer, significantly affecting oral health and quality of life. The marked interindividual variability observed in its severity suggests the involvement of intrinsic biological factors, including genetic determinants. This integrative review aimed to gather the available evidence on the influence of GST (GSTM1, GSTT1, GSTP1) and MTHFR (C677T, A1298C) gene polymorphisms on susceptibility to chemotherapy-induced xerostomia in the treatment of cervical cancer. The review was conducted according to PRISMA-ScR guidelines and integrative review methodology, including empirical studies retrieved from biomedical databases and supported by theoretical literature for contextualization. The findings suggest that genetic variants associated with reduced antioxidant capacity and impaired folate metabolism may increase salivary gland vulnerability to chemotherapy-induced damage. However, direct clinical evidence remains limited and heterogeneous. This integrative review highlights that chemotherapy-associated xerostomia arises from a multifactorial interaction involving pharmacological, pathophysiological, and genetic determinants. The integration of insights from pharmacogenetics, salivary gland biology, and gynecologic oncology is particularly relevant for understanding the interindividual variability observed in clinical practice. In this context, future prospective studies with robust methodological designs will be essential to clarify the role of these polymorphisms as potential risk markers and to support the development of more effective prevention, monitoring, and intervention strategies in oncologic dentistry.
Chemotherapy-induced xerostomia is a frequent and clinically relevant complication in patients with cervical cancer, significantly affecting oral health and quality of life. The marked interindividual variability observed in its severity suggests the involvement of intrinsic biological factors, including genetic determinants. This integrative review aimed to gather the available evidence on the influence of GST (GSTM1, GSTT1, GSTP1) and MTHFR (C677T, A1298C) gene polymorphisms on susceptibility to chemotherapy-induced xerostomia in the treatment of cervical cancer. The review was conducted according to PRISMA-ScR guidelines and integrative review methodology, including empirical studies retrieved from biomedical databases and supported by theoretical literature for contextualization. The findings suggest that genetic variants associated with reduced antioxidant capacity and impaired folate metabolism may increase salivary gland vulnerability to chemotherapy-induced damage. However, direct clinical evidence remains limited and heterogeneous. This integrative review highlights that chemotherapy-associated xerostomia arises from a multifactorial interaction involving pharmacological, pathophysiological, and genetic determinants. The integration of insights from pharmacogenetics, salivary gland biology, and gynecologic oncology is particularly relevant for understanding the interindividual variability observed in clinical practice. In this context, future prospective studies with robust methodological designs will be essential to clarify the role of these polymorphisms as potential risk markers and to support the development of more effective prevention, monitoring, and intervention strategies in oncologic dentistry.
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Xerostomia Quimioterapia Polimorfismos genéticos Cancro do colo do útero Chemotherapy Genetic polymorphisms GSTs MTHFR Cervical cancer