Immune Dysfunction in Medication-Related Osteonecrosis of the Jaw.
Ilaria RoatoRodolfo MauceriVincenzo NotaroTullio GenovaVittorio FuscoFederico Davide MussanoPublished in: International journal of molecular sciences (2023)
The pathogenesis of medication-related osteonecrosis of the jaw (MRONJ) is multifactorial and there is a substantial consensus on the role of antiresorptive drugs (ARDs), including bisphosphonates (BPs) and denosumab (Dmab), as one of the main determinants. The time exposure, cumulative dose and administration intensity of these drugs are critical parameters to be considered in the treatment of patients, as cancer patients show the highest incidence of MRONJ. BPs and Dmab have distinct mechanisms of action on bone, but they also exert different effects on immune subsets which interact with bone cells, thus contributing to the onset of MRONJ. Here, we summarized the main effects of ARDs on the different immune cell subsets, which consequently affect bone cells, particularly osteoclasts and osteoblasts. Data from animal models and MRONJ patients showed a deep interference of ARDs in modulating immune cells, even though a large part of the literature concerns the effects of BPs and there is a lack of data on Dmab, demonstrating the need to further studies.
Keyphrases
- bone mineral density
- induced apoptosis
- acute respiratory distress syndrome
- bone loss
- cell cycle arrest
- extracorporeal membrane oxygenation
- mechanical ventilation
- end stage renal disease
- healthcare
- signaling pathway
- postmenopausal women
- systematic review
- electronic health record
- soft tissue
- oxidative stress
- bone regeneration
- chronic kidney disease
- ejection fraction
- risk factors
- emergency department
- peripheral blood
- intensive care unit
- big data
- high intensity
- pi k akt