Preventing bisphosphonate induced osteonecrosis of the jaw with a polyguanidine conjugate (GuaDex): A promising new approach

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Bone Pub Date : 2024-07-23 DOI:10.1016/j.bone.2024.117211
Arquímedes Cantorán-Castillo , Belinda Beltrán-Salinas , Jorge M. Antúnez-Treviño , Ricardo Martínez-Pedraza , Rodolfo Franco-Márquez , Mario A. Guzmán-García , Ricardo M. Cerda-Flores , Raúl V. Perales-Pérez , Christian Zakian , Jesús Ancer-Rodriguez , Marcela Márquez-Méndez
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Abstract

Osteonecrosis of the jaw (ONJ) is a relatively rare side effect after prolonged use of bisphosphonates, which are drugs used to treat bone resorption in osteoporosis and certain cancers. This study introduces a novel ONJ model in rats by combining exposure to bisphosphonates, oral surgery, and bacterial inoculation. Potential ONJ preventive effects of polyguanidine (GuaDex) or antibiotics were evaluated.

The study consisted of twenty-four male Wistar rats were divided into four groups. Groups 1 to 3 were given weekly doses of i.v. Zoledronic acid (ZA), four weeks before and two weeks after an osteotomy procedure on their left mandibular first molar. Group 4 was a negative control. Streptococcus gordonii bacteria were introduced into the osteotomy pulp chamber and via the food for seven days. On day eight, the rats were given different treatments. Group 1 was given a GuaDex injection into the osteotomy socket, Group 2 was given an intramuscular (i.m.) injection of clindamycin, Group 3 (positive control) was given an i.m. injection of saline, and Group 4 was given an i.m. injection of saline. Blood samples were taken two weeks after the osteotomy procedure, after which the rats were euthanized. Bone healing, bone mineral density, histology, and blood status were analyzed.

The results showed that Group 1 (GuaDex) had no ONJ, extensive ongoing bone regeneration, active healing activity, vascularization, and no presence of bacteria. Group 2 (clindamycin) showed early stages of ONJ, avascular areas, and bacteria. Group 3 showed stages of ONJ, inflammatory infiltrates, defective healing, and bacterial presence, and Group 4 had normal healing activity and no bacterial presence.

Conclusion: ZA treatment and bacterial inoculation after tooth extraction inhibited bone remodeling/healing and induced ONJ characteristic lesions in the rats. Only GuaDex apparently prevented ONJ development, stimulated bone remodeling, and provided an antimicrobial effect.

用聚胍共轭物(GuaDex)预防双磷酸盐诱发的颌骨坏死:一种前景广阔的新方法。
双膦酸盐是一种用于治疗骨质疏松症和某些癌症患者骨吸收的药物,长期使用双膦酸盐后,颌骨坏死(ONJ)是一种相对罕见的副作用。本研究通过将暴露于双膦酸盐、口腔手术和细菌接种结合起来,在大鼠中引入了一种新型颌骨缺血性坏死模型。研究还评估了聚胍(GuaDex)或抗生素预防 ONJ 的潜在作用。研究将二十四只雄性 Wistar 大鼠分为四组。第1至第3组在左下颌第一臼齿截骨术前四周和术后两周每周静脉注射唑来膦酸(ZA)。第 4 组为阴性对照组。将戈登链球菌导入截骨术的牙髓腔并通过食物导入,为期七天。第八天,对大鼠进行不同的处理。第 1 组向截骨臼齿注射瓜地克司,第 2 组肌肉注射克林霉素,第 3 组(阳性对照组)肌肉注射生理盐水,第 4 组肌肉注射生理盐水。截骨手术两周后采集血液样本,然后对大鼠实施安乐死。对骨愈合、骨矿物质密度、组织学和血液状况进行分析。结果显示,第 1 组(GuaDex)没有 ONJ,骨再生正在广泛进行,愈合活动活跃,血管化,并且没有细菌存在。第 2 组(克林霉素)出现早期 ONJ、无血管区域和细菌。第 3 组出现阶段性 ONJ、炎症浸润、愈合缺陷和细菌,第 4 组愈合活动正常,无细菌。结论拔牙后的ZA治疗和细菌接种抑制了大鼠的骨重塑/愈合,并诱发了ONJ特征性病变。只有 GuaDex 能明显阻止 ONJ 的发展,刺激骨重塑,并提供抗菌效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bone
Bone 医学-内分泌学与代谢
CiteScore
8.90
自引率
4.90%
发文量
264
审稿时长
30 days
期刊介绍: BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.
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