Correlations between Immune Response and Etiopathogenic Factors of Medication-Related Osteonecrosis of the Jaw in Cancer Patients Treated with Zoledronic Acid.

Impairment of the immune response in MRONJ (medication-related osteonecrosis of the jaws) is one of the still unclear etiopathogenic mechanisms of this condition encountered in cancer patients treated with bisphosphonates, with negative effects on the patient's quality of life. The aim of the present study was to correlate the immune response with etiopathogenic factors via immunohistochemical evaluation of the maxillary tissues in zoledronic acid osteonecrosis. The retrospective study included a group of 51 patients with various types of cancers, diagnosed with stage 2 or 3 MRONJ at zoledronic acid and treated surgically. Immunohistochemical expressions of αSMA, CD3, CD4, CD8, CD20, CD79α, CD68, CD204, and tryptase were evaluated. Immunohistochemical markers expressions were statistically analyzed according to the duration of the treatment, the trigger factor, the location of the MRONJ, and the healing status. Analysis of the immune response included T lymphocytes, B lymphocytes, plasma cells, macrophages, and mast cells. The duration of treatment significantly influenced the immunohistochemical expression of most markers (p < 0.05). For an increasing trend in treatment duration, a decreasing trend in marker score was observed, suggesting an inverse correlation. The expression of the markers was different depending on the trigger factor, on MRONJ localization (maxilla/mandible), and the healing status, being more intense in patients cured per primam compared to those who had relapses. The patient's immune response was negatively influenced by the duration of the treatment, the trigger factor, the location of the lesion in the mandible, and the recurrence of MRONJ.

Combination of Pentoxifylline and Ginko Biloba Nephroprotective Effect in Animal Models with Vancomycin-Induced Nephrotoxicity.

Antioxidants have been commonly used in medicine for thousands of years. Clinically, pentoxifylline and Ginkgo biloba have beneficial renal effects. Our study evaluated the nephroprotective effect of Gingko biloba in combination with Pentoxifiln in an experimental model of vancomycin-induced nephrotoxicity. Male Winstar rats were used in 3 groups: CONTROL, VANCO and VANCO+GBI+PTX and each group included 6 rats. Insufficient studies in the literature on the prevention of acute kidney injury by the combination of Ginkgo biloba and pentoxifylline led to the necessity to perform the study. Acute kidney injury was demonstrated by measuring serum values of classical markers such as urea and creatinine but also by measuring the urinary N-acetyl-ß-d-glucosaminidase index, a topical marker in modern medicine. The significant decrease of the biochemical parameters in group III (VANCO+GBI+PTX) compared to group II (VANCO) and values similar to group I (CONTROL), demonstrates, the nephroprotective effect of the use in combination of the two substances.