Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.942
Filtrar
1.
Br Dent J ; 231(4): 225-231, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34446893

RESUMO

'Necrotising periodontal diseases' is an umbrella term for necrotising gingivitis, necrotising periodontitis, necrotising stomatitis and noma. These rapidly destructive conditions are characterised by pain, interdental ulceration and gingival necrosis which, if left untreated, can result in osteonecrosis. Research indicates that patients with a history of alcohol misuse are at an increased risk of malnutrition, which negatively affects the immune response and predisposition to necrotising periodontal diseases. This article will discuss that osteonecrosis of the alveolar bone does not exclusively occur in association with antiresorptive medications, but can occur as a severe form of necrotising gingivitis. In this article, we will describe two cases to highlight the occurrence, presentation and management of necrotising periodontal diseases secondary to alcohol misuse.


Assuntos
Alcoolismo , Gengivite Ulcerativa Necrosante , Gengivite , Noma , Osteonecrose , Doenças Periodontais , Alcoolismo/complicações , Gengivite Ulcerativa Necrosante/etiologia , Gengivite Ulcerativa Necrosante/terapia , Humanos , Osteonecrose/induzido quimicamente , Osteonecrose/terapia
3.
Acta Oncol ; 60(9): 1140-1145, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34309491

RESUMO

Background: Osteonecrosis (ON) is a recognized complication of childhood ALL, but its optimal management remains unestablished. This study evaluated the effect of bisphosphonate (BP) treatment on the evolution of ON lesions in childhood ALL.Material and Methods: We included a national cohort of ALL patients diagnosed with symptomatic ON before 18 years of age and treated with BPs (N = 10; five males). Patients were followed both clinically and with serial MRIs. ON lesions were graded according to the Niinimäki classification.Results: The 10 patients had a total of 55 ON lesions. The median age was 13.3 years at ALL diagnosis and 14.8 years at ON diagnosis. Four patients had received HSCT before the ON diagnosis. BPs used were pamidronate (N = 7), alendronate (N = 2) and ibandronate (N = 1). The duration of BP treatment varied between 4 months and 4 years. In 4/10 patients, BP treatment was given during the chemotherapy. BPs were well-tolerated, with no severe complications or changes in kidney function. At the end of follow up 13/55 (24%) ON lesions were completely healed both clinically and radiographically; all these lesions were originally graded 3 or less. In contrast, ON lesions originally classified as grade 5 (joint destruction; N = 4) remained at grade 5. All grade 5 hip joint lesions needed surgical treatment. During BP treatment, the pain was relieved in 7/10 patients. At the end of follow-up, none of the patients reported severe or frequent pain.Conclusion: BP treatment was safe and seemed effective in relieving ON-induced pain in childhood ALL. After articular collapse (grade 5) lesions did not improve with BP treatment. Randomized controlled studies are needed to further elucidate the role of BPs in childhood ALL-associated ON.


Assuntos
Conservadores da Densidade Óssea , Osteonecrose , Leucemia-Linfoma Linfoblástico de Células Precursoras , Adolescente , Conservadores da Densidade Óssea/efeitos adversos , Criança , Difosfonatos/efeitos adversos , Humanos , Masculino , Osteonecrose/induzido quimicamente , Osteonecrose/diagnóstico por imagem , Osteonecrose/tratamento farmacológico , Pamidronato , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Radiografia
5.
Nutrients ; 13(5)2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-34068498

RESUMO

Medication-related osteonecrosis of the jaw (MRONJ) is a potentially severe side effect of mostly antiresorptive drugs. The aim of this prospective clinical study was to evaluate the nutritional status in MRONJ patients scheduled for surgical treatment (intraoral soft tissue closure). The following parameters were evaluated: body weight, body height, BMI, nutritional risk index (NRI), bioelectric impedance analysis (BIA), vitamins A, B12, D3, E, K1, folic acid, iron, total protein, transferrin, ferritin, prealbumin, albumin, and zinc. All subjects were admitted to hospital four to five days before surgery and sip-fed with Nutritia Fortimel Compact Protein in addition to regular oral food intake. During surgery, a nasogastric tube was inserted and only removed on hospital discharge five days postoperatively. A total of 58 patients could be included. Half of the MRONJ patients were identified to be at risk for malnutrition. Deficiencies regarding protein levels were revealed, whereas hardly any relevant deficits of micronutrients were noted. The intraoral wound healing four weeks post-surgery was highly satisfactory with a low dehiscence rate of intraoral mucosal sites. Of all parameters analyzed, the dehiscence rate at the last follow-up four weeks post-surgery was significantly influenced by vitamin K, transferrin, and ferritin levels (p = 0.030, p = 0.004, and p = 0.023, respectively). In conclusion, perioperative dietary counselling and appropriate nutritional therapy are important supportive measures in MRONJ patients scheduled for intraoral soft tissue closure.


Assuntos
Conservadores da Densidade Óssea/efeitos adversos , Estado Nutricional , Osteonecrose/dietoterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Peso Corporal , Conservadores da Densidade Óssea/administração & dosagem , Denosumab/administração & dosagem , Denosumab/efeitos adversos , Proteínas na Dieta/administração & dosagem , Difosfonatos/administração & dosagem , Difosfonatos/efeitos adversos , Impedância Elétrica , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Desnutrição/complicações , Desnutrição/diagnóstico , Desnutrição/dietoterapia , Micronutrientes/administração & dosagem , Micronutrientes/sangue , Pessoa de Meia-Idade , Avaliação Nutricional , Osteonecrose/induzido quimicamente , Pré-Albumina/metabolismo , Estudos Prospectivos , Inquéritos e Questionários , Cicatrização/efeitos dos fármacos
6.
Int J Oral Implantol (Berl) ; 14(1): 87-98, 2021 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-34006074

RESUMO

PURPOSE: To compare radiographic predictors of medication-related osteonecrosis of the jaw in dental extraction sites. MATERIALS AND METHODS: Forty-one oncological patients undergoing intravenous or subcutaneous antiresorptive treatment, with a history of dental extraction visualised by panoramic imaging, were included in this retrospective study. Age-, sex- and extracted tooth-matched healthy patients who had previously undergone panoramic imaging were selected as controls (n = 57). A total of 288 extraction sites were independently evaluated by two oral and maxillofacial radiologists, who assessed eight distinct radiographic features. The radiographic features of extraction sites were noted to allow comparison between and within subjects regarding healing and osteonecrosis development. The association between radiographic findings, underlying dental disease and medication-related osteonecrosis of the jaw was also tested. The level of significance was set at 5%. RESULTS: Patients under antiresorptive treatment presented with widening of the periodontal ligament space, thickening of the lamina dura, sclerotic bone pattern, horizontal bone loss and periapical radiolucency with bone reaction (P ≤ 0.05). Development of medication-related osteonecrosis of the jaw was associated with altered bone pattern, angular bone loss, furcation involvement and unsatisfactory endodontic treatment (P ≤ 0.05). An association between medication-related osteonecrosis of the jaw and previous dental disease was also found, particularly for periapical lesions and endodontic-periodontal disease (P ≤ 0.05). CONCLUSIONS: Radiographic predictors of further development of medication-related osteonecrosis of the jaw in extraction sites include heterogeneous bone pattern, angular bone loss and furcation involvement. Extraction sites with underlying bony changes related to endodontic and endodontic-periodontal disease are more prone to development of medication-related osteonecrosis of the jaw.


Assuntos
Conservadores da Densidade Óssea , Osteonecrose , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Humanos , Osteonecrose/induzido quimicamente , Estudos Retrospectivos , Alvéolo Dental
7.
J Cell Mol Med ; 25(11): 5164-5176, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33939272

RESUMO

Glucocorticoid-induced osteonecrosis of the femoral head (GIONFH) is a common orthopaedic disease. GIONFH primarily manifests clinically as hip pain in the early stages, followed by the collapse of the femoral head, narrowing of the hip joint space and damage to the acetabulum, resulting in severely impaired mobility. However, the pathogenesis of GIONFH is not clearly understood. Recently, biomechanical forces and non-coding RNAs have been suggested to play important roles in the pathogenesis of GIONFH. This study aimed to evaluate the role of biomechanical forced and non-coding RNAs in GIONFH. We utilized an in vivo, rat model of GIONFH and used MRI, µCT, GIONFH-TST (tail suspension test), GIONFH-treadmill, haematoxylin and eosin staining, qRT-PCR and Western blot analysis to analyse the roles of biomechanical forces and non-coding RNAs in GIONFH. We used RAW264.7 cells and MC3T3E1 cells to verify the role of MALAT1/miR-329-5p/PRIP signalling using a dual luciferase reporter assay, qRT-PCR and Western blot analysis. The results demonstrated that MALAT1 and PRIP were up-regulated in the femoral head tissues of GIONFH rats, RAW264.7 cells, and MC3T3E1 cells exposed to dexamethasone (Dex). Knockdown of MALAT1 decreased PRIP expression in rats and cultured cells and rescued glucocorticoid-induced osteonecrosis of femoral head in rats. The dual luciferase reporter gene assay revealed a targeting relationship for MALAT1/miR-329-5p and miR-329-5p/PRIP in MC3T3E1 and RAW264.7 cells. In conclusion, MALAT1 played a vital role in the pathogenesis of GIONFH by binding to ('sponging') miR-329-5p to up-regulate PRIP. Also, biomechanical forces aggravated the pathogenesis of GIONFH through MALAT1/miR-329-5p/PRIP signalling.


Assuntos
Cabeça do Fêmur/patologia , Regulação da Expressão Gênica , Glucocorticoides/toxicidade , MicroRNAs/genética , Coativadores de Receptor Nuclear/metabolismo , Osteonecrose/patologia , RNA Longo não Codificante/genética , Animais , Fenômenos Biomecânicos , Células Cultivadas , Cabeça do Fêmur/efeitos dos fármacos , Cabeça do Fêmur/metabolismo , Masculino , Coativadores de Receptor Nuclear/genética , Osteonecrose/induzido quimicamente , Osteonecrose/genética , Osteonecrose/metabolismo , Ratos , Ratos Sprague-Dawley
8.
Artigo em Inglês | MEDLINE | ID: mdl-33934955

RESUMO

OBJECTIVE: The aim of this systematic review was to describe the quality of life and oral health-related quality of life of patients affected by medication-related osteonecrosis of the jaw. STUDY DESIGN: The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A combination of keywords and MeSH terms was used in PubMed, Scopus, Cochrane Library, Web of Science, and EBSCO up to December 13, 2020. RESULTS: A total of 1066 results were obtained after duplicate exclusion and 11 articles were included in the final qualitative analysis. Most of the articles described the quality of life in patients with osteonecrosis of the jaw secondary to cancer treatment. The main drugs associated with the disease were bisphosphonates. Surgical treatment of the osteonecrosis improves the quality of life of these patients. CONCLUSIONS: The present systematic review suggested the negative influence of osteonecrosis of the jaw on the quality of life and oral health-related quality of life among oncologic and osteoporotic patients. The use of quality of life questionnaires in daily practice could be an important tool to better diagnose and manage patients affected by osteonecrosis of the jaws who have received or are receiving drugs associated with this complication.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Osteonecrose , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos , Humanos , Arcada Osseodentária , Osteonecrose/induzido quimicamente , Qualidade de Vida
9.
Br J Oral Maxillofac Surg ; 59(6): 648-660, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34023155

RESUMO

Medication-related osteonecrosis of the jaw (MRONJ) is a severe condition that affects the jaw in patients exposed to specific drugs. More often it has been described in association with bisphosphonates (BP), but nowadays it has been observed with the use of other medications, such as denosumab (a RANK ligand inhibitor and monoclonal antibody agent) and antiangiogenic drugs. Managing the condition has unfortunately proven difficult and still remains a major challenge for clinicians and surgeons. The aim of this systematic review was to identify and analyse the evidence on mandibular segmental resection in patients with advanced MRONJ. A multi-database (PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials) systematic search was performed. Any type of study on human patients treated with antiresorptive and antiangiogenic drugs was considered. The primary aim was to understand the success of mandibular segmental resection in the short, medium, and long term, and to understand its effects before, during, and after the operation. The search yielded 11 studies that were eligible for analysis with a total of 67 patients. Of the 11 studies, seven reported no complications, and overall, postoperative complications were seen in 16 cases. Recurrence of osteonecrosis was reported in one study. The most common postoperative complication was removal of hardware (n = 11). The mean (SD) follow-up time for eight studies was 35.57 (17.73) months. According to the limited data available in the literature, mandibular segmental resection is a viable treatment that has been used successfully in patients with various stages of MRONJ. The data show a relatively high percentage of recurrence. Additional data based on a larger cohort of patients or case-control studies are necessary to justify routine use of this type of intervention in patients affected by the condition.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Neoplasias , Osteonecrose , Inibidores da Angiogênese/efeitos adversos , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/uso terapêutico , Humanos , Osteonecrose/induzido quimicamente , Osteonecrose/cirurgia
10.
Cancer Chemother Pharmacol ; 87(6): 871-877, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33791853

RESUMO

PURPOSE: Switch from zoledronic acid (ZA) to denosumab may increase the risk of medication-related osteonecrosis of the jaw (MRONJ) owing to the additive effect of denosumab on the jawbone and residual ZA activities. We evaluated the risk of developing MRONJ in patients who received ZA, denosumab, or ZA-to-denosumab for the treatment of bone metastases. METHODS: The medical charts of patients with cancer who received denosumab or ZA for bone metastases were retrospectively reviewed. Patients who did not undergo a dental examination at baseline were excluded. Primary endpoint was the evaluation of the risk of developing MRONJ in the ZA-to-denosumab group. Secondary endpoints were probability of MRONJ and the relationship between risk factors and the time to the development of MRONJ. RESULTS: Among the 795 patients included in this study, 65 (8.2%) developed MRONJ. The incidence of MRONJ was significantly higher in the ZA-to-denosumab group than in the ZA group [7/43 (16.3%) vs. 19/350 (5.4%), p = 0.007]. Multivariate Cox proportional hazards regression analysis revealed that denosumab treatment [hazard ratio (HR), 2.41; 95% confidence interval (CI), 1.37-4.39; p = 0.002], ZA-to-denosumab treatment (HR, 4.36; 95% CI, 1.63-10.54, p = 0.005), tooth extraction after starting ZA or denosumab (HR, 4.86; 95% CI, 2.75-8.36; p < 0.001), and concomitant use of antiangiogenic agents (HR, 1.78; 95% CI, 1.06-2.96; p = 0.030) were significant risk factors for MRONJ. CONCLUSION: Our results suggest that switching from ZA to denosumab significantly increases the risk for developing MRONJ in patients with bone metastases.


Assuntos
Conservadores da Densidade Óssea/efeitos adversos , Conservadores da Densidade Óssea/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Denosumab/efeitos adversos , Denosumab/uso terapêutico , Arcada Osseodentária/efeitos dos fármacos , Osteonecrose/induzido quimicamente , Ácido Zoledrônico/uso terapêutico , Idoso , Inibidores da Angiogênese/uso terapêutico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Extração Dentária/métodos
11.
Osteoporos Int ; 32(10): 2095-2103, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33877383

RESUMO

This study investigated risk factors for osteonecrosis involving multiple joints (MJON) among glucocorticoid-treated patients. The best predictor of MJON was cumulative oral glucocorticoid dose. Risk of MJON was 12-fold higher in patients who had a second risk factor for osteonecrosis. Further research is needed into strategies for prevention of MJON. INTRODUCTION: Osteonecrosis (ON) is a debilitating musculoskeletal condition in which bone cell death can lead to mechanical failure. When multiple joints are affected, pain and disability are compounded. Glucocorticoid treatment is one of the most common predisposing factors for ON. This study investigated risk factors for ON involving multiple joints (MJON) among glucocorticoid-treated patients. METHODS: Fifty-five adults with glucocorticoid-induced ON were prospectively enrolled. MJON was defined as ON in ≥ three joints. Route, dose, duration, and timing of glucocorticoid treatment were assessed. RESULTS: Mean age of enrolled subjects was 44 years, 58% were women. Half had underlying conditions associated with increased ON risk: systemic lupus erythematosus (29%), acute lymphoblastic leukemia (11%), HIV (9%), and alcohol use (4%). Mean daily oral dose of glucocorticoids was 29 mg. Average cumulative oral dose was 30 g over 5 years. The best predictor of MJON was cumulative oral glucocorticoid dose. For each increase of 1,000 mg, risk of MJON increased by 3.2% (95% CI 1.03, 1.67). Glucocorticoid exposure in the first 6 months of therapy, peak dose (oral or IV), and mean daily dose did not independently increase risk of MJON. The risk of MJON was 12-fold in patients who had a second risk factor (95% CI 3.2, 44.4). CONCLUSIONS: Among patients with glucocorticoid-induced ON, cumulative oral dose was the best predictor of multi-joint disease; initial doses of IV and oral glucocorticoids did not independently increase risk. Further research is needed to better define optimal strategies for prevention and treatment of MJON.


Assuntos
Artropatias , Lúpus Eritematoso Sistêmico , Osteonecrose , Adulto , Feminino , Glucocorticoides/efeitos adversos , Humanos , Osteonecrose/induzido quimicamente , Osteonecrose/epidemiologia , Fatores de Risco
12.
Br J Oral Maxillofac Surg ; 59(4): 398-406, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33789811

RESUMO

Medication-related osteonecrosis of the jaw (MRONJ) is a challenging condition to treat. It has primarily been associated with anti-resorptive and anti-angiogenic drugs, which are increasingly being used to prevent adverse skeletally-related complications in patients with cancer and bone pathologies. Although these medications have been proven to cause osteonecrosis of the jaws (ONJ) there are also a number of other drugs that could potentially cause this condition. The aim of this systematic review is to ascertain whether there is an associated risk of osteonecrosis of the jaw (ONJ) in recreational drug users (RDU). Three authors independently searched PubMed, MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials for published reports of osteonecrosis of the jaw (ONJ) in recreational drug users (RDU) or illicit drug users (IDU) who had no history of treatment with anti-angiogenic or anti-resorptive agents. Only 30 studies were eligible for analysis, and all were independently assessed for risk of bias. There was a total of 101 patients with ONJ attributed solely to illicit drug consumption. The most common site of ONJ was the maxilla (n=54). The most common illicit drug related to ONJ was desmorphine, known as 'Krokodil', this was followed by cocaine, methamphetamine, anabolic steroids, and hydrocodone/acetaminophen. In 52 of the cases, the ONJ resolved following treatment, however, eight showed a recurrence. Although all the studies were judged to be at a high risk of bias, the limited data suggest that some patients are at risk of developing ONJ as a result of illicit drug usage. Studies of higher quality are needed to establish the relative risk of ONJ in this patient group.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Drogas Ilícitas , Doenças Maxilomandibulares , Osteonecrose , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/epidemiologia , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Difosfonatos , Humanos , Drogas Ilícitas/efeitos adversos , Osteonecrose/induzido quimicamente
13.
Mol Med Rep ; 23(5)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33760114

RESUMO

Steroid­induced avascular necrosis of the femoral head (SANFH) is a common orthopaedic disease that is difficult to treat. The present study investigated the effects of total flavonoids of Rhizoma drynariae (TFRD) on SANFH and explored its underlying mechanisms. The SANFH rat model was induced by intramuscular injection of lipopolysaccharides and methylprednisolone. Osteoblasts were isolated from the calvariae of neonatal rats and then cultured with dexamethasone (Dex). TFRD was used in vitro and in vivo, respectively. Haematoxylin and eosin staining was used to assess the pathological changes in the femoral head. Terminal deoxynucleotidyl transferase­mediated deoxyuridine triphosphate nick end labelling assay and flow cytometry were conducted to detect apoptosis of osteoblasts. The 2',7'­dichlorofluorescein­diacetate staining method was used to detect reactive oxygen species (ROS) levels in osteoblasts and the 3­(4,5­dimethylthiazol­2­yl)­2,5­diphenyltetrazolium bromide assay was used to detect osteoblast proliferation. The expression of caspase­3, Bax, Bcl­2, VEGF, runt­related transcription factor 2 (RUNX2), osteoprotegerin (OPG), osteocalcin (OCN), receptor activator of nuclear factor κB ligand (RANKL) and phosphoinositide 3­kinase (PI3K)/AKT pathway related­proteins were detected via western blotting. It was found that TFRD reduced the pathological changes, inhibited apoptosis, increased the expression of VEGF, RUNX2, OPG and OCN, decreased RANKL expression and activated the PI3K/AKT pathway in SANFH rats. TFRD promoted proliferation, inhibited apoptosis and reduced ROS levels by activating the PI3K/AKT pathway in osteoblasts. In conclusion, TFRD protected against SANFH in a rat model. In addition, TFRD protected osteoblasts from Dex­induced damage through the PI3K/AKT pathway. The findings of the present study may contribute to find an effective treatment for the management of SANFH.


Assuntos
Flavonoides/farmacologia , Osteonecrose/tratamento farmacológico , Extratos Vegetais/farmacologia , Polypodiaceae/química , Animais , Proliferação de Células/efeitos dos fármacos , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Modelos Animais de Doenças , Cabeça do Fêmur/patologia , Flavonoides/química , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Osteoblastos/efeitos dos fármacos , Osteogênese por Distração/métodos , Osteonecrose/induzido quimicamente , Osteonecrose/patologia , Osteoprotegerina/genética , Fosfatidilinositol 3-Quinases/genética , Extratos Vegetais/química , Proteínas Proto-Oncogênicas c-akt/genética , Ligante RANK/genética , Ratos , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Esteroides/efeitos adversos
14.
Int J Med Sci ; 18(6): 1375-1381, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33628093

RESUMO

Introduction: Recently, the efficacy of mesenchymal stem cells (MSCs) mediated by their tissue repair and anti-inflammatory actions in the prevention and therapy of various disorders has been reported. In this research, our attention was focused specifically on the prevention and therapy of glucocorticoid-induced osteonecrosis. We investigated the stress resistance of MSC against glucocorticoid administration and hypoxic stress, which are factors known to induce osteocytic cell death. Materials and Methods: Mouse bone cells (MLO-Y4) and bone-marrow derived mouse MSCs were exposed to dexamethasone (Dex), hypoxia of 1% oxygen or both in vitro. Mitochondrial membrane potentials were estimated by mitochondria labeling with a cell-permeant probe (Mito tracker red); expression of these apoptosis-inducing molecules, oxidative stress marker (8-hydroxy-2'-deoxyguanosine), caspase-3, -9, and two apoptosis-inhibiting molecules, energy-producing ATP synthase (ATP5A) and X-linked inhibitor of apoptosis protein (XIAP), were analyzed by both immunofluorescence and western blot. Results: With exposure to either dexamethasone or hypoxia, MLO-Y4 showed reduced mitochondrial membrane potential, ATP5A and upregulation of 8-OHdG, cleaved caspases and XIAP. Those changes were significantly enhanced by treatment with dexamethasone plus hypoxia. In MSCs, however, mitochondrial membrane potentials were preserved, while no significant changes in the pro-apoptosis or anti-apoptosis molecules analyzed were found even with exposure to both dexamethasone and hypoxia. No such effects induced by treatment with dexamethasone, hypoxia, or both were demonstrated in MSCs at all. Discussion: In osteocyte cells subjected to the double stresses of glucocorticoid administration and a hypoxic environment osteocytic cell death was mediated via mitochondria. In contrast, MSC subjected to the same stressors showed preservation of mitochondrial function and reduced oxidative stress. Accordingly, even under conditions sufficiently stressful to cause the osteocytic cell death in vivo, it was thought that the function of MSC could be preserved, suggesting that in the case of osteonecrosis preventative and therapeutic strategies incorporating their intraosseous implantation may be promising.


Assuntos
Glucocorticoides/efeitos adversos , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/efeitos dos fármacos , Osteócitos/efeitos dos fármacos , Osteonecrose/terapia , Animais , Apoptose/efeitos dos fármacos , Hipóxia Celular/efeitos dos fármacos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Dexametasona/efeitos adversos , Modelos Animais de Doenças , Humanos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Células-Tronco Mesenquimais/patologia , Camundongos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/patologia , Osteócitos/patologia , Osteonecrose/induzido quimicamente , Osteonecrose/patologia
15.
Clin Nucl Med ; 46(7): 592-594, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33577198

RESUMO

ABSTRACT: Patient was a 73-year-old woman with metastatic renal cell carcinoma. Bone scan showed multifocal bone metastases. The patient received cabozantinib treatment for more than 1 year. On the follow-up bone scan, the previously biopsy-proven left pelvic bone lesion has improved, whereas the right maxillary lesion showed increased extent and intensity of abnormal radiotracer uptake. Given the different change pattern of these lesions, the right maxillary lesion was further evaluated. Biopsy results confirmed devitalized bone with bacterial colonies overgrowth and without tumor cell, suggestive of medication-related osteonecrosis.


Assuntos
Anilidas/efeitos adversos , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Osteonecrose/induzido quimicamente , Osteonecrose/diagnóstico por imagem , Piridinas/efeitos adversos , Idoso , Anilidas/uso terapêutico , Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/patologia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/patologia , Piridinas/uso terapêutico , Tomografia Computadorizada por Raios X
16.
Stem Cell Res Ther ; 12(1): 18, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413642

RESUMO

BACKGROUND: Steroid-induced osteonecrosis of the femoral head (SONFH) is a devastating orthopedic disease, which seriously affects the quality of life of patients. The study aims to investigate the effects of LncRNA NORAD on SONFH. METHODS: Human bone marrow-derived mesenchymal stem cells (hBMSCs) were isolated from the proximal femur of patients during routine orthopedic surgery and then cultured with dexamethasone (Dex) and transfected with NORAD overexpression vector, siRNA-NORAD and miR-26a-5p mimics. The mRNA expression of NORAD, miR-26a-5p, OPG, RANK, and RANKL was detected by RT-qPCR. Cell proliferation and apoptosis was measured by CCK-8 assay and flow cytometry, respectively. The protein expression of RUNX2, OPG, RANK, and RANKL was detected by western blot. The dual-luciferase reporter gene assay was performed to confirm the binding between NORAD and miR-26a-5p. RESULTS: NORAD expression was downregulated in SONFH tissues, while miR-26a-5p expression was upregulated. Overexpression of NORAD improved DEX-induced inhibition of proliferation and differentiation, and promotion of apoptosis in hBMSCs, while knockdown of NORAD led to the opposite results. Moreover, NORAD improved DEX-induced inhibition of proliferation and differentiation, and promotion of apoptosis by regulation of miR-26a-5p in hBMSCs. CONCLUSIONS: NORAD expression was downregulated in SONFH tissues, while miR-26a-5p expression was upregulated. NORAD improved DEX-induced inhibition of proliferation and differentiation, and promotion of apoptosis by regulation of miR-26a-5p in hBMSCs.


Assuntos
MicroRNAs , Osteonecrose , RNA Longo não Codificante , Células da Medula Óssea , Diferenciação Celular , Proliferação de Células , Cabeça do Fêmur , Humanos , MicroRNAs/genética , Osteonecrose/induzido quimicamente , Osteonecrose/genética , Qualidade de Vida , RNA Longo não Codificante/genética , Esteroides
17.
Oral Maxillofac Surg ; 25(3): 421-425, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33411057

RESUMO

Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon adverse drug reaction that can be induced by certain therapeutic drugs, including antiresorptive and antiangiogenic agents. Here, we describe the first case of ONJ induced by bosutinib, a tyrosine kinase inhibitor, in a patient with chronic myeloid leukemia (CML) who was not taking an antiresorptive agent. A 65-year-old male with no history of either antiresorptive treatment or dental surgery but diagnosed with CML had been undergoing treatment with bosutinib for 2 years. He developed right mandibular stage 2 osteonecrosis. The patient eventually underwent extensive surgery consisting of removal of the necrotic bone and infected soft tissue in combination with nasolabial flap reconstruction. He obtained complete resolution of MRONJ at 12 months postoperatively. As new cancer therapies become available, it is important that clinicians are aware of this novel case of bosutinib-induced ONJ in a patient undergoing CML treatment.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Leucemia Mielogênica Crônica BCR-ABL Positiva , Osteonecrose , Quinolinas , Idoso , Compostos de Anilina , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Difosfonatos , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Nitrilas , Osteonecrose/induzido quimicamente , Osteonecrose/diagnóstico por imagem , Osteonecrose/cirurgia , Quinolinas/efeitos adversos
18.
Oral Dis ; 27(2): 312-319, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32623770

RESUMO

OBJECTIVE: To attempt defining differential radiographic diagnostic characteristics for osteonecrotic lesions using 2D as opposed to 3D images. MATERIALS AND METHODS: This was a cross-sectional study. Subjects presenting mandibular osteonecrotic lesions (osteomyelitis, osteoradionecrosis, and medication-related osteonecrosis of the jaws) were selected and compared to a group of age- and gender-matched controls, all having both cone-beam computed tomographic images (CBCT) and panoramic radiographs (PANO). Both imaging modalities (predictor variables) were evaluated by two radiologists that scored lesion presence, eight additional radiological features, and a composite severity index (outcome variables). For each pathologic condition, characteristic features were assessed in PANO and CBCT by the Wilcoxon signed-rank test. Regression tree analysis revealed the predictive value of PANO and CBCT (α = 5%). RESULTS: Overall, the predictive value of PANO reached 74%, while for CBCT it became 90%. Regarding the composite severity index, CBCT enabled to detect more subtle lesions. Also, CBCT imaging allowed showing more distinct radiographic diagnostic features as compared to PANO imaging, more specifically when distinguishing osteomyelitis from both other lesions. CONCLUSIONS: Cone-beam computed tomography enabled showing more differences in radiological features between distinct osteonecrosis disease entities. CBCT imaging might be a better contributor for the detection of early lesions and to monitor further pathological developments in the mandible.


Assuntos
Osteomielite , Osteonecrose , Osteorradionecrose , Tomografia Computadorizada de Feixe Cônico Espiral , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Humanos , Mandíbula , Osteomielite/diagnóstico por imagem , Osteonecrose/induzido quimicamente , Osteonecrose/diagnóstico por imagem , Osteorradionecrose/diagnóstico por imagem , Radiografia Panorâmica
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...