Division of Hematology, University of Messina, Messina, Italy.
Acta Haematol. 2010;124(2):79-85. doi: 10.1159/000313787. Epub 2010 Jul 15.
Bisphosphonates (BPs) are the current standard of care for bone lesions in patients with multiple myeloma (MM) but they are associated with a number of side effects such as osteonecrosis of the jaw. The exact mechanisms of osteonecrosis are not elucidated, and its physiopathology is based on several hypotheses such as a decrease in bone remodeling or an inhibitory effect on angiogenesis. The aim of our study was to investigate the mechanism involved in the pathogenesis of osteonecrosis. We examined the apoptosis of circulating endothelial progenitor cells in MM subjects before and after BP treatment and in osteonecrosis patients using a flow-cytometric analysis. Our data showed an increase in endothelial cell apoptosis in MM patients after BP administration and in osteonecrosis subjects. Our study seems in agreement with the hypothesis that BPs can inhibit angiogenesis interfering with endothelial cell proliferation and survival, leading to loss of blood vessels and avascular necrosis.
双膦酸盐（BPs）是目前多发性骨髓瘤（MM）患者骨病变的标准治疗方法，但它们与许多副作用相关，如颌骨坏死。颌骨坏死的确切机制尚未阐明，其病理生理学基于几个假设，如骨重塑减少或对血管生成的抑制作用。我们的研究旨在探讨颌骨坏死发病机制中涉及的机制。我们使用流式细胞术分析检测了 MM 患者在 BP 治疗前后和颌骨坏死患者循环内皮祖细胞的凋亡情况。我们的数据显示，BP 给药后 MM 患者和颌骨坏死患者的内皮细胞凋亡增加。我们的研究似乎与以下假设一致，即 BPs 可以通过干扰内皮细胞增殖和存活来抑制血管生成，导致血管丧失和血管性坏死。
