Beck-Broichsitter Benedicta E, Dau Heino, Moest Tobias, Jochens Arne, Stockmann Philipp, Wiltfang Jörg, Becker Stephan T
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Oral Pathol Med. 2015 Feb;44(2):88-93. doi: 10.1111/jop.12202. Epub 2014 Jun 16.
The majority of patients diagnosed with osteomyelitis of the jaw have severe complaints. Unfortunately, the pathogenesis still remains unclear. Human ß-defensins expressed in epithelial and bone tissues as a part of the innate immunity may be involved in disease development. In this study, we hypothesize that expression levels of human ß-defensin-1 and -2 in the acute and secondary chronic osteomyelitis may be altered in comparison with healthy bone and with bisphosphonate-associated necrosis as well as irradiation from a previous study.
Bone samples were collected during surgical debridement in a total of eight patients suffering from acute or secondary chronic osteomyelitis of the jaw. Expression levels of hBD-1 and -2 were quantified and related to non-stained cells. Ratios were compared by one-way ANOVA and multiple tests by Holm-Bonferroni.
Multiple testing revealed no significant differences for expression levels of human ß-defensin-1 between all groups, whereas labeling index of human ß-defensin-2 was significantly different between specimens of bisphosphonate-associated osteonecrosis of the jaws and all other groups. No significant difference occurred between samples of floride osteomyelitis and healthy bone for expression of hBD-1 and -2.
Although the affected patients showed all clinical signs of acute inflammation, expression levels in acute and secondary chronic osteomyelitis in the jaws did not reveal statistically significant differences compared with healthy bone samples. The weak immunological host response in terms of a putative genetically predisposition should be further discussed as pathogenesis factor for osteomyelitis in the future.
大多数被诊断为颌骨骨髓炎的患者都有严重的症状。遗憾的是,其发病机制仍不清楚。作为先天免疫一部分在上皮组织和骨组织中表达的人β-防御素可能参与疾病发展。在本研究中,我们假设与健康骨以及先前研究中的双膦酸盐相关坏死和放疗相比,急性和继发性慢性骨髓炎中人类β-防御素-1和-2的表达水平可能会发生改变。
在手术清创过程中,共收集了8例患有颌骨急性或继发性慢性骨髓炎患者的骨样本。对hBD-1和-2的表达水平进行定量,并与未染色细胞相关联。通过单因素方差分析比较比率,并采用Holm-Bonferroni进行多重检验。
多重检验显示,所有组之间人β-防御素-1的表达水平无显著差异,而在双膦酸盐相关颌骨坏死标本与所有其他组之间,人β-防御素-2的标记指数有显著差异。氟骨骨髓炎样本与健康骨样本在hBD-1和-2表达方面无显著差异。
尽管受影响患者表现出急性炎症的所有临床体征,但与健康骨样本相比,颌骨急性和继发性慢性骨髓炎中的表达水平未显示出统计学上的显著差异。未来应进一步讨论假定的遗传易感性方面的弱免疫宿主反应作为骨髓炎发病机制因素。