Kolokythas Antonia, Karras Maria, Collins Edward, Flick William, Miloro Michael, Adami Guy
Associate Professor, Program Director, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL.
Dental Student, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL.
J Oral Maxillofac Surg. 2015 Sep;73(9):1741-7. doi: 10.1016/j.joms.2015.03.034. Epub 2015 Mar 19.
The purpose of this study was to investigate the use of saliva as a medium for the identification of biomarkers associated with bone resorption and formation. The authors hypothesized that biomarkers, such as N-telopeptide of type I collagen (NTX) and bone-specific alkaline phosphatase (B-AP), could be identified in saliva. They further hypothesized that there would be a difference between these biomarkers in the saliva of patients with medication-relation osteonecrosis of the jaws (MRONJ) and those who have no risk factors for the development of MRONJ.
This case-and-control study compared 2 salivary biomarkers, NTX and B-AP, in a group of patients with MRONJ and a control group. The predictor variable was the presence or absence of the disease (MRONJ or control group); the outcome variables were the levels of the 2 salivary biomarkers, NTX and B-AP. Saliva samples from 20 patients with a diagnosis of MRONJ and 14 control participants who were comparable to the study group with no history of antiresorptive medication use were collected. The saliva samples were analyzed using 2 commercially available assays for NTX and B-AP to evaluate for levels of each marker. A 2-tailed t test for 2 groups of unequal distribution was used for statistical analysis, with P values less than .05 considered statistically.
The 2 biomarkers, NTX and B-AP, were detected in saliva samples from the MRONJ and control groups. A statistically significant difference was found in the levels of NTX in saliva of patients with MRONJ compared with the control participants (P = .0067).
In this exploratory study, the 2 bone deterioration biomarkers (NTX and B-AP) were detected in saliva. There was a statistical difference in the levels of salivary NTX between patients with MRONJ and controls. Saliva evaluation could provide a novel method to detect, diagnose, stage, and potentially guide treatment decisions and monitor outcomes for patients with MRONJ in the future.
本研究旨在探讨将唾液作为一种介质用于鉴定与骨吸收和形成相关的生物标志物。作者假设可以在唾液中鉴定出生物标志物，如I型胶原N-端肽（NTX）和骨特异性碱性磷酸酶（B-AP）。他们进一步假设，药物相关性颌骨坏死（MRONJ）患者唾液中的这些生物标志物与无MRONJ发病风险因素者唾液中的生物标志物会存在差异。
本病例对照研究比较了一组MRONJ患者和一个对照组中的两种唾液生物标志物NTX和B-AP。预测变量为疾病的存在与否（MRONJ组或对照组）；结果变量为两种唾液生物标志物NTX和B-AP的水平。收集了20例诊断为MRONJ的患者以及14名与研究组具有可比性且无抗吸收药物使用史的对照参与者的唾液样本。使用两种市售的NTX和B-AP检测方法对唾液样本进行分析，以评估每种标志物的水平。采用两组非等分布的双侧t检验进行统计分析，P值小于0.05被认为具有统计学意义。
在MRONJ组和对照组的唾液样本中均检测到了两种生物标志物NTX和B-AP。与对照参与者相比，MRONJ患者唾液中NTX水平存在统计学显著差异（P = 0.0067）。
在本探索性研究中，在唾液中检测到了两种骨退化生物标志物（NTX和B-AP）。MRONJ患者与对照组之间唾液NTX水平存在统计学差异。唾液评估可能为未来检测、诊断、分期MRONJ患者并潜在地指导治疗决策和监测结果提供一种新方法。
